Covid-19: politicisation, "corruption," and suppression of science

COVID-19 pandemic in Bangladesh: A scoping review of governance issues affecting response in public sector

Background

On January 30, 2020, WHO declared COVID-19 as a Global Public Health Emergency. The first three COVID-19 cases in Bangladesh were confirmed on March 8, 2020. Thus, Bangladesh got substantial time to prepare the people and the health systems to respond to the outbreak However, neither the health ministry nor the government was found to rise to the occasion and provide the necessary stewardship for a coordinated and comprehensive response.

Objective

The importance of governance to mount an evidence-based pandemic response cannot be overemphasised. This study presents critical reflections on the Bangladesh government's COVID-19 response through a review of selected papers, with expert deliberations on the review findings to consolidate emerging lessons for future pandemic preparedness.

Study design

A scoping review approach was taken for this study.

Methods

Documents focusing on COVID-19 governance were selected from a repository of peer-reviewed articles published by researchers using data from Bangladesh (n = 11).

Results

Findings reveal Bangladesh's COVID-19 response to be delayed, slow, and ambiguous, reflecting poorly on its governance. Lack of governance capability in screening for COVID-19, instituting quarantine and lockdown measures in the early weeks, safety and security of frontline healthcare providers, timely and equitable COVID-19 testing, and logistics and procurement were phenomenal. The pandemic unmasked the weaknesses of the health system in this regard and "created new opportunities for corruption." The failure to harmonise coordination among the government's different agencies for the COVID-19 response, along with poor risk communication, which was not culture-sensitive and context-specific. Over time, the government initiated necessary actions to mitigate the pandemic's impact on the lives and livelihoods of the people. Diagnostic and case management services gained strength after some initial faltering; however, the stewardship functions were not seamless.

Conclusions

Shortage of healthcare workers, incapability of health facilities to cater to COVID-19 suspects and cases, absence of health system resilience, and corruption in procurement and purchases were limited the government's COVID-19 response. These need urgent attention from policymakers to better prepare for the next epidemic/pandemic.

Publishing important work that lacks validity or reproducibility - pushing frontiers or corrupting science?

Scientific research requires objectivity, impartiality and stringency. However, scholarly literature is littered with preliminary and explorative findings that lack reproducibility or validity. Some low-quality papers with perceived high impact have become publicly notable. The collective effort of fellow researchers who follow these false leads down blind alleys and impasses is a waste of time and resources, and this is particularly damaging for early career researchers. Furthermore, the lay public might also be affected by socioeconomic repercussions associated with the findings. It is arguable that the nature of scientific research is such that its frontiers are moved and shaped by cycles of published claims inducing in turn rounds of validation by others. Using recent example cases of room-temperature superconducting materials research, I argue instead that publication of perceptibly important or spectacular claims that lack reproducibility or validity is epistemically and socially irresponsible. This is even more so if authors refuse to share research materials and raw data for verification by others. Such acts do not advance, but would instead corrupt science, and should be prohibited by consensual governing rules on material and data sharing within the research community, with malpractices appropriately sanctioned.

Corruption risks in health procurement during the COVID-19 pandemic and anti-corruption, transparency and accountability (ACTA) mechanisms to reduce these risks: a rapid review

BACKGROUND

Health systems are often susceptible to corruption risks. Corruption within health systems has been found to negatively affect the efficacy, safety, and, significantly, equitable distribution of health products. Enforcing effective anti-corruption mechanisms is important to reduce the risks of corruption but requires first an understanding of the ways in which corruption manifests. When there are public health crises, such as the COVID-19 pandemic, corruption risks can increase due to the need for accelerated rates of resource deployment that may result in the bypassing of standard operating procedures.

MAIN BODY

A rapid review was conducted to examine factors that increased corruption risks during the COVID-19 pandemic as well as potential anti-corruption, transparency and accountability (ACTA) mechanisms to reduce these risks. A search was conducted including terms related to corruption, COVID-19, and health systems from January 2020 until January 2022. In addition, relevant grey literature websites were hand searched for items. A single reviewer screened the search results removing those that did not meet the inclusion criteria. This reviewer then extracted data relevant to the research objectives from the included articles. 20 academic articles and 17 grey literature pieces were included in this review. Majority of the included articles described cases of substandard and falsified products. Several papers attributed shortages of these products as a major factor for the emergence of falsified versions. Majority of described corruption instances occurred in low- and middle-income countries. The main affected products identified were chloroquine tablets, personal protective equipment, COVID-19 vaccine, and diagnostic tests. Half of the articles were able to offer potential anti-corruption strategies.

CONCLUSION

Shortages of health products during the COVID-19 pandemic seemed to be associated with increased corruption risks. We found that low- and middle-income countries are particularly vulnerable to corruption during global emergencies. Lastly, there is a need for additional research on effective anti-corruption mechanisms.

Addressing conflicts of interest regarding the vaccine in infectious disease outbreaks based on good governance for health approach: a policy brief

BACKGROUND

Infectious disease outbreaks pose a significant threat to public health, and achieving herd immunity highlights the importance of addressing conflicts of interest (COI) in vaccine development and policy-making. This policy brief aims to present policy options that address COI regarding vaccines in infectious disease outbreaks, based on good governance for health approach.

METHODS

Our study used a scoping review methodology. We conducted a systematic search, which led to identifying 43 eligible articles. A qualitative approach (i.e., content analysis) was employed for data analysis, using "ATLAS.ti 9" software. The primary results underwent a process of cleaning, categorisation, and subsequent discussion in three sessions with the research team.

RESULTS

Relationships between theindustry and "government/policymakers" as well as "academic institutions/researchers" are prominent origins of COI regarding the vaccine in infectious disease outbreaks. To address this issue, we present nine policy options that target both the root cause of the problem and the adoption of good governance for health approach.

