My editorial comment - I think the most valuable solutions are not going to come from scientists, but rather from people experienced in implementation and the "public health slog." We have a set of tools that we know can help. How do we make them work more effectively? 7/8

Importantly, the work is difficult because of the missing social safety net. People have "tested positive because their jobs required them to be caregivers... Now we’re requiring them, in terms of solidarity, to flatten the curve, to stay home. But they... can’t get food." 6/8

A tracer needs "a long list of agencies supplying various services, and volunteers willing to run errands for people who can’t. Much of his day is spent finding someone to pick up a particular bag of groceries from a particular food pantry, or a nebulizer from a pharmacy." 5/8

Category 3: Care-resource coordinators help people solve problems that might prevent them from being able to isolate themselves - how to get food or find a place to stay. "Without helping people to isolate, you would never persuade them to do so." 4/8

Category 2: Contact tracers call each of these contacts, ask them to isolate, and then follow up frequently to make sure they were doing so and to check for any symptoms. The essential part of their job is to persuade the contacts to isolate at home. "Voluminous coaxing." 3/8

Twenty-two thousand people have applied to work with PIH, some "comically overqualified" for the job. Hires are divided into three job categories. Category 1: Case investigators quickly call people who have tested positive and interview them extensively about their contacts. 2/8

Partners in Health @PIH is used to working in the poorest regions of the poorest countries. Now they are leading Massachusetts' contact tracing. Their experiences remind us of the importance of "support" in test, trace, isolate, support. (A thread 1/8)

“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor”

The Corruption of Evidence Based Medicine — Killing for Profit

Reduced face-to-face contact among teenagers and their friends during the pandemic could have damaging long-term consequences, neuroscientists say.

Coronavirus social-contact curbs 'put adolescents at risk'

10.1016/S1473-3099(20)30483-7

Clinical research is necessary for an effective response to an emerging infectious disease outbreak. However, research efforts are often hastily organised and done using various research tools, with the result that pooling data across studies is challenging. In response to the needs of the rapidly evolving COVID-19 outbreak, the Clinical Characterisation and Management Working Group of the WHO Research and Development Blueprint programme, the International Forum for Acute Care Trialists, and the International Severe Acute Respiratory and Emerging Infections Consortium have developed a minimum set of common outcome measures for studies of COVID-19. This set includes three elements: a measure of viral burden (quantitative PCR or cycle threshold), a measure of patient survival (mortality at hospital discharge or at 60 days), and a measure of patient progression through the health-care system by use of the WHO Clinical Progression Scale, which reflects patient trajectory and resource use over the course of clinical illness. We urge investigators to include these key data elements in ongoing and future studies to expedite the pooling of data during this immediate threat, and to hone a tool for future needs.

A minimal common outcome measure set for COVID-19 clinical research

More than a dozen US states have seen a surge in coronavirus cases in recent weeks. Many of them, including Arizona, North Carolina, Oregon and Florida, are experiencing spikes in confirmed cases as they lift stay-at-home orders – so is reopening to blame? Yes, among other factors, say experts.

Coronavirus second waves emerge in several US states as they reopen

Much of the world is starting to open up again, with many countries easing or planning to ease coronavirus travel restrictions. But would-be travellers face a confusing, uncertain and fast-changing situation.

How can international travel resume during the coronavirus pandemic?

10.1016/S1473-3099(20)30460-6

The pandemic spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the cause of COVID-19, has placed lives and economies of many countries under unprecedented stress. Many countries have shut schools and workplaces and imposed physical distancing to reduce virus transmission, in an effort to prevent the number of COVID-19 cases from overwhelming health-care systems. Such measures, however, are not economically sustainable. Schools and workplaces will have to be reopened. An important challenge for returning to normality is the prevalence of asymptomatic infection and the question of whether such individuals could sustain community virus transmission.1Gandhi M Yokoe DS Havlir DV Asymptomatic transmission, the Achilles' heel of current strategies to control Covid-19.N Engl J Med. 2020; (published online April 24.)DOI:10.1056/NEJMe2009758Crossref Google Scholar As the health community debates and examines the epidemiological significance of asymptomatic individuals, such cases present unique opportunities to gain insight into COVID-19 pathogenesis.

Asymptomatic SARS-CoV-2 infection

The COVID-19 pandemic will end only when a sufficient number of people have become immune, thus preventing future outbreaks. Principally, so-called exit strategies differ on whether immunity is achieved through natural infections, or whether it is achieved through a vaccine. Countries across the world are scrambling to find an adequate exit strategy, with differential success.

