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A thread on U.S. #camps and #schools that experienced #COVID19 outbreaks since opening. I'll continually add to this thread as more are reported.

The total impact of the coronavirus pandemic—the loss of life and the economic, social, and psychological costs arising from both the pandemic itself and the policies implemented to prevent its spread—defy any characterization. Though the pandemic continues to unsettle, disrupt, and challenge communities, we might take a moment to appreciate and applaud the diversity, breadth, and scope of our responses—from individual actions to national policies—and even more important, to reflect on how they will produce a post–Covid-19 world far better than the world that preceded it. In this brief essay, I describe how our adaptive responses to the coronavirus will lead to beneficial policy innovations. I do so from the perspective of a many-model thinker.1New York: Basic Books, 2018More Info → By that I mean that I will use several formal models to theoretically elucidate the potential pathways to creating a better world. I offer this with the intent that it instills optimism that our current efforts to confront this tragic and difficult challenge will do more than combat the virus now and teach us how to combat future viruses. They will, in the long run, result in an enormous number of innovations in policy, business practices, and our daily lives.

We may have a vaccine in the next 12 months...And already we are seeing the rise of an anti-vaccination movement...' 'We in the public health community need to build public trust in the evidence.’ @RichardHorton1 of @TheLancet joined this morning's COVID-19 briefing 1/2

The COVID-19 pandemic has led many gov­ern­ments to implement lockdowns. While lockdowns may help to contain the spread of the virus, they may result in sub­stan­tial damage to pop­u­la­tion well-​being. We use Google Trends data to test whether the lockdowns im­ple­mented in Europe and America led to changes in well-​being related topic search terms. Using differences-​in-differences and a re­gres­sion dis­con­ti­nu­ity design to evaluate the causal effects of lockdown, we find a sub­stan­tial increase in the search intensity for boredom in Europe and the US. We also found a sig­nif­i­cant increase in searches for lone­li­ness, worry and sadness, while searches for stress, suicide and divorce on the contrary fell. Our results suggest that people’s mental health may have been severely affected by the lockdown.

In­no­va­tion and Com­mu­ni­ca­tion Media in Virtual Teams – An Ex­per­i­men­tal Study

In a novel real-​effort setting, we ex­per­i­men­tally study the effects of different com­mu­ni­ca­tion media on creative per­for­mance in a col­lab­o­ra­tive tasks. We find that creative per­for­mance sig­nif­i­cantly decreases when group members com­mu­ni­cate via chat instead of face-​to-face. However, we find no sig­nif­i­cant dif­fer­ence between per­for­mances of groups that com­mu­ni­cate via video con­fer­ences as compared to face-​to-face. Thus, we provide evidence that barriers to cre­ativ­ity in virtual teams can be mitigated by real-time video con­fer­ence com­mu­ni­ca­tion.

In­no­va­tion and Com­mu­ni­ca­tion Media in Virtual Teams – An Ex­per­i­men­tal Study

In public good provision and other col­lec­tive action problems, people are uncertain about how to balance self-​interest and proso­cial­ity. Actions of others may inform this decision. We conduct an ex­per­i­ment to test the effect of watching private citizens and public officials acting in ways that either increase or decrease the spread of the coro­n­avirus. For private role models, positive examples lead to a 34% increase in donations to the CDC Emergency Fund and a 20% increase in learning about COVID-19-related vol­un­teer­ing compared to negative examples. For public role models these effects are reversed. Negative examples lead to a 29% and 53% increase in donations and vol­un­teer­ing, re­spec­tively. Results are con­sis­tent with the Norm Ac­ti­va­tion Model: positive private role models lead to more prosocial behavior because they increase norms of trust, while negative public role models increase a sense of re­spon­si­bil­ity among in­di­vid­u­als which convinces them to act more proso­cially.