CONCLUSIONS

The key principles of good governance for health, including, "Transparency", "The Rule of Law", "Effectiveness", "Efficiency", "Participation", "Consensus Orientation", "Equality", "Responsibility", "Responsiveness" and "Accountability" must be taken into account when formulating policy options to address COI regarding the vaccine in infectious disease outbreaks. The effectiveness of the policy options outlined in this policy brief should be assessed in practical contexts, as this evaluation may uncover the need for revisions.

Communicating science in the COVID-19 news in the UK during Omicron waves: exploring representations of nature of science with epistemic network analysis

News media plays a vital role in communicating scientific evidence to the public during the COVID-19 pandemic. Such communication is important for convincing the public to follow social distancing guidelines and to respond to health campaigns such as vaccination programmes. However, newspapers were criticised that they focus on the socio-political perspective of science, without explaining the nature of scientific works behind the government's decisions. This paper examines the connections of the nature of science categories in the COVID-19 era by four local newspapers in the United Kingdom between November 2021 to February 2022. Nature of science refers to different aspects of how science works such as aims, values, methods and social institutions of science. Considering the news media may mediate public information and perception of scientific stories, it is relevant to ask how the various British newspapers covered aspects of science during the pandemic. In the period explored, Omicron variant was initially a variant of concern, and an increasing number of scientific evidence showed that the less severity of this variant might move the country from pandemic to endemic. We explored how news articles communicate public health information by addressing how science works during the period when Omicron variants surge. A novel discourse analysis approach, epistemic network analysis is used to characterise the frequency of connections of categories of the nature of science. The connection between political factors and the professional activities of scientists, as well as that with scientific practices are more apparent in left-populated and centralist outlets than in right-populated news outlets. Among four news outlets across the political spectrum, a left-populated newspaper, the Guardian, is not consistent in representing relations of different aspects of the nature of scientific works across different stages of the public health crisis. Inconsistency of addressing aspects of scientific works and a downplay of the cognitive-epistemic nature of scientific works likely lead to failure in trust and consumption of scientific knowledge by the public in the healthcare crisis.

Against Authority: The Bioethics of Ivermectin Use for COVID-19 Infection

BACKGROUND

The COVID-19 pandemic has brought new ethical challenges to both health care professionals and the general public. Among the ethical problems amplified during this period were the making of medical decisions to quickly introduce some drugs into therapeutic practice with unproven or insufficiently proven effects (such as ivermectin), the validity of drug testing, and the allocation of limited resources.

FIELDS OF UNCERTAINTY

The COVID-19 pandemic brought to the attention of the entire scientific world a new problem, which exceeded the guidelines and rules known until then. Out of the desire to quickly solve this medical problem, a series of measures were taken, however not sufficiently validated in scientific terms; the recommendations regarding the use of drugs known for their properties to treat a greater number of conditions, such as ivermectin, was tried.

DATA SOURCES

A narrative review of the specialized literature was carried out using keywords such as COVID-19, ivermectin, ethics, and off-label medication from Scopus and Google Scholar but also of official documents developed at the international level (World Health Organization).

ETHICS AND THERAPEUTIC ADVANCES

The off-label use of ivermectin alone or in combination with other medications during COVID pandemic raised problems related to the demonstration of its effectiveness, but also to ethics, starting from the expectations that both the medical staff and the population had of it. Ivermectin therapy was also evaluated by analyzing the behavior of ivermectin based on ethical principles (nonmaleficence, beneficence, and respect for one's autonomy) or on justice. Even in times of pandemic, exceptionalism must not triumph, and finding an effective treatment must be done through studies that respect ethical standard.

CONCLUSIONS

The failures or rather lack of success in decision making during the pandemic showed that alongside scientific knowledge and the development of health policies, it is necessary to constantly evaluate the measures and decisions from an ethical point of view, and the prevention of slippages and abuses is not only necessary but even mandatory.

What isn't public health?

By recognizing the structural causes of health and illness, public health has often been associated with values of compassion and solidarity, and a relational understanding of human agency. Rather than supporting the consistent integration and application of these insights, however, public health is now sometimes invoked more as a rhetorical move, used to construct issues as simple questions of neoliberal scientistic rationalism. Public health practitioners must reckon, therefore, with how the field can be discursively deployed in the public square, for multiple divergent political ends. If public health is always positioned as a value-neutral and detached scientific approach to addressing complex subjects, from drug use to pandemics, it not only fails to connect with the arguments of its critics, but further divorces what was once called the public health 'movement' from the strong and progressive political and theoretical positions it was founded upon and should advocate for today.

Learning from Nursing Home Infection Prevention and Control Citations During the COVID-19 Pandemic

The devastating effects of coronavirus disease 2019 (COVID-19) highlight the critical need for effective infection prevention and control (IPC) practices in nursing homes. Nursing management and infection preventionists should be cognizant of the most common reasons underlying federal IPC citations during the pandemic. Analysis of IPC citation data from the first 7 months of the public health emergency identified that adherence to personal protective equipment (PPE) and mask use, appropriate transmission-based precautions, and hand hygiene were the most common reasons for COVID-19-related F880 citations, including those that placed a person at immediate risk for serious injury or death. More specific staff practices and other factors leading to a citation are also highlighted. Although nursing homes may have limited control over factors such as PPE supply and staffing resources, nursing management and infection preventionists can use these results to help ensure that operational mechanisms, staff training, and adherence monitoring efforts effectively address the areas most associated with COVID-19 IPC noncompliance. [Journal of Gerontological Nursing, 49(2), 36-42.].

A systematic review of the impact of corruption in Latin America during the spread of the first wave of COVID-19

As the Covid-19 pandemic crisis raged in Latin America, numerous acts of corruption affected containment strategies and weakened institutional systems. A systematic review was conducted during the first wave of contagion in 2020 to analyse the relationship between corruption and Covid-19 in Latin American countries, highlighting its components and the institutions involved. Following the PRISMA guidelines, scientific databases and prepublications were searched using the terms (((SARS-CoV-2) OR (Covid-19)) AND ((Corruption [Mesh]) AND (Latin America))). Seventy-two studies were included in the initial search, 36 in MEDLINE/PubMed, 20 in Scielo, and 11 prepublications. Of the 25 eligible studies, none met the required standard for inclusion. Although corruption is endemic in Latin America, its levels and impact during the first wave of Covid-19 contagion have not been quantified.