Interactive exploration of COVID-19 exit strategies

After nearly 45,000 Covid deaths in England and Wales, we can see that people of different ages have been exposed to dramatically differing risks. Fatalities among school-children have been remarkably low. Taking women aged 30–34 as an example, around 1 in 70,000 died from Covid over the 9 peak weeks of the epidemic. Since over 80% of these had pre-existing medical conditions, we estimate that a healthy women in this age-group had less than a 1 in 350,000 risk of dying from Covid, around 1/4 of the normal risk of an accidental death over this period.Healthy children and young adults have been exposed to an extremely small risk during the peak of the epidemic, which would normally be deemed an acceptable part of life. Risks can be far higher for the elderly and those with pre-existing medical conditions.

What have been the fatal risks of Covid, particularly to children and younger adults?

10.7326/M20-3012

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly throughout the world since the first cases of coronavirus disease 2019 (COVID-19) were observed in December 2019 in Wuhan, China. It has been suspected that infected persons who remain asymptomatic play a significant role in the ongoing pandemic, but their relative number and effect have been uncertain. The authors sought to review and synthesize the available evidence on asymptomatic SARS-CoV-2 infection. Asymptomatic persons seem to account for approximately 40% to 45% of SARS-CoV-2 infections, and they can transmit the virus to others for an extended period, perhaps longer than 14 days. Asymptomatic infection may be associated with subclinical lung abnormalities, as detected by computed tomography. Because of the high risk for silent spread by asymptomatic persons, it is imperative that testing programs include those without symptoms. To supplement conventional diagnostic testing, which is constrained by capacity, cost, and its one-off nature, innovative tactics for public health surveillance, such as crowdsourcing digital wearable data and monitoring sewage sludge, might be helpful.

Prevalence of Asymptomatic SARS-CoV-2 Infection

In new guidance for mathematical modelers and public health officials, the US Centers for Disease Control and Prevention is estimating that about a third of coronavirus infections are asymptomatic.The CDC also says its "best estimate" is that 0.4% of people who show symptoms and have Covid-19 will die, and the agency estimates that 40% of coronavirus transmission is occurring before people feel sick.

CDC estimates that 35% of coronavirus patients don't have symptoms

31. Sort of. The problem is that IHME's model missed in the wrong direction for Handley's argument. It massively *underestimated* the number of US deaths, because it used a Farr's law approach to fitting the epidemic trajectory. (We'll come back to this.)

30. Handley then attacks the (original version of the) IHME model. He correctly notes that it performed very poorly, and questions its utility for prediction. I've said all of the same things at various times, so we should be in agreement on this much at least, right?

29. Handley goes on to drag Ferguson for other past predictions, without understanding how certainty ranges work. If Ferguson predicted 50 to 50,000 dead and in fact 117 died, you can complain that his range is broad but you can't complain that he was wrong.

28. But is this an overestimate? We've put controls into place, and we've had 117 thousand deaths in the US to date. At most about 5% of the population has been infected. Herd immunity will be at 50% or higher. Given that, Ferguson's estimate seems right on target.

27. Handley's attacks on Ferguson are the same old same old. Ferguson predicted 2.2M US deaths if the pandemic went through to herd immunity uncontrolled and 1.1M US deaths if it went through to herd immunity with controls in place. Handley sells this as an overestimate.

26. Fact 9 is misleading. It consists of an attack on Neil Ferguson's work at Imperial College, and on IHME's work at my own employer, the UW. I've been intensely critical of IHME's work myself, which adds an interesting twist here.

25. Handley's 8th fact is not wrong, to the best of my knowledge, but it may be a bit rhetorically misleading. We've reached other rather important milestones on the basis of "only theoretical modeling"—for example, detonating an atomic bomb, or landing humans on the moon.

24. Handley's 7th fact is perhaps not well phrased, but I largely concur. There's nothing magical about six feet of social distancing. It's a rough compromise between protection and feasibility. I'd rather see 12 or 18 feet when possible.

23. He cites the WHO: "Just today, the World Health Organization announced that masks should only be worn by healthy people if they are taking care of someone infected with COVID-19:" That recommendation is from MARCH. Here are the current WHO guidelines: https://who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks&publication=advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak

22. To back up this claim, Handley cites a paper about influenza, a very different disease than COVID19. (He claims it is hosted on the CDC's own website which is at best misleading; it is a paper published in Emerging Infectious Diseases, a journal hosted by the CDC.)

