Government Reactions, Citizens' Responses, and COVID-19 around the World

The impact of social cohesion and risk communication on excess mortality due to COVID-19 in 213 countries: a retrospective analysis

BACKGROUND

Tools for assessing a country's capacity in the face of public health emergencies must be reviewed, as they were not predictive of the COVID-19 pandemic. Social cohesion and risk communication, which are related to trust in government and trust in others, may have influenced adherence to government measures and mortality rates due to COVID-19.

OBJECTIVE

To analyse the association between indicators of social cohesion and risk communication and COVID-19 outcomes in 213 countries.

RESULTS

Social cohesion and risk communication, in their dimensions (public trust in politicians, trust in others, social safety nets, and equal distribution of resources index), were associated with lower excess mortality due to COVID-19. The number of COVID-19-related disorder events and government transparency were associated with higher excess mortality due to COVID-19. The lower the percentage of unemployed people, the higher the excess mortality due to COVID-19. Most of the social cohesion and risk communication variables were associated with better vaccination indicators, except for social capital and engaged society, which had no statistically significant association. The greater the gender equality, the better the vaccination indicators, such as the number of people who received all doses.

CONCLUSION

Public trust in politicians, trust in others, equal distribution of resources and government that cares about the most vulnerable, starting with the implementation of programs, such as cash transfers and combating food insecurity, were factors that reduced the excess mortality due to COVID-19. Countries, especially those with limited resources and marked by social, economic, and health inequalities, must invest in strengthening social cohesion and risk communication, which are robust strategies to better cope with future pandemics.

Vietnamese Americans' level of trust in sources of information and willingness to participate in COVID-19 clinical trials

The survey investigates COVID-19 information source trust levels and Vietnamese Americans' willingness to participate in clinical trials. An analysis of 212 completed surveys revealed that trust in coronavirus disease 2019 (COVID-19) clinical trial information from university hospitals and drug companies was associated with willingness to participate in clinical trials. Trust in COVID-19 information from federal governments and state governments was also associated with willingness to participate in clinical trials. However, trust in local health facilities was linked to trial participation reluctance. The results suggest that Vietnamese Americans' participation in clinical trials can be increased by identifying and using trusted sources of information.

Meta-analysis of KAP toward COVID-19 in Chinese residents

Background

During the coronavirus disease-2019 (COVID-19) pandemic, there have been many studies on knowledge, attitudes, and practices (KAP) toward prevention of COVID-19 infection in China. Except for symptomatic treatment and vaccination, KAP toward COVID-19 plays an important role in the prevention of COVID-19. There is no systematic evaluation and meta-analysis of KAP toward COVID-19 in China. This study is the earliest meta-analysis of KAP toward COVID-19 in China's general population. Hence, this systematic review aimed to summarize the knowledge, attitudes, and practices (KAP) of Chinese residents toward COVID-19 during the pandemic.

Methodology

Following the PRISMA guidelines, articles relevant to COVID-19 KAP that were conducted among the Chinese population were found in databases such as Scopus, ProQuest, PubMed, EMbase, Web of Science, Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, CQVIP, Wanfang and Google Scholar. A random-effect meta-analysis is used to summarize studies on knowledge, attitudes, and practice levels toward COVID-19 infection in China's general population.

Results

Fifty-seven articles published between August 2020 and November 2022 were included in this review. Overall, 75% (95% CI: 72-79%) of Chinese residents had good knowledge about COVID-19, 80% (95% CI: 73-87%) of Chinese residents had a positive attitude toward COVID-19 pandemic control and prevention (they believe that Chinese people will win the battle against the epidemic), and the aggregated proportion of residents with a correct practice toward COVID-19 was 84% (95% CI: 82-87%, I2 = 99.7%).In the gender subgroup analysis, there is no significant difference between Chinese men and Chinese women in terms of their understanding of COVID-19. However, Chinese women tend to have slightly higher levels of knowledge and a more positive attitude toward the virus compared to Chinese men. When considering the urban and rural subgroup analysis, it was found that Chinese urban residents have a better understanding of COVID-19 compared to Chinese rural residents. Interestingly, the rural population displayed higher rates of correct behavior and positive attitudes toward COVID-19 compared to the urban population. Furthermore, in the subgroup analysis based on different regions in China, the eastern, central, and southwestern regions exhibited higher levels of knowledge awareness compared to other regions. It is worth noting that all regions in China demonstrated good rates of correct behavior and positive attitudes toward COVID-19.