Is public health just science? Values, politics and varied but collective practices to secure better health with justice

This paper asks: Is public health just science? That question invites analysis from the field of public health ethics of how we might distinguish public health as being built simply on scientific evidence bases and its being founded on science and ideas of justice. In conducting the analysis, the paper explores the essentially political nature of public health as well as reasons why members of the public health community might aim not to 'be political' in their practice: in particular, considering professional competence/expertise, democratic legitimacy and the possibly damaging consequences of being seen as engaged in politics. Such considerations, while valid, do not stop public health from being political in nature and directed to the realization of ethical aims. The paper, therefore, then explores how members of the public health community might seek to realize the moral mandates of public health. Although that requires political outcomes, it does not mean there is an ethical requirement to be as directly politically engaged as possible. On the contrary, we find good reason to look to public health as a collective enterprise, with individual roles and activities within it being more or less directly activist.

Responding to "Don't Say Gay" Laws in the US: Research Priorities and Considerations for Health Equity

INTRODUCTION

Despite increased legal rights for lesbian, gay, bisexual, transgender, and queer-identifying (LGBTQ +) people in the USA over the past 30 years, there has been an increasing number of anti-LGBTQ + laws proposed and passed at the state level. One of the most notorious laws, Florida's HB 1557, also known as the "Don't Say Gay" law, garnered substantial national attention for prohibiting discussions of sexual orientation or gender identity in public school classrooms. Other states quickly proposed similar laws, but little scholarship exists on the potential impacts of these laws.

METHODS

We explore the potential health equity ramifications of laws like Florida's HB 1557, focusing on the individual, interpersonal, and broader policy and practice implications. Examining these policies through the lens of political determinants of health, we identify theoretical and methodological approaches needed to address recent "Don't Say Gay" policies.

RESULTS

Theoretical approaches emphasizing power, intersectionality, and the role of politics in health should guide research examining the impacts of recent anti-LGBTQ + policies. Laws like Florida's HB 1557 emphasize the need for methodological approaches that emphasize collaborative engagement between researchers and community members, and future research may be needed to understand how stressors created by law and policy can have individual and interpersonal consequences.

CONCLUSIONS

Public health researchers have a role to play in reversing policies that negatively affect LGBTQ + individuals and undermine health equity. Research combating harmful policies may require theoretical approaches attentive to power differences and methodological approaches that squarely focus on disrupting power imbalances.

Censorship and Suppression of Covid-19 Heterodoxy: Tactics and Counter-Tactics

The emergence of COVID-19 has led to numerous controversies over COVID-related knowledge and policy. To counter the perceived threat from doctors and scientists who challenge the official position of governmental and intergovernmental health authorities, some supporters of this orthodoxy have moved to censor those who promote dissenting views. The aim of the present study is to explore the experiences and responses of highly accomplished doctors and research scientists from different countries who have been targets of suppression and/or censorship following their publications and statements in relation to COVID-19 that challenge official views. Our findings point to the central role played by media organizations, and especially by information technology companies, in attempting to stifle debate over COVID-19 policy and measures. In the effort to silence alternative voices, widespread use was made not only of censorship, but of tactics of suppression that damaged the reputations and careers of dissenting doctors and scientists, regardless of their academic or medical status and regardless of their stature prior to expressing a contrary position. In place of open and fair discussion, censorship and suppression of scientific dissent has deleterious and far-reaching implications for medicine, science, and public health.

The pharmaceutical industry is dangerous to health. Further proof with COVID-19

Background:

The COVID-19 period highlights a huge problem that has been developing for decades, the control of science by industry. In the 1950s, the tobacco industry set the example, which the pharmaceutical industry followed. Since then, the latter has been regularly condemned for illegal marketing, misrepresentation of experimental results, dissimulation of information about the dangers of drugs, and considered as criminal. Therefore, this study was conducted to show that knowledge is powerfully manipulated by harmful corporations, whose goals are: 1/financial; 2/to suppress our ability to make choices to acquire global control of public health.

Methods:

Pharmaceutical industry techniques for manipulating science and COVID-19 reporting were reviewed. Several sources of official documents were used: PubMed; National Institutes of Health resources; pharmaceutical companies; policy documents; national newspapers and news agencies; and books by prominent professionals (scientific and legal). A few studies have not been published in peer-reviewed journals; however, they have been conducted by reputable scientists in their respective fields.

Results:

Since the beginning of COVID-19, we can list the following methods of information manipulation which have been used: falsified clinical trials and inaccessible data; fake or conflict-of-interest studies; concealment of vaccines’ short-term side effects and total lack of knowledge of the long-term effects of COVID-19 vaccination; doubtful composition of vaccines; inadequate testing methods; governments and international organizations under conflicts of interest; bribed physicians; the denigration of renowned scientists; the banning of all alternative effective treatments; unscientific and liberticidal social methods; government use of behavior modification and social engineering techniques to impose confinements, masks, and vaccine acceptance; scientific censorship by the media.

Conclusion:

By supporting and selecting only the one side of science information while suppressing alternative viewpoints, and with obvious conflicts of interest revealed by this study, governments and the media constantly disinform the public. Consequently, the unscientifically validated vaccination laws, originating from industry-controlled medical science, led to the adoption of social measures for the supposed protection of the public but which became serious threats to the health and freedoms of the population.

Are persistent aircraft trails a threat to the environment and health?