21. Handley's sixth claim is just bizarre and contradicts a huge swath of evidence published over the past weeks. One of the big surprises that epidemiologists have encountered during the pandemic is just how valuable masks appear to be in stemming the spread of this disease.

20. Other studies have also shown outdoor transmission, e.g. https://medrxiv.org/content/10.1101/2020.02.28.20029272v2… ( Still, I'm somewhat sympathetic to Handley here. While his claim is wrong, I agree that outdoor transmission may be rare—and efforts to shut down outdoor recreation may be excessive.)

19. But this very study in fact shows the opposite of what he claims. From the abstract of Handley's own source:

18. Handley's 5th fact is FALSE as well. He claims that COVID-19 does not spread outdoors, and picks a single study that he claims supports his assertion.

17. Finally, Handley's sole source for Fact 4 does not inspire a lot of confidence with statements like this:

16. We also know enough about the germ theory of disease to understand that longer times lead to higher probabilities of transmission simply because there are more opportunities, not because there's some threshold amount of time in the same place necessary to transmit.

15. Science works by establishing *mechanisms*, and we know a lot about mechanisms of COVID transmission. We know that respiratory droplets are important, and that spread can readily occur that way.

14. Community spread while shopping etc is much harder to track down via contact tracing methodology than spread among co-workers, family members, etc., because there is no easy way to figure out who was in the store at the same time and connect spread that way.

13. Handley's fourth "fact" confuses the absence of evidence for the evidence of absence. This is not based on emerging science in the sense of actual research papers; it's based on a single interview in Business Insider.

12. Here's a thread on what happened with the WHO's misleading statement:

11. That's not how science works. You can't pick and choose like that. There is overwhelming evidence that people without symptoms—particular but not exclusively those who are presymptomatic—can transmit COVID. Here's one review paper:

10. Handley's third claim is FALSE, and outrageously irresponsible. He cherry picks two sources of evidence: 1) A single study based on a single patient 2) A confusing claim that Dr. Van Kerkove of the WHO made in a press conference, and subsequently retracted.

9. Handley's second claim is that older people have higher risk than the average IFR and younger people have lower risk than the IFR. This is TRUE. Risk increases with age, and that's how averages work.

8. Meanwhile flu is often cited as having an infection fatality rate of 0.1%. This is tricky to know because flu fatality rates vary so much from strain to strain and because so many cases go undiagnosed, but overall this seems at least two-fold too high.

7. Best estimates range from 0.5% to 1.5%. Even the CDC's lowball estimates, which caused a scandal when released, ranged from a best case of 0.1% to a best-guess of 0.4% to a worst case of 0.8%. That's far higher than Handley asserts.

6. We've been over the COVID19 IFR thing so many times. Here's one of many threads about the issue:

5. The first claim is that the infection fatality rate (IFR) for COVID19 is between 0.07 and 0.20, in line with seasonal flu. This is FALSE, on both counts. IFR for COVID-19 is higher. IFR for flu is lower.

4. I don't know if I have the energy to go through his whole #COVID19 blog post, but let's at least give it a go. The post is organized around a series of "facts" that are more like cherry-picked claims. I'll address them in order.

3. That's a gentle way of saying that Handley is committed to the false claim that vaccines cause autism. The three other posts on his blog revolve around this claim. The first of them, for example, makes the false claim that aluminum in vaccines causes autism.

2. This one is from J. B. Handley, who co-founded Generation Rescue, the organization that morphed into Jenny McCarthy's Autism Organization. Handley has some...heterodox...ideas.

1. Another day, another blog post of #COVID19 misinformation making the rounds.

RT @MaartenvSmeden: Often more than 300 COVID-19 related scientific articles published *per day* Data from @evidencelive

RT @mrjamesob: An absolutely riveting report. Journalism of the very highest order. https://t.co/BxgW1tp1vq

Much of the U.S. has opted for the worst of both worlds: 1) allow enough “reopening” to seed super-spreading 2) but full economic activity can’t resume because people don’t feel safe

The goal of this Research Topic is to stimulate novel investigations and theoretical perspectives on how people are psychologically affected by and coping with the COVID-19 emergency. We intend for this article collection to be a discussion platform on how to help people cope with and adjust to the critical situation. Specific aims include reducing the risk of developing distress, improving well-being, as well as promoting preventive behaviors. Further, this Research Topic aims to offer governments and policymakers evidence-based strategies to improve public and clinical intervention systems. Finally, we aim to elucidate strategies to effectively manage mental health in the COVID-19 pandemic.