We examine the short-​term impact of COVID-19 on con­sump­tion spending and labor market outcomes. Using monthly panel data of in­di­vid­u­als mainly aged 50–70 in Singapore, we find that COVID-19 reduced con­sump­tion spending and labor market outcomes im­me­di­ately after its outbreak, and its negative impact quickly evolved. At its peak, the pandemic reduced total household con­sump­tion spending by 22.8% and labor income by 5.9% in April. Prob­a­bil­ity of full-time work also went down by 1.2 pp and 6.0 pp in April and May, re­spec­tively, but em­ploy­ment and self-​employment were only mildly affected. Our het­ero­gene­ity analysis indicates that the reduction in con­sump­tion spending was greater among those with higher net worth, while the decreases in labor market outcomes were greater among those with lower net worth. However, we find little evidence that those in worse health status ex­pe­ri­enced larger re­duc­tions in con­sump­tion spending and labor market outcomes. Re­duc­tions in con­sump­tion spending cor­re­lated with increased risk avoidance behavior, the na­tion­wide partial lockdown, worsening economic outlook, and reduced income.

Social dis­tanc­ing re­stric­tions and demand shifts from COVID-19 are expected to shutter many small busi­nesses, but there is very little early evidence on impacts. This paper provides the first analysis of impacts of the pandemic on the number of active small busi­nesses in the United States using na­tion­ally rep­re­sen­ta­tive data from the April 2020 CPS – the first month fully capturing early effects from the pandemic. The number of active business owners in the United States plummeted by 3.3 million or 22 percent over the crucial two-month window from February to April 2020. The drop in business owners was the largest on record, and losses were felt across nearly all in­dus­tries and even for in­cor­po­rated busi­nesses. African-​American busi­nesses were hit es­pe­cially hard ex­pe­ri­enc­ing a 41 percent drop. Latinx business owners fell by 32 percent, and Asian business owners dropped by 26 percent. Sim­u­la­tions indicate that industry com­po­si­tions partly placed these groups at a higher risk of losses. Immigrant business owners ex­pe­ri­enced sub­stan­tial losses of 36 percent. Female-​owned busi­nesses were also dis­pro­por­tion­ately hit by 25 percent. These findings of early-​stage losses to small busi­nesses have important policy im­pli­ca­tions and may portend longer-​term ram­i­fi­ca­tions for job losses and economic in­equal­ity.

and medical authority. Why am I – a public health doctor – so distressed by the mandatory masks policy?  And why are people telling me it would be brave to write about this? I’ve been wondering for a while why I feel so upset about it.  I’ve no health or disability exemptions, and can wear a mask with no more inconvenience than anyone else.  My menagerie of relatives and friends with deafness, cognitive difficulties or other exemptions is average.  Does it trigger memories of being mugged in the dark ?  Nice try, but I haven’t thought about that for years. 

5. New report @Mehganteherani @EmoryPediatrics @jpidsociety @Abxaware

2. Front page @sdut today, the San Diego experience to date by @PaulSisson @radychildrens ~30,000 kids tests, 3.4% positive (overall here 4.8%) Kids hospitalized 5.6%, Adults 8.3%; much less ICU (7 v 25%)

1. On the rise as proportion of total infections @sdutgraphics @theheroofthyme

Erik, as people inside and outside Sweden continue to grapple with what exactly the Swedish strategy might have been, there are two aspects that have seemed potentially troubling to me (and only more so in light of the FOI email releases): 1/21RepliesReconfigBehSci@SciBeh·18 Aug 2020Replying to @SciBeh and @ErikAngner2/2 1. mandatory schooling (where there exemptions for immune-compromised parents?) 2. encouraging household members of infected individuals to go to work/school Could you provide more background here and how you see these policies in the wider context?

Sneak peek: I’m doing a Reddit #AMA on Aug 27! I’m a total Reddit newbie. What do I need to know?

Social distancing measures following the outbreak of COVID-19 have led to a rapid shift to virtual and telephone care. Social workers and mental health providers in VA home-based primary care (HBPC) teams face challenges providing psychosocial support to their homebound, medically complex, socially isolated patient population who are high risk for poor health outcomes related to COVID-19. We developed and disseminated an 8-week telephone or virtual group intervention for front-line HBPC social workers and mental health providers to use with socially isolated, medically complex older adults. The intervention draws on skills from evidence-based psychotherapies for older adults including Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, and Problem-Solving Therapy. The manual was disseminated to VA HBPC clinicians and geriatrics providers across the United States in March 2020 for expeditious implementation. Eighteen HBPC teams and three VA Primary Care teams reported immediate delivery of a local virtual or telephone group using the manual. In this paper we describe the manual’s development and clinical recommendations for its application across geriatric care settings. Future evaluation will identify ways to meet longer-term social isolation and evolving mental health needs for this patient population as the pandemic continues.