According to most scientific studies, media and governments, the white trails that can be seen behind aircraft in flight, corresponding to condensation mixed with engine particulate emissions, only persist under specific atmospheric conditions. They are called condensation trails, and cirrus contrails when they remain for hours to reach several kilometers wide. The fact that they have gradually filled the skies over the last twenty years would be due to the increase in air traffic. However, other official documents link these persistent trails to a weather modification technology called solar geoengineering by stratospheric aerosol injection (SAI). These sprays would be mainly composed of metallic particles (Al, Ba, Sr, Fe, nanoparticles) and sulfur, which would considerably increase air, soil and water pollution. Many of the current environmental and health problems are consistent with those described in the literature on solar geoengineering by SAI if this method was employed. For example, metal particles used are well known environmental contaminants, ozone layer depletion, cardiorespiratory diseases, neurodegenerative diseases, sunburn. The observations (whiter skies, less solar power) also correspond to the same risks as those described in the solar geoengineering works. Patents show that this weather modification technology has been known and mastered for a long time. In addition, some scientific papers as well as policy documents suggest that solar geoengineering by SAI has been used for many years. The amount of official information presented in this review is intended to open new ways of investigation, free of conflicts of interest, about the growing global pollution of persistent aircraft trails and their possible links with solar geoengineering by SAI.

Managing the risk of COVID-19 via vaccine passports: Modeling economic and policy implications

The increasing use of vaccine passports (VPs) to certify immunity from the prevailing coronavirus has created positive and negative aspects that have shaken the workings of markets. The VPs are, however, not universally used and not required by all businesses and governments at this point. Given the newness associated with VPs and the ongoing uncertainty of the pandemic, full implications of VPs have not been considered. This paper provides some formal insights into the implications of the use of VPs, borrowing from the established economic theory. Recommendations for public policy are provided.

COVID-19 Vaccine Mandates for Healthcare Professionals in the United States

Healthcare workers (HCWs) need to be vaccinated against COVID-19 because they care for vulnerable patients. Hesitation to receiving the COVID-19 vaccine stems from the argument of bodily autonomy, novel mRNA vaccine technology, and conspiracy theories. However, vaccinations may prevent thousands of hospitalizations and deaths. HCWs have previously complied with other required vaccinations to care for children, elderly, and immunocompromised patients. Yet, COVID-19 vaccination mandates in the healthcare setting have been faced with resistance and subsequent staffing shortages. As HCWs display their hesitation to the vaccine, the community loses trust in its efficacy and safety. Speculation on pharmaceutical profiteering has also contributed to vaccine mistrust. As the pandemic continues, the healthcare field must decide on a course of action: adhere to vaccination mandates and cope with decreased staffing, repeal vaccination mandates to recover staff, rely on personal protective equipment (PPE) alone for protection, or do nothing and expect survival through herd immunity. To date, the United States has chosen to mandate COVID-19 vaccinations for any healthcare worker employed by Medicare and/or Medicaid-accepting facilities, allowing allergy and religious exemptions. This COVID-19 vaccination mandate for HCWs ethically protects the vulnerable people who HCWs vow to care for.

Aggressive measures, rising inequalities, and mass formation during the COVID-19 crisis: An overview and proposed way forward

A series of aggressive restrictive measures were adopted around the world in 2020-2022 to attempt to prevent SARS-CoV-2 from spreading. However, it has become increasingly clear the most aggressive (lockdown) response strategies may involve negative side-effects such as a steep increase in poverty, hunger, and inequalities. Several economic, educational, and health repercussions have fallen disproportionately on children, students, young workers, and especially on groups with pre-existing inequalities such as low-income families, ethnic minorities, and women. This has led to a vicious cycle of rising inequalities and health issues. For example, educational and financial security decreased along with rising unemployment and loss of life purpose. Domestic violence surged due to dysfunctional families being forced to spend more time with each other. In the current narrative and scoping review, we describe macro-dynamics that are taking place because of aggressive public health policies and psychological tactics to influence public behavior, such as mass formation and crowd behavior. Coupled with the effect of inequalities, we describe how these factors can interact toward aggravating ripple effects. In light of evidence regarding the health, economic and social costs, that likely far outweigh potential benefits, the authors suggest that, first, where applicable, aggressive lockdown policies should be reversed and their re-adoption in the future should be avoided. If measures are needed, these should be non-disruptive. Second, it is important to assess dispassionately the damage done by aggressive measures and offer ways to alleviate the burden and long-term effects. Third, the structures in place that have led to counterproductive policies should be assessed and ways should be sought to optimize decision-making, such as counteracting groupthink and increasing the level of reflexivity. Finally, a package of scalable positive psychology interventions is suggested to counteract the damage done and improve humanity's prospects.

Ethnic inequalities in COVID-19 vaccine uptake and comparison to seasonal influenza vaccine uptake in Greater Manchester, UK: A cohort study

BACKGROUND

COVID-19 vaccine uptake is lower amongst most minority ethnic groups compared to the White British group in England, despite higher COVID-19 mortality rates. Here, we add to existing evidence by estimating inequalities for 16 minority ethnic groups, examining ethnic inequalities within population subgroups, and comparing the magnitudes of ethnic inequalities in COVID-19 vaccine uptake to those for routine seasonal influenza vaccine uptake.