Coronavirus Disease (COVID-19): Psychological, Behavioral, Interpersonal Effects, and Clinical Implications for Health

Aims and Scope The British Journal of Health Psychology publishes original research on all aspects of psychology related to health, health-related behaviour and illness across the lifespan including: • experimental and clinical research on aetiology • management of acute and chronic illness • responses to ill-health • screening and medical procedures • psychosocial mediators of health-related behaviours • influence of emotion on health and health-related behaviours • psychosocial processes relevant to disease outcomes• health related behaviour change • psychological interventions in health and disease • emotional and behavioural responses to ill health, screening and medical procedures • psychological aspects of prevention It encourages submissions of papers reporting experimental, theoretical and applied studies using quantitative, qualitative and mixed-methods approaches. Research carried out at the individual, group and community levels is welcome. The journal also welcomes systematic reviews and meta-analyses. Submissions concerning clinical applications and interventions are particularly encouraged.

British Journal of Health Psychology

Aims and Scope The British Journal of Social Psychology publishes work from scholars based in all parts of the world, and manuscripts that present data on a wide range of populations inside and outside the UK. It publishes original papers in all areas of social psychology including: • social cognition• attitudes• group processes• social influence• intergroup relations• self and identity• nonverbal communication• social psychological aspects of personality, affect and emotion• language and discourse Submissions addressing these topics from a variety of approaches and methods, both quantitative and qualitative are welcomed. We publish papers of the following kinds: • empirical papers that address theoretical issues; • theoretical papers, including analyses of existing social psychological theories and presentations of theoretical innovations, extensions, or integrations; • review papers that provide an evaluation of work within a given area of social psychology and that present proposals for further research in that area; • methodological papers concerning issues that are particularly relevant to a wide range of social psychologists; • an invited agenda article as the first article in the first part of every volume. The editorial team aims to handle papers as efficiently as possible. In 2016, papers were triaged within less than a week, and the average turnaround time from receipt of the manuscript to first decision sent back to the authors was 47 days.

British Journal of Social and Clinical Psychology.

There have been claims that #COVID19 has acquired mutations leading to more transmissible strains. We formally tested whether this was the case using 15,000 #SARSCoV2 genomes from all over the world:... and the answer is no, not at all!

Prof Francois Balloux

To facilitate the dissemination of findings on psychologically relevant aspects of the COVID-19 crisis, the Association for Psychological Science and SAGE publications have joined together to fast-track the publication of articles in Psychological Science that deal with COVID-19. As always, Psychological Science welcomes the submission of papers presenting original research, theory, or applications on mind, brain, or behavior. Preference is given to papers that make a new and notable contribution—an idea, a discovery, a connection—to psychological science, broadly interpreted, and that are written to be relevant for and intelligible to a wide range of readers. These standards will not change. What is new in response to the crisis is that Psychological Science makes the commitment to expedite the peer review process for COVID-19 related submissions. As well, pre-copyedited manuscripts will be posted on SAGE’s site immediately upon acceptance and then will be replaced with the final version once it is ready. By taking these steps, APS and Psychological Science will speed dissemination of information that will help us deal with this unprecedented crisis. Best wishes for good health.

Fast-Tracking COVID-19 Submissions

10.1038/s41562-020-0879-9

There is no business-as-usual during this uniquely challenging time. Here is what we are doing to help the scientific community both in providing much needed evidence to guide policy and in managing the personal impacts of the pandemic on individual researchers.

Science in the time of COVID-19

The COVID-19 pandemic is having many life-altering short- and likely long-term effects. There are many potential applications of psychological theory, practice, and research that can contribute to the public good at this time of national and international crisis. American Psychologist invites papers related directly to the pandemic. As for all American Psychologist manuscripts, we seek high-impact papers of broad interest covering science, practice, education, or policy. Manuscripts should be written in a style that is accessible to all psychologists and the public. For manuscripts that appear to be a good fit, we will follow our usual procedures and conduct a quick initial review of submissions to assure a fit with the type of articles published in this journal. Please note that American Psychologist does not publish independent commentaries (other than comments on recently published articles in the journal). Those manuscripts selected for further consideration will be peer reviewed and fast-tracked for publication if accepted. We will strive to provide editorial decision letters within one week of completed submission. Authors will be expected to revise manuscripts promptly. Accepted articles will be posted online within a short time frame and prioritized for publication. Manuscripts will be considered as they are received independently, not for a special issue. Authors should follow the American Psychologist manuscript submission guidelines and submit to the manuscript submission portal, selecting as article type "COVID-19". We ask that you indicate prominently in your cover letter that your manuscript is related to the COVID-19 pandemic. Submissions for this call will be received through August 31, 2020.

