Perceptions and reactions with regard to pneumonic plague

Challenges in Media Attention toward COVID-19-Preventive Behaviors: Dual Roles of Threat and Perceived Capability for Information Systems and Health Care

Based on the extended parallel process model, this study investigated the relationship between young adults' media exposure to COVID-19 and their adoption of protective behaviors. This study surveyed 141 college students and found that increased risk perceptions led to greater intentions to engage in COVID-19-preventive behaviors and that these intentions were mediated by normative beliefs. There was no significant difference in risk perceptions between traditional media and social media. The results showed that college students took precautions against COVID-19 because they perceived themselves to be both vulnerable and capable.

Viral social media videos can raise pro-social behaviours when an epidemic arises

Access to information via social media is one of the biggest differentiators of public health crises today. During the early stages of the Covid-19 outbreak in January 2020, we conducted an experiment in Wuhan, China to assess the impact of viral social media content on pro-social and trust behaviours and preferences towards risk taking with known and unknown probabilities. Prior to the experiment, participants viewed one of two videos that had been widely and anonymously shared on Chinese social media: a central government leader visiting a local hospital and supermarket, or health care volunteers transiting to Wuhan. In a control condition, participants watched a Neutral video, unrelated to the crisis. Viewing one of the leadership or volunteer videos leads to higher levels of pro-sociality and lesser willingness to take risks in an ambiguous situation relative to the control condition. The leadership video, however, induces lower levels of trust. We provide evidence from two post-experiment surveys that the video’s impact on pro-sociality is modulated by influencing the viewer’s affective emotional state.

What Factors Influence Symptom Reporting and Access to Healthcare During an Emerging Infectious Disease Outbreak? A Rapid Review of the Evidence

During any emerging infectious disease outbreak, people with symptoms of the illness are asked to report to a health service immediately to facilitate contact tracing. Several factors may influence a person's willingness to report symptoms and their ability to access healthcare services. Understanding these factors has become urgent during the COVID-19 pandemic. To determine which factors influence symptom reporting during an emerging infectious disease outbreak, we conducted a rapid review of the evidence. Studies included in the review were based on primary research, published in a peer-reviewed journal, written in English, included factors associated with symptom reporting or accessing healthcare, and were related to a major public health incident involving an infectious disease outbreak. Five themes were identified as facilitators of symptom reporting or accessing healthcare: accurate and informative communication about the disease and the need to seek help, symptom severity, concern about disease exposure, ease of access to healthcare facilities, and relationship with the healthcare provider. Seven themes were identified as barriers to symptom reporting or accessing healthcare: lack of knowledge of the disease and its treatment, fear of the disease and fear of subsequent treatments or requirements, stigmatization attached to having a disease, invasion of privacy, low concern about symptoms, economic consequences of disease diagnosis, and challenges related to attending a healthcare facility. For contract tracing services to be effective, members of the public need to have the capability, opportunity, and motivation to use them. The themes identified should be used to evaluate information provided to the public to ensure as many people as possible with relevant symptoms report them to a healthcare provider.

The psychological and psychiatric effects of terrorism: lessons from London

The 7 July 2005 bombings in London caused heightened levels of distress among some in the general community. This distress was most notable in Muslims and members of ethnic minority groups. These effects were transient for most. An estimated 30% of those who were more affected by the attacks, including victims and witnesses, developed psychiatric disorders as a result. An outreach program was set up to screen those who were exposed to potentially traumatic events and to offer them evidence-based treatment. This article discusses what lessons might be learned from studies of the general community and the screen-and-treat approach.

The impact of communication materials on public responses to a radiological dispersal device (RDD) attack

It is a common assumption that, in the event of a chemical, biological, radiological, or nuclear (CBRN) attack, a well-prepared and informed public is more likely to follow official recommendations regarding the appropriate safety measures to take. We present findings from a UK study investigating the ability of crisis communication to influence perceptions of risk and behavioral intentions in the general public in response to CBRN terrorism. We conducted a focus group study involving a scenario presented in mock news broadcasts to explore levels of public knowledge, information needs, and intended behavioral reactions to an attack involving an overt radiological dispersal device (RDD), or dirty bomb. We used the findings from these focus groups to design messages for the public that could be presented in a short leaflet. We then tested the effects of the leaflet on reactions to the same scenario in 8 further focus groups. The impact of the new messages on levels of knowledge, information needs, and intended compliance with official recommendations was assessed. The provision of information increased the perceived credibility of official messages and increased reported levels of intended compliance with advice to return to normal/stop sheltering, attend a facility for assessment and treatment, and return to a previously contaminated area after decontamination of the environment has taken place. Should a real attack with an RDD occur, having pretested messages available to address common concerns and information needs should facilitate the public health response to the attack.

Why disgust matters

The new synthesis about disgust is that it is a system that evolved to motivate infectious disease avoidance. There are vital practical and intellectual reasons why we need to understand disgust better. Practically, disgust can be harnessed to combat the behavioural causes of infectious and chronic disease such as diarrhoeal disease, pandemic flu and smoking. Disgust is also a source of much human suffering; it plays an underappreciated role in anxieties and phobias such as obsessive compulsive disorder, social phobia and post-traumatic stress syndromes; it is a hidden cost of many occupations such as caring for the sick and dealing with wastes, and self-directed disgust afflicts the lives of many, such as the obese and fistula patients. Disgust is used and abused in society, being both a force for social cohesion and a cause of prejudice and stigmatization of out-groups. This paper argues that a better understanding of disgust, using the new synthesis, offers practical lessons that can enhance human flourishing. Disgust also provides a model system for the study of emotion, one of the most important issues facing the brain and behavioural sciences today.