METHODS AND FINDINGS

We conducted a retrospective cohort study using the Greater Manchester Care Record, which contains de-identified electronic health record data for the population of Greater Manchester, England. We used Cox proportional hazards models to estimate ethnic inequalities in time to COVID-19 vaccination amongst people eligible for vaccination on health or age (50+ years) criteria between 1 December 2020 and 18 April 2021 (138 days of follow-up). We included vaccination with any approved COVID-19 vaccine, and analysed first-dose vaccination only. We compared inequalities between COVID-19 and influenza vaccine uptake adjusting by age group and clinical risk, and used subgroup analysis to identify populations where inequalities were widest. The majority of individuals (871,231; 79.24%) were White British. The largest minority ethnic groups were Pakistani (50,268; 4.75%), 'other White background' (43,195; 3.93%), 'other ethnic group' (34,568; 3.14%), and Black African (18,802; 1.71%). In total, 83.64% (919,636/1,099,503) of eligible individuals received a COVID-19 vaccine. Uptake was lower compared to the White British group for 15 of 16 minority ethnic groups, with particularly wide inequalities amongst the groups 'other Black background' (hazard ratio [HR] 0.42, 95% CI 0.40 to 0.44), Black African (HR 0.43, 95% CI 0.42 to 0.44), Arab (HR 0.43, 95% CI 0.40 to 0.48), and Black Caribbean (HR 0.43, 95% CI 0.42 to 0.45). In total, 55.71% (419,314/752,715) of eligible individuals took up influenza vaccination. Compared to the White British group, inequalities in influenza vaccine uptake were widest amongst the groups 'White and Black Caribbean' (HR 0.63, 95% CI 0.58 to 0.68) and 'White and Black African' (HR 0.67, 95% CI 0.63 to 0.72). In contrast, uptake was slightly higher than the White British group amongst the groups 'other ethnic group' (HR 1.11, 95% CI 1.09 to 1.12) and Bangladeshi (HR 1.08, 95% CI 1.05 to 1.11). Overall, ethnic inequalities in vaccine uptake were wider for COVID-19 than influenza vaccination for 15 of 16 minority ethnic groups. COVID-19 vaccine uptake inequalities also existed amongst individuals who previously took up influenza vaccination. Ethnic inequalities in COVID-19 vaccine uptake were concentrated amongst older and extremely clinically vulnerable adults, and the most income-deprived. A limitation of this study is the focus on uptake of the first dose of COVID-19 vaccination, rather than full COVID-19 vaccination.

CONCLUSIONS

Ethnic inequalities in COVID-19 vaccine uptake exceeded those for influenza vaccine uptake, existed amongst those recently vaccinated against influenza, and were widest amongst those with greatest COVID-19 risk. This suggests the COVID-19 vaccination programme has created additional and different inequalities beyond pre-existing health inequalities. We suggest that further research and policy action is needed to understand and remove barriers to vaccine uptake, and to build trust and confidence amongst minority ethnic communities.

Constituents' Inferences of Local Governments' Goals and the Relationship Between Political Party and Belief in COVID-19 Misinformation: Cross-sectional Survey of Twitter Followers of State Public Health Departments

Background

Amid the COVID-19 pandemic, social media have influenced the circulation of health information. Public health agencies often use Twitter to disseminate and amplify the propagation of such information. Still, exposure to local government-endorsed COVID-19 public health information does not make one immune to believing misinformation. Moreover, not all health information on Twitter is accurate, and some users may believe misinformation and disinformation just as much as those who endorse more accurate information. This situation is complicated, given that elected officials may pursue a political agenda of re-election by downplaying the need for COVID-19 restrictions. The politically polarized nature of information and misinformation on social media in the United States has fueled a COVID-19 infodemic. Because pre-existing political beliefs can both facilitate and hinder persuasion, Twitter users' belief in COVID-19 misinformation is likely a function of their goal inferences about their local government agencies' motives for addressing the COVID-19 pandemic.

Objective

We shed light on the cognitive processes of goal understanding that underlie the relationship between partisanship and belief in health misinformation. We investigate how the valence of Twitter users' goal inferences of local governments' COVID-19 efforts predicts their belief in COVID-19 misinformation as a function of their political party affiliation.

Methods

We conducted a web-based cross-sectional survey of US Twitter users who followed their state's official Department of Public Health Twitter account (n=258) between August 10 and December 23, 2020. Inferences about local governments' goals, demographics, and belief in COVID-19 misinformation were measured. State political affiliation was controlled.

Results

Participants from all 50 states were included in the sample. An interaction emerged between political party affiliation and goal inference valence for belief in COVID-19 misinformation (∆R ²=0.04; F _8,249=4.78; P<.001); positive goal inference valence predicted increased belief in COVID-19 misinformation among Republicans (β=.47; t ₂₄₉=2.59; P=.01) but not among Democrats (β=.07; t ₂₄₉=0.84; P=.40).

Conclusions

Our results reveal that favorable inferences about local governments' COVID-19 efforts can accelerate belief in misinformation among Republican-identifying constituents. In other words, accurate COVID-19 transmission knowledge is a function of constituents' sentiment toward politicians rather than science, which has significant implications on public health efforts for minimizing the spread of the disease, as convincing misinformed constituents to practice safety measures might be a political issue just as much as it is a health one. Our work suggests that goal understanding processes matter for misinformation about COVID-19 among Republicans. Those responsible for future COVID-19 public health messaging aimed at increasing belief in valid information about COVID-19 should recognize the need to test persuasive appeals that address partisans' pre-existing political views in order to prevent individuals' goal inferences from interfering with public health messaging.

Acceptability of government measures against COVID-19 pandemic in Senegal: A mixed methods study

While the first case of COVID-19 was declared on March 2 2020 in Senegal, the government banned the attendance of places of worship on 14 March, as a first measure. On March 23, it introduced a curfew, a ban on movement between regions, and the closure of markets. The objective of this study is to measure and understand the acceptability of these four governmental measures as well as the level of public trust in the state to fight the pandemic. We carried out a mixed-method research. The acceptability variables were defined using the theoretical framework of acceptability (TFA). At the quantitative level, we carried out a telephone survey (June/July 2020) at the national level (n = 813) with a sampling strategy by marginal quotas. We conducted a qualitative survey (August/September 2020) with a nested sample (n = 30). The results show a relatively high acceptability of the measures but a heterogeneity of responses. People considered curfews to be much more important (85.7% [83.2%; 88.0%]) than the closure of places of worship (55.4%; [51.9%; 58.7%]), which is least in line with the values and positive affective attitude. Several positive unintended effects of the curfew were stated (security and social/family cohesion). People over the age of 60 have more confidence in the government to fight the pandemic than people under the age of 25, although not significant (7.72 ± 3.12 vs. 7.07 ± 3.11, p = 0.1); and they are more in favour of the closure of places of worship. The more regions are affected by the pandemic, the less confidence respondents report in the government and the less they perceive the measures as effective. The results confirm the importance of government communication and trust in the state to strengthen the acceptability of pandemic measures. Important differences in acceptability show the need to adapt measures and their explanations, instead of unqualified universal action.