Call for Papers: COVID-19 Pandemic

One important response to the pandemic has been social distancing, that is, asking people to keep a minimum safe distance from others not in their household. How can you encourage individuals to keep the recommended minimal distance to others?

How can you encourage individuals to keep the recommended minimal distance to others?

A pressing, non-health, question for policy-makers is how far behavioural changes during the lock-down period "stick." Specifically:What types of behaviours will stick and which might even re-bound. For example, which individuals/business will shift permanently to greater use of video conferencing? Will people remain averse to air travel? Public spaces, transport? Large gatherings? And for how long?How much does the length of the lockdown effect the "stickiness" of new behaviours?Lots of basic psychology relevant here - but also what do we know about relevant real-world cases?

"Stickiness" and behavioural change - what do we know about the importance of time?

Yes, to be maximally effective we should, as behavioural scientists be addressing either policy relevant questions, or be conducting research that will directly inform policy relevant questions.This poses a challenge for scientists not directly engaged in the policy process. However, I think there are a couple of additional considerations beyond what you list that might be in play for COVID-19. One is that the pandemic is global, but countries are going through it on different time tables. So even if we are interested primarily in the policy of our own country we can potentially look ahead, using resources such as the INGSA policy tracker (ingsa.org) to see what is coming.Second, our role as behavioural scientists might actually most effective at spotting issues, not providing answers (see here and here for discussion), that is, considering policy options and trying to identify problems/issues they might raise (a bit like here or here). Scibeh.org is about to launch a process involving these reddits that tries to make that a bit more systematic!

What research is policy-relevant? (And how to make it so?)

INGSA provides the forum for policy makers, practitioners, national academies, scientific societies, and researchers to share experience, build capacities, and develop theoretical and practical approaches to the use of scientific evidence in informing policy at all levels of government.

INGSA

How can I promote my class without pestering my friends? This is not a small problem to me. #ethicalmarketing So, as my wise German friends say "Geklagtes Leid ist halbes Leid" (a problem shared is a problem halved) let me share a #sketchnote mapping where I am and what I have.

10.31234/osf.io/hyd57

Objective: Social distancing has been one of the primary interventions used to slow the spread of COVID-19. State-wide stay-at-home orders received a large degree of attention as a public health intervention to increase social distancing, but relatively little peer-reviewed research has examined the extent to which stay-at-home orders affected people’s behavior. Method: This study used GPS-derived movement from 2,858 counties in the United States from March 1 to May 7, 2020 to test the degree to which changes in state-level stay-at-home orders were associated with movement outside the home. Results: From the first week of March to the first week of April, people in counties within states that enacted stay-at-home orders decreased their movement significantly more than people in counties within states that did not enact state-level stay-at-home orders. From the first week of April to the first week of May, people in counties within states that ended their stay-at-home orders increased their movement significantly more than people in counties within states whose stay-at-home orders remained in place. The magnitude of change in movement associated with state-level stay-at-home orders was many times smaller than the total change in movement across all counties over the same periods of time in both cases. Conclusions: Stay-at-home orders are likely insufficient to reduce people’s movement outside the home without additional public health actions. Existing research on behavior change would be useful to determine what additional interventions could support social distancing behaviors during the COVID-19 pandemic if becomes necessary to reduce movement in the future.

State-level Stay-at-home Orders and Objectively Measured Movement in the United States During the COVID-19 Pandemic

If anyone has any good training resources for sci comm, feel free to share them below. We could all benefit!

A general comment about science communications. Scientists are rarely trained to talk to the public. It’s hard to explain complicated concepts simply. It’s easier to retreat to our familiar technical language.

The spread of COVID-19 in the U.S. passed an inflection point in the last 2 weeks. The number of articles published about the global pandemic went from hundreds a day to a weekday average of roughly 1,400 articles. Spending endless hours reading COVID-19 updates quickly loses its marginal utility and can drive our underlying levels of anxiety, so knowing where to go for the best coverage is essential. Early on in the crisis, we looked at which outlets had the most credible stories; this week, we wanted to see which specific journalists you can rely on for credible, timely information—real updates on the global pandemic that actually matter. 

The Most Credible Journalists on COVID-19