Conclusion

This study reviews the level of KAP toward COVID-19 during the pandemic period in China. The results show that the KAP toward COVID-19 in Chinese residents was above a favorable level, but the lack of translation of knowledge into practice should be further reflected on and improved. A subgroup analysis suggests that certain groups need more attention, such as males and people living in rural areas. Policy makers should pay attention to the results of this study and use them as a reference for the development of prevention and control strategies for major public health events that may occur in the future.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=348246, CRD42022348246.

Individualism, economic development, and democracy as determinants of COVID-19 risk information on 132 government websites

Little is known about how governments transparently communicate about COVID-19. This study conducted a content analysis of 132 government COVID-19 websites to identify the salience of health messages (i.e., perceived threat, perceived efficacy, and perceived resilience) and cross-national determinants of information provision. Multinomial logistic regression was used to estimate the relationship between country-level predictors (i.e., economic development, democracy scores, and individualism index) and information salience. The numbers of deaths, discharged patients, and daily new cases were prevalent on the main webpages. Subpages provided information about vulnerability statistics, government responses, and vaccination rates. Less than 10% of governments included messages that may instill self-efficacy. Democratic countries had higher chances of providing threat statistics on subpages, including daily new cases (Relative Risk Ratio, RRR = 1.66, 95% CI: 1.16-2.37), mortalities (RRR = 1.69, 95% CI: 1.23-2.33), hospitalizations (RRR = 1.63, 95% CI: 1.12-2.37), and positivity rates (RRR = 1.55, 95% CI: 1.07-2.23). On subpages, democratic governments emphasized information about perceived vulnerability (RRR = 2.36, 95% CI: 1.50-3.73), perceived response efficacy (RRR = 1.48, 95% CI: 1.06-2.06), recovery numbers (RRR = 1.84, 95% CI: 1.31-2.60), and vaccinations (RRR = 2.14, 95% CI: 1.39-3.30). Developed countries reported the number of daily new cases, perceived response efficacy, and vaccination rates on their COVID-19 main pages. Individualism scores predicted the salience of vaccination rates on main pages and the omission of information related to perceived severity and perceived vulnerability. Democracy levels were more predictive of reporting information about perceived severity, perceived response efficacy, and perceived resilience on subpages of dedicated websites. Improving public health agencies' communication about COVID-19 is warranted.

Clinical Characteristics of Coronavirus Disease (COVID-19) in Mexican Children and Adolescents

BACKGROUND

We analyzed the demographic, clinical, and diagnostic data of children and adolescents in Mexico, from the first case of coronavirus disease (COVID-19) to 28 February 2022.

METHODS

Using the open databases of the Ministry of Health and a tertiary pediatric hospital, we obtained demographic and clinical data from the beginning of the COVID-19 pandemic until 28 February 2022. In addition, quantitative reverse-transcription polymerase chain reaction outputs were used to determine the viral load, and structural protein-based serology was performed to evaluate IgG antibody levels.

RESULTS

Of the total 437,832 children and adolescents with COVID-19, 1187 died. Of these patients, 1349 were admitted to the Hospital Infantil de Mexico Federico Gómez, and 11 died. Obesity, asthma, and immunosuppression were the main comorbidities, and fever, cough, and headache were the main symptoms. In this population, many patients have a low viral load and IgG antibody levels.

CONCLUSION

During the first 2 years of the COVID-19 pandemic in Mexico, children and adolescents had low incidence and mortality. They are a heterogeneous population, but many patients had comorbidities such as obesity, asthma, and immunosuppression; symptoms such as fever, cough, and headache; and low viral load and IgG antibodies.