National health governance, science and the media: drivers of COVID-19 responses in Germany, Sweden and the UK in 2020

The COVID-19 pandemic is an unprecedented global crisis in which governments had to act in a situation of rapid change and substantial uncertainty. The governments of Germany, Sweden and the UK have taken different paths allowing learning for future pandemic preparedness. To help inform discussions on preparedness, inspired by resilience frameworks, this paper reviews governance structures, and the role of science and the media in the COVID-19 response of Germany, Sweden and the UK in 2020. We mapped legitimacy, interdependence, knowledge generation and the capacity to deal with uncertainty.

Our analysis revealed stark differences which were linked to pre-existing governing structures, the traditional role of academia, experience of crisis management and the communication of uncertainty—all of which impacted on how much people trusted their government. Germany leveraged diversity and inclusiveness, a ‘patchwork quilt’, for which it was heavily criticised during the second wave. The Swedish approach avoided plurality and largely excluded academia, while in the UK’s academia played an important role in knowledge generation and in forcing the government to review its strategies. However, the vivant debate left the public with confusing and rapidly changing public health messages. Uncertainty and the lack of evidence on how best to manage the COVID-19 pandemic—the main feature during the first wave—was only communicated explicitly in Germany. All country governments lost trust of their populations during the epidemic due to a mix of communication and transparency failures, and increased questioning of government legitimacy and technical capacity by the public.

Disease transmission and control modelling at the science-policy interface

The coronavirus disease 2019 (COVID-19) pandemic has disrupted the lives of billions across the world. Mathematical modelling has been a key tool deployed throughout the pandemic to explore the potential public health impact of an unmitigated epidemic. The results of such studies have informed governments' decisions to implement non-pharmaceutical interventions to control the spread of the virus. In this article, we explore the complex relationships between models, decision-making, the media and the public during the COVID-19 pandemic in the United Kingdom of Great Britain and Northern Ireland (UK). Doing so not only provides an important historical context of COVID-19 modelling and how it has shaped the UK response, but as the pandemic continues and looking towards future pandemic preparedness, understanding these relationships and how they might be improved is critical. As such, we have synthesized information gathered via three methods: a survey to publicly list attendees of the Scientific Advisory Group for Emergencies, the Scientific Pandemic Influenza Group on Modelling and other comparable advisory bodies, interviews with science communication experts and former scientific advisors, and reviewing some of the key COVID-19 modelling literature from 2020. Our research highlights the desire for increased bidirectional communication between modellers, decision-makers and the public, as well as the need to convey uncertainty inherent in transmission models in a clear manner. These aspects should be considered carefully ahead of the next emergency response.

Prioritization of Surgery in Cancer Patients During the COVID-19 Pandemic: Lessons From a Failed Balancing Act

The prioritization of surgical oncology over other elective interventions during COVID-19 has failed to preserve the quality of care in oncology and will likely lead to an increase of cancer-related mortality in the coming years. We propose five components for systems to improve the organization of surgical oncology during future crises, namely (1) a multidisciplinary governance structure employing predictive models and risk/benefit evaluations, (2) predefined quality objectives based on measurable markers (regularly reviewed and adapted), (3) temporary flexibility in therapeutic algorithms and authorization procedures (with associated safeguards), (4) systems to ensure access to transparent, apolitical information, and (5) explicit, dedicated logistical surgical capacities to optimize coordination and resource allocation.

The stabilizing effect of social distancing: Cross-country differences in financial market response to COVID-19 pandemic policies

COVID-19 has had far-reaching global effects on the health and wellbeing of individuals on every continent. The economic and financial market response has been equally disastrous with high levels of volatility observed. This study explores the temporal relations between structural breaks, market volatility and government stay-at-home policy interventions and social distancing measures for 28 countries and their respective indices. We present results which indicate the establishment of stay-at-home policies influence sharp discontinuities in 15 of 28 markets (53.57 %) and increase market efficiency in 30 of 49 cases observed (61.22 %). These results indicate a small, statistically significant degree of stabilization in international financial markets responding to government stay-at-home policies and social distancing measures, a promising result for political actors concerned with economic performance during the public health response to the coronavirus 2019 pandemic.

The Role of European Schools and University Departments of Public Health in the 2020 COVID-19 Response, European Region, 2020

Objective: The main objective was to examine, how European Schools of Public Health (SPHs) responded to the COVID-19 pandemic through 2020, across the main activity domains of the SPHs. Methods: A cross-sectional survey based on an online questionnaire concerning the anti-COVID-19 activities from 1st March to 31st October 2020 of the 117 members of the Association of Schools of Public Health in the European Region (ASPHER). The questionnaire asked about 33 sub-themes within the four main themes of teaching, health communication to the public, research, and consultancy/advice. Results: Fifty-nine SPHs (50%) completed the questionnaire. Seventy-nine per cent of participants were involved in COVID-19 related teaching; health communication to the public, 76%; research, 80%; consultancy/advice, 81%. Eight out of ten participants had been involved in all of the four main themes. Conclusion: The study demonstrated a substantial body of COVID-19 related work by SPHs in Europe, and an outstanding potential to deliver crucial knowledge and skills to support the governance and the public health systems necessary to combat COVID-19.

Following the science? Views from scientists on government advisory boards during the COVID-19 pandemic: a qualitative interview study in five European countries

INTRODUCTION

In order to tackle the pandemic, governments have established various types of advisory boards to provide evidence and recommendations to policy makers. Scientists working on these boards have faced many challenges, including working under significant time constraints to produce 'evidence' as quickly as possible. However, their voices are still largely missing in the discussion. This study explores the views and experiences of scientists working on government advisory boards during the COVID-19 pandemic, with the aim to learn lessons for future pandemic management and preparedness.

