Tag: coronavirus

How to overcome COVID-19 vaccine hesitancy: Build confidence and establish trust


Countering misinformation, leaning on community leaders, using the proper terminology. USC experts explain why all this and more is needed to slow the spread of COVID-19.

By Leigh Hopper

LAC+USC Pharmacy Supervisor Kevin Weissman holds a vial of the Pfizer COVID-19 vaccine, Dec. 15, 2020. (Photo/Michael Owen Baker)

The COVID-19 pandemic has spiraled out of control as a more contagious version of the virus spreads, increasing the urgency to quickly vaccinate as many people as possible. Just this week, Los Angeles County and Orange County designated Dodger Stadium and Disneyland as vaccination supersites.

Yet polling over the last several months has shown that many Americans have safety concerns and don’t want the vaccine just yet. USC experts say that hesitancy can be overcome by normalizing the process surrounding the COVID-19 vaccine with straightforward information from trusted sources such as clinicians and pharmacists.

Lourdes Baezconde-Garbanati, a professor of preventive medicine and the associate dean for community initiatives at the Keck School of Medicine of USC, says mistrust and misinformation abound.

Among the false claims: vaccines cause infertility, vaccines give you COVID-19, vaccines alter your genetic makeup, vaccines are a ploy by the government to implant microchips to track people.

“We see a lot of concern about vaccines, fueled in part by an anti-vaccine movement that we happened to walk into with the COVID-19 pandemic,” she said.

“We’re seeing a trend where at first there was a high level of support for vaccines, but that started to diminish among the African American and Hispanic communities. Then we found health care providers were hesitant to get the vaccine.

“We see huge disparities in acceptance. Unless we get herd immunity with lots of people vaccinated, we’re not going to get this disease under control.”

To lessen hesitancy, bring the COVID-19 vaccine to the community

Tailoring the message to the audience, using simple information and making vaccination visible and accessible could go a long way toward creating buy-in, experts say.

“Converting Dodger Stadium from a testing center into a vaccine supersite, as L.A. is doing this week, makes COVID vaccination more visible in a positive way and helps normalize it — especially for a Black and Latino population that has historically been discriminated against in health care,” said April Thames, an associate professor of psychology and psychiatry at the USC Dornsife College of Letters, Arts and Sciences.

“Having a vaccination center in the heart of the community can open up lines of trust.”

Pharmacists are well-positioned to lead the way in vaccine encouragement — partly because many of them get to know their customers personally, says Vassilios Papadopoulos, dean of the USC School of Pharmacy.

“Pharmacists are the most-contacted health professionals for people with chronic conditions such as diabetes and hypertension — those at high risk for COVID-19,” he said. “At many independent community pharmacies, pharmacists know their patients well enough to be proactive in urging them to come in for a vaccination.

“The plan is to open dozens of additional vaccination sites, many of which will be retail pharmacies. Pharmacists are in a good place to lead COVID-19 vaccine encouragement efforts; 90% of the population lives within five miles of a pharmacy.”

Proper communication about COVID-19 vaccination is key, especially if the virus mutates

Using the wrong vocabulary can cause outreach efforts to misfire, says Wändi Bruine de Bruin, USC Dornsife Provost Professor of Public Policy, Psychology and Behavioral Science at the USC Price School of Public Policy.

In a 2008 study she conducted, she learned that parents seeking information about vaccination would search online using the word “shots.” The search results pointed them to anti-vaccine websites instead of the information from sources like the U.S. Centers for Disease Control and Prevention.

“Using a nationally representative survey that we’ve been doing every two weeks, we’ve been asking people since March 2020 how likely they are to get the coronavirus vaccine if it’s available. In March, 83% of our participants said they would get it. In December, that declined to 63%,” Bruine de Bruin said.

“That suggests we really need to get in place a good vaccine allocation and communication strategy to encourage people to get vaccinated.”

Recent news about the more contagious variant of the virus may cast doubt on the efficacy of the current vaccine — but those concerns aren’t warranted.