Public anxiety and information seeking following the H1N1 outbreak: blogs, newspaper articles, and Wikipedia visits

Web-based methodologies may provide a new and unique insight into public response to an infectious disease outbreak. This naturalistic study investigates the effectiveness of new web-based methodologies in assessing anxiety and information seeking in response to the 2009 H1N1 outbreak by examining language use in weblogs ("blogs"), newspaper articles, and web-based information seeking. Language use in blogs and newspaper articles was assessed using Linguistic Inquiry and Word Count, and information seeking was examined using the number of daily visits to H1N1-relevant Wikipedia articles. The results show that blogs mentioning "swine flu" used significantly higher levels of anxiety, health, and death words and lower levels of positive emotion words than control blogs. Change in language use on blogs was strongly related to change in language use in newspaper coverage for the same day. Both the measure of anxiety in blogs mentioning "swine flu" and the number of Wikipedia visits followed similar trajectories, peaking shortly after the announcement of H1N1 and then declining rapidly. Anxiety measured in blogs preceded information seeking on Wikipedia. These results show that the public reaction to H1N1 was rapid and short-lived. This research suggests that analysis of web behavior can provide a source of naturalistic data on the level and changing pattern of public anxiety and information seeking following the outbreak of a public health emergency.

An individual-based simulation of pneumonic plague transmission following an outbreak and the significance of intervention compliance

The existence of primary pneumonic plague outbreaks raises concerns over the use of the causative bacteria as an aerosol-based bioweapon. We employed an individual-based model, parameterised using published personal contact information, to assess the severity of a deliberate release in a discrete community, under the influence of two proposed intervention strategies. We observed that the severity of the resulting epidemic is determined by the degree of personal compliance with said strategies, implying that prior preparedness activities are essential in order that public awareness and willingness to seek treatment is achieved quickly.

A plague on five of your houses--statistical re-assessment of three pneumonic plague outbreaks that occurred in Suffolk, England, between 1906 and 1918

BACKGROUND

Plague is a re-emerging disease and its pneumonic form is a high priority bio-terrorist threat. Epidemiologists have previously analysed historical outbreaks of pneumonic plague to better understand the dynamics of infection, transmission and control. This study examines 3 relatively unknown outbreaks of pneumonic plague that occurred in Suffolk, England, during the first 2 decades of the twentieth century.

METHODS

The Kolmogorov-Smirnov statistical test is used to compare the symptomatic period and the length of time between successive cases (i.e. the serial interval) with previously reported values. Consideration is also given to the case fatality ratio, the average number of secondary cases resulting from each primary case in the observed minor outbreaks (termed R(minor)), and the proportion of individuals living within an affected household that succumb to pneumonic plague via the index case (i.e. the household secondary attack rate (SAR)).

RESULTS

2 of the 14 cases survived giving a case fatality ratio of 86% (95% confidence interval (CI) = {57%, 98%}). For the 12 fatal cases, the average symptomatic period was 3.3 days (standard deviation (SD) = 1.2 days) and, for the 11 non index cases, the average serial interval was 5.8 days (SD = 2.0 days). R(minor) was calculated to be 0.9 (SD = 1.0) and, in 2 households, the SAR was approximately 14% (95% CI = {0%, 58%}) and 20% (95% CI = {1%, 72%}), respectively.

CONCLUSIONS

The symptomatic period was approximately 1 day longer on average than in an earlier study but the serial interval was in close agreement with 2 previously reported values. 2 of the 3 outbreaks ended without explicit public health interventions; however, non-professional caregivers were particularly vulnerable - an important public health consideration for any future outbreak of pneumonic plague.

Reassuring and managing patients with concerns about swine flu: qualitative interviews with callers to NHS Direct

Background

During the early stages of the 2009 swine flu (influenza H1N1) outbreak, the large majority of patients who contacted the health services about the illness did not have it. In the UK, the NHS Direct telephone service was used by many of these patients. We used qualitative interviews to identify the main reasons why people approached NHS Direct with concerns about swine flu and to identify aspects of their contact which were reassuring, using a framework approach.

Methods

33 patients participated in semi-structured interviews. All patients had telephoned NHS Direct between 11 and 14 May with concerns about swine flu and had been assessed as being unlikely to have the illness.

Results

Reasons for seeking advice about swine flu included: the presence of unexpectedly severe flu-like symptoms; uncertainties about how one can catch swine flu; concern about giving it to others; pressure from friends or employers; and seeking 'peace of mind.' Most participants found speaking to NHS Direct reassuring or useful. Helpful aspects included: having swine flu ruled out; receiving an alternative explanation for symptoms; clarification on how swine flu is transmitted; and the perceived credibility of NHS Direct. No-one reported anything that had increased their anxiety and only one participant subsequently sought additional advice about swine flu from elsewhere.

Conclusions

Future major incidents involving other forms of chemical, biological or radiological hazards may also cause large numbers of unexposed people to seek health advice. Our data suggest that providing telephone triage and information is helpful in such instances, particularly where advice can be given via a trusted, pre-existing service.