METHODS

We conducted online video or telephone semi-structured interviews between December 2020 and April 2021 with 21 scientists with an official government advisory role during the COVID-19 pandemic in Belgium, the Netherlands, UK, Sweden and Germany. The interviews were audio-recorded and transcribed and analysed using a combination of inductive and deductive thematic analysis techniques.

RESULTS

Scientists viewed the initial focus on biomedically oriented work during the pandemic as somewhat one-dimensional, but also highlighted difficulties of working in an interdisciplinary way. They found it difficult at times to ensure that the evidence is understood and taken on board by governments. They found themselves taking on new roles, the boundaries of which were not clearly defined. Consequently, they were often perceived and treated as a public figure.

CONCLUSION

Scientists working on advisory boards in European countries faced similar challenges, highlighting key lessons to be learnt. Future pandemic preparedness efforts should focus on building interdisciplinary collaboration through development of scientists' skills and appropriate infrastructure; ensuring transparency in how boards operate; defining and protecting the boundaries of the scientific advisor role; and supporting scientists to inform the public in the fight against disinformation, while dealing with potential hostile reactions.

Toolkit for detecting misused epidemiological methods

BACKGROUND

Critical knowledge of what we know about health and disease, risk factors, causation, prevention, and treatment, derives from epidemiology. Unfortunately, its methods and language can be misused and improperly applied. A repertoire of methods, techniques, arguments, and tactics are used by some people to manipulate science, usually in the service of powerful interests, and particularly those with a financial stake related to toxic agents. Such interests work to foment uncertainty, cast doubt, and mislead decision makers by seeding confusion about cause-and-effect relating to population health. We have compiled a toolkit of the methods used by those whose interests are not aligned with the public health sciences. Professional epidemiologists, as well as those who rely on their work, will thereby be more readily equipped to detect bias and flaws resulting from financial conflict-of-interest, improper study design, data collection, analysis, or interpretation, bringing greater clarity-not only to the advancement of knowledge, but, more immediately, to policy debates.

METHODS

The summary of techniques used to manipulate epidemiological findings, compiled as part of the 2020 Position Statement of the International Network for Epidemiology in Policy (INEP) entitled Conflict-of-Interest and Disclosure in Epidemiology, has been expanded and further elucidated in this commentary.

RESULTS

Some level of uncertainty is inherent in science. However, corrupted and incomplete literature contributes to confuse, foment further uncertainty, and cast doubt about the evidence under consideration. Confusion delays scientific advancement and leads to the inability of policymakers to make changes that, if enacted, would-supported by the body of valid evidence-protect, maintain, and improve public health. An accessible toolkit is provided that brings attention to the misuse of the methods of epidemiology. Its usefulness is as a compendium of what those trained in epidemiology, as well as those reviewing epidemiological studies, should identify methodologically when assessing the transparency and validity of any epidemiological inquiry, evaluation, or argument. The problems resulting from financial conflicting interests and the misuse of scientific methods, in conjunction with the strategies that can be used to safeguard public health against them, apply not only to epidemiologists, but also to other public health professionals.

CONCLUSIONS

This novel toolkit is for use in protecting the public. It is provided to assist public health professionals as gatekeepers of their respective specialty and subspecialty disciplines whose mission includes protecting, maintaining, and improving the public's health. It is intended to serve our roles as educators, reviewers, and researchers.

Drivers of COVID-19 vaccinations: vaccine delivery and delivery efficiency in the United States

This paper adds some formal research to the success of ongoing efforts to combat the COVID-19 pandemic by examining the drivers of the administration and delivery efficiency of coronavirus vaccines. For this purpose, we use data from the 50 US states and place the formal analysis in the context of socio-economic drivers of vaccinations. Results show that state-economic prosperity and rural population aid vaccine administration and delivery efficiency. Delivery efficiency improves in states with more nursing homes per capita, in states with more COVID-19 deaths, and with more health workers. A subset of health workers, including physicians and nurses, did not significantly impact administration or efficiency. On the other hand, vaccination efficiency was lower in states with a centralized public health agency. States with a larger share of the elderly population and those with Democrats as governors were no different from others with regard to vaccinations. Robustness checks are performed using vaccination data from a more recent period. Finally, a state’s legacy of corrupt activity, across two different time dimensions, is broadly consistent with the greasing effects of corruption. Some policy implications based on the evolving data are discussed.

COVID-19 vaccine rollout-scale and speed carry different implications for corruption

The sanctioning of different coronavirus vaccines (with some approved by regulators for public delivery, and others in the pipeline) has met with relief by many sections of the public and the government. However, partly due to the damages associated with the pandemic and the ensuing euphoria over vaccines' arrival, some of the challenges are mostly being ignored or are not recognized. This paper identifies some pitfalls and drawbacks in vaccine delivery. We argue that the somewhat unique tension between the speed of vaccine delivery and its scale can create opportunities for corrupt behavior that are often at odds with effective means to check abuse. While data on instances of abuse will emerge over time, it is useful to point out different avenues of abuse so that some preventive government actions can be undertaken. Specifically, we argue that the potential for out of turn delivery of vaccines and the stockpiling by unauthorized agents creates incentives for corruption, with the public or bureaucrats initiating corrupt transactions. An understanding of the potential avenues for corruption should guide the formulation of appropriate corruption-control policies and similar challenges that will be faced by policy makers in addressing future pandemics.

The Human Genome Organisation (HUGO) and the 2020 COVID-19 pandemic

This letter is the Human Genome Organisation's summary reaction to the 2020 COVID-19 pandemic. It identifies key areas for genomics research, and areas in which genomic scientists can contribute to a global response to the pandemic. The letter has been reviewed and endorsed by the HUGO Committee on Ethics, Law and Society (CELS) and the HUGO Council.