Early viral load peak in the disease course indicates that preventing onward transmission requires immediate self-isolation with symptom onset (for a min of 5 days). Messages should prioritise isolation practices, and policies should include supported isolation. (24/n)

ur article is now published online. We argue that SARS-CoV-2 transmission dynamics should inform policy decisions about mitigation strategies for targeted interventions. https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1442/5910315

This thread is based on our new paper with @JuliaLMarcus Caroline Buckee and @aetiology Accepted in CID - preprint version can be accessed here: (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3692807…)

Public health strategies will be needed to mitigate transmission in nursing homes, prisons and jails, shelters, meat-packing plants such as personal protective equipment and routine testing to identify infected individuals early in the disease course. (28/n)

Avoid crowded indoor poorly ventilated environments. Spend more time outdoors. Maintain your distance (more is better but 2 metre is not a panacea). Improve ventilation: open windows/doors. Wear a mask indoors. Wash hands. (27/n) (https://vox.com/science-and-health/2020/5/22/21265180/cdc-coronavirus-surfaces-social-distancing-guidelines-covid-19-risks…)

Policymakers and health experts can help the public differentiate between lower-risk and higher-risk activities and environments and public health messages could convey a spectrum of risk to the public to support engagement in alternatives for safer interaction (26/n

There are many things that could be done within families to decrease transmission. We need to provide clear instructions, and means of support to enable those with symptoms/positive test and their contacts to isolate. (25/n) https://abc.net.au/news/2020-09-15/coronavirus-swept-through-jos-house.-heres-how-he-dodged-it/12660218

hese include social and income protection and support to ensure low paid, non-salaried and zero-hours contract workers can afford to follow isolation and quarantine recommendations, provision of protective equipment for workplaces and community settings. (23/n)

In summary: The disproportionate impact of COVID-19 on households living in poverty, and the racial and ethnic disparities observed in many countries, emphasize the need to urgently update our definition of "vulnerable" populations for COVID-19 & address these inequities. (22/n)

A real overlap in the causes of mortality and deprivation can be seen here. The age-standardised rate of deaths involving COVID-19 in the most deprived quintile was more than double (2.3 times higher) than in the least deprived quintile in Scotland. (21/n) https://nrscotland.gov.uk/files/statistics/covid19/covid-deaths-report-week-19.pdf

Covid-19 could now be endemic in some parts of England that combine severe deprivation, poor housing and large BAME communities, national lockdown in these parts of the north of England had little effect in reducing the level of infections (20/n) (https://theguardian.com/world/2020/sep/05/covid-19-could-be-endemic-in-deprived-parts-of-england//…)

Previous research suggests that although social distancing during the 2009 H1N1 pandemic was effective in reducing infections, this was most pronounced in households w greater socioeconomic advantage. Similar findings are emerging for COVID-19. (19/n) (https://pnas.org/content/117/33/19658//…)

n Madrid, 37 neighbourhoods are seeing the highest incidence, 4 x the Spanish average. Common factors: these areas are poorer, denser and have a high proportion of immigrant population. (18/n) (https://elpais.com/sociedad/2020-09-19/como-son-las-zonas-restringidas-en-madrid-mas-densas-con-mas-inmigrantes-y-sobre-todo-mas-pobres.html…)

PHE surveillance report shows that while the number of infections is increasing mainly in 20-29, 30-39 ages in England, SARS-CoV-2 is spreading most in highly deprived areas - where people are in poorly paid work and can't afford to isolate. (17/n) https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/919676/Weekly_COVID19_Surveillance_Report_week_38_FINAL_UPDATED.pdf

Households in socioeconomically deprived areas are more likely to be overcrowded, increasing the risk of transmission within the household. These disparities also shape the strong geographic heterogeneities observed in the burden of cases and deaths. (16/n)

People in lower-paid occupations are often classified as essential workers who must work outside the home and may travel to work on public transport. These occupations often involve greater social mixing, exposure risk due to prolonged working hours and job insecurity. (15/n)