Transparent scientific reporting is imperative during the pandemic

The coronavirus pandemic has exposed not only the lack of preparation to combat the deadly disease, but also the nature of response by governments worldwide. This article analyses how some governments suppress science reporting in the Asia Pacific region during the pandemic. It also highlights how the political interference in science undermines liability and openness leading to the lack of freedom to express facts honestly.

Complex scenarios with competing factors: A conception paper applied to the COVID-19 case

A theory to analyze complex scenarios facing threats with competing factors and limited resources has been introduced. The scenarios are modeled as closed systems. Hamilton's principle of stationary action is used to conceive a theory in which competing factors dispute available resources to minimize undesirable outcomes. The result indicates that the minimum response is obtained by a combination of the competing factors weighted by their corresponding criticalities. The theory has been applied to the COVID-19 pandemic with two competing factors: Health and Economy. As main result, to minimize the total number of deaths, the recommendation is to balance the emphasis on both factors. This implies to give more emphasis to the economic factor, by avoiding restrict interventions like lockdowns and business closures. The model may evolve from a qualitative to a quantitative status, allowing for computational simulations aimed at validations and forecasting. As such, this approach may become a useful tool for strategic decision-making regarding resources allocations to reduce guessing in scenarios full of uncertainties.

Deceptology in cancer and vaccine sciences: Seeds of immune destruction-mini electric shocks in mitochondria: Neuroplasticity-electrobiology of response profiles and increased induced diseases in four generations - A hypothesis

From Rockefeller's support of patent medicine to Gates' patent vaccines, medical establishment invested a great deal in intellectual ignorance. Through the control over medical education and research it has created a public illusion to prop up corporate profit and encouraged the lust for money and power. An overview of data on cancer and vaccine sciences, the status of Americans' health, a survey of repeated failed projects, economic toxicity, and heavy drug consumption or addiction among young and old provide compelling evidence that in the twentieth century nearly all classic disease categories (congenital, inheritance, neonatal, or induced) shifted to increase induced diseases. Examples of this deceptology in ignoring or minimizing, and mocking fundamental discoveries and theories in cancer and vaccine sciences are attacks on research showing that (a), effective immunity is responsible for defending and killing pathogens and defective cancerous cells, correcting and repairing genetic mutations; (b) viruses cause cancer; and (c), abnormal gene mutations are often the consequences of (and secondary to) disturbances in effective immunity. The outcomes of cancer reductionist approaches to therapies reveal failure rates of 90% (+/-5) for solid tumors; loss of over 50 million lives and waste of $30-50 trillions on too many worthless, out-of-focus, and irresponsible projects. Current emphasis on vaccination of public with pathogen-specific vaccines and ingredients seems new terms for drugging young and old. Cumulative exposures to low level carcinogens and environmental hazards or high energy electronic devices (EMF; 5G) are additional triggers to vaccine toxicities (antigen-mitochondrial overload) or "seeds of immune destruction" that create mini electrical shocks (molecular sinks holes) in highly synchronized and regulated immune network that retard time-energy-dependent biorhythms in organs resulting in causes, exacerbations or consequences of mild, moderate or severe immune disorders. Four generations of drug-dependent Americans strongly suggest that medical establishment has practiced decades of intellectual deception through its claims on "war on cancer"; that cancer is 100, 200, or 1000 diseases; identification of "individual" genetic mutations to cure diseases; "vaccines are safe". Such immoral and unethical practices, along with intellectual harassment and bullying, censoring or silencing of independent and competent professionals ("Intellectual Me Too") present grave concerns, far greater compared with the sexual harassment of 'Me Too' movement that was recently spearheaded by NIH. The principal driving forces behind conducting deceptive and illogical medical/cancer and vaccine projects seem to be; (a) huge return of investment and corporate profit for selling drugs and vaccines; (b) maintenance of abusive power over public health; (c) global control of population growth via increased induction of diseases, infertility, decline in life-span, and death. An overview of accidental discoveries that we established and extended since 1980s, on models of acute and chronic ocular inflammatory diseases, provides series of the first evidence for a direct link between inflammation and multistep immune dysfunction in tumorigenesis and angiogenesis. Results are relevant to demonstrate that current emphasis on vaccinating the unborn, newborn, or infant would induce immediate or long-term immune disorders (eg, low birth weight, preterm birth, fatigue, autism, epilepsy/seizures, BBB leakage, autoimmune, neurodegenerative or digestive diseases, obesity, diabetes, cardiovascular problems, or cancers). Vaccination of the unborn is likely to disturb trophoblast-embryo-fetus-placenta biology and orderly growth of embryo-fetus, alter epithelial-mesenchymal transition or constituent-inducible receptors, damage mitochondria, and diverse function of histamine-histidine pathways. Significant increased in childhood illnesses are likely due to toxicities of vaccine and incipient (eg, metals [Al, Hg], detergents, fetal tissue, DNA/RNA) that retard bioenergetics of mitochondria, alter polarization-depolarization balance of tumoricidal (Yin) and tumorigenic (Yang) properties of immunity. Captivated by complex electobiology of immunity, this multidisciplinary perspective is an attempt to initiate identifying bases for increased induction of immune disorders in three to four generations in America. We hypothesize that (a) gene-environment-immune biorhythms parallel neuronal function (brain neuroplasticity) with super-packages of inducible (adaptive or horizontal) electronic signals and (b) autonomic sympathetic and parasympathetic circuitry that shape immunity (Yin-Yang) cannot be explained by limited genomics (innate, perpendicular) that conventionally explain certain inherited diseases (eg, sickle cell anemia, progeria). Future studies should focus on deep learning of complex electrobiology of immunity that requires differential bioenergetics from mitochondria and cytoplasm. Approaches to limit or control excessive activation of gene-environment-immunity are keys to assess accurate disease risk formulations, prevent inducible diseases, and develop universal safe vaccines that promote health, the most basic human right.