Socioeconomic factors and racial/ethnic disparities: Global figures suggest that COVID-19 pandemic is strongly shaped by structural inequities, adverse living and working conditions and structural racism that drive household and occupational risks. (14/n)

The largest clusters of cases observed in the USA have all been associated with prisons or jails. In the largest meat packing plant in Germany, while the common point of potential contact was workplace, risk was higher for a single shared apartment, bedroom and carpool. (13/n)

Much worryingly the largest outbreaks from across the world are reported in long term care facilities such as nursing homes, homeless shelters, prisons, and meat-packing plants where many people spend several hours working, living together, and share communal spaces. (12/n)

Replying to @mugecevikThe largest clusters of cases observed in the USA have all been associated with prisons or jails. In the largest meat packing plant in Germany, while the common point of potential contact was workplace, risk was higher for a single shared apartment, bedroom and carpool. (13/n)

Much worryingly the largest outbreaks from across the world are reported in long term care facilities such as nursing homes, homeless shelters, prisons, and meat-packing plants where many people spend several hours working, living together, and share communal spaces. (12/n)

Prolonged indoor contact in a crowded and poorly ventilated environment increases the risk of transmission substantially. But decreasing occupancy and improving ventilation through opening windows/doors can lower the risk. (11/n)

While asymptomatic patients can transmit the virus to others, emerging evidence suggests that asymptomatic index cases transmit to fewer secondary cases. Attack rates are highly correlated with symptom severity (8/n) (https://medrxiv.org/content/10.1101/2020.09.01.20135194v1…) and (https://medrxiv.org/content/10.1101/2020.04.25.20079103v3…)

Prolonged indoor contact in a crowded and poorly ventilated environment increases the risk of transmission substantially. But decreasing occupancy and improving ventilation through opening windows/doors can lower the risk. (11/n)

Environment: Contact pattern also depends on the setting of the encounter. Contact tracing studies suggest an almost 20x higher risk of transmission indoors compared with outdoor environments. (10/n) (https://ft.com/content/2418ff87-1d41-41b5-b638-38f5164a2e94…)

Transmission is also affected by other host factors, including host defence mechanisms and age. For instance, given the same exposure, susceptibility to infection increases with age, higher in > 60yo compared to younger or middle-aged adults. (9/n) (https://medrxiv.org/content/10.1101/2020.07.19.20157362v2…)

When we look at the viral load dynamics & contact tracing studies, those who are infected are very infectious for a short window, likely 1-2 days before and 5 days following symptom onset. No transmission documented so far after the first week of symptom onset. (7/n)

Individual factors: Many ppl either do not infect anyone or infect a single person, and a large number of secondary cases are caused by a small # of infected ppl. Although this also is related to other factors, individual variation in infectiousness plays a major role.(6/n)

For non-household contacts, engaging in group activities such as dining together or board games have been found to be high risk for transmission. So, the risk increases with longer & frequent exposure, close proximity, # of contacts, and group activities especially dining (5/n)

Even in the same household being a spouse/partner, sleeping in the same room or sharing the same sleeping space, frequent daily contact with the index case, and dining in close proximity has been associated with increased risk of transmission. (4/n)

Contact pattern: We now know that sustained close contact drives the majority of infections and clusters. For instance, close family/friend contacts and gatherings are a higher risk for transmission than market shopping or brief community encounters. (3/n)

Over the last 6 months, we've learned a lot about how SARS-CoV-2 spreads What does the evidence so far tell us about SARS-CoV-2 transmission dynamics, high-risk activities and environments? Thread (1/n) https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3692807

More from @IAStartingLine

atest Iowa COVID case numbers, for context https://nytimes.com/interactive/2020/us/iowa-coronavirus-cases.html…

I'd say it's shocking that a sitting senator would be floating the (debunked) idea that COVID actually killed less than 10,000 people, but of course the president was retweeting it so I guess it's not so shocking after all.

owa COVID numbers are spiking. Jodi Ernst says she doesn't believe them, suggests doctors may be inflating figures to get higher reimbursement. Via @wcfcourier https://wcfcourier.com/news/local/ernst-in-rural-waterloo-says-senate-race-will-be-expensive-close/article_c29ee1b6-be44-5dc7-ab11-7261353cda39.html…