“The good news about our immune response to vaccines is that it’s multifaceted, creating antibodies, for example, that will recognize different parts of the virus spike protein,” said Paula Cannon, a Distinguished Professor of Molecular Microbiology and Immunology at the Keck School of Medicine and an expert in how viruses are transmitted and controlled.

“Even if the virus mutates and perhaps becomes resistant to one antibody, there will be others lining up to take its place. So far, very early lab experiments suggest that the new strains will be just as sensitive to the immunity created by these vaccines.”

IIGH hosts David Nabarro for lecture on COVID-19, climate change Sept. 21

The USC Institute on Inequalities in Global Health, in collaboration with the USC Presidential Working Group on Sustainability, is hosting a lecture Sept. 21 titled “Addressing the Dual Challenges of Climate Change and COVID-19.”

The featured speaker is David Nabarro, a World Health Organization Special Envoy on COVID-19 and co-director of the Institute of Global Health Innovation at Imperial College London. Nabarro served as United Nations Under Secretary-General for the 2030 Agenda for Sustainable Development and Climate Change, and he was co-chair of the forum on Climate Change and Health. 

The lecture kicks off with remarks from USC President Carol L. Folt. 

The event begins at 9 a.m. PDT. Click here for information and to RSVP, which is required.

Why COVID-19 vaccines need to prioritize ‘superspreaders’

Why COVID-19 vaccines need to prioritize ‘superspreaders’

How should COVID-19 vaccine be prioritized? AP Photo/Ted S. Warren, File
Dana Goldman, University of Southern California; David Conti, University of Southern California, and Matthew E. Kahn, Johns Hopkins University

Once safe and effective COVID-19 vaccines are available, tough choices will need to be made about who gets the first shots.

A committee of the National Academies of Sciences, Engineering, and Medicine – at the behest of the Centers for Disease Control and Prevention and National Institutes of Health – has proposed an equitable way to allocate the vaccine.

They recommend first responders and health care workers take top priority. Older adults in congregate living situations would also be part of a first vaccination phase, according to the plan.

We are faculty at Johns Hopkins University and the University of Southern California who have spent decades studying health economics and epidemiology. One of us is a member of the National Academy of Medicine.

Having seen firsthand the real risks of rapid, asymptomatic spread of COVID-19 among younger adults, we disagree with some of the recommendations. Asymptomatic spread is shutting down schools and universities nationwide and threatening surrounding communities.

We argue that this pandemic requires a different model for making vaccination choices. After taking care of essential workers, vaccinations should be given to the biggest transmitters of the virus – mostly the young – and only then to the most vulnerable.

Lessons from 2009 flu epidemic

The textbook vaccine model goes out the window when novel viruses emerge.

Some lessons can be drawn from the 2009 H1N1 flu epidemic, which killed an estimated 500,000 people around the world. In the U.S, President Barack Obama declared the spread a national emergency.

A vaccine was developed as early as the fall of 2009. However, only 16 million doses were initially available. The CDC was required to make some difficult decisions about allocation. Some states requested 10 times the amount they were allocated.

In the end, the CDC allocated the vaccine strictly in proportion to a state’s population – that is, on a per capita basis. States then allocated them, often with priority to infants and the elderly, along with people at high risk.

This priority – to protect the most frail – has been public policy since at least the 1957-1958 influenza pandemic.

Later studies, however, have shown that a better way to protect older people was to control spread among the young, which often has meant vaccinating school-age children early.

One of the lessons from these past pandemics is that vaccinating the likely asymptomatic spreaders early can avert multiple infections with others.

[You need to understand the coronavirus pandemic, and we can help. Read The Conversation’s newsletter.]

The superspreaders

The experience of the past few months has shown how important it is to check transmission with COVID-19. A recent study found that as few as 10% of those infected lead to 80% of the infection cases. What has made it more difficult is that up to 40% of those who carry the virus, often known as superspreaders, show no symptoms at all.

Very few of the COVID-19 superspreaders are elderly. It is the younger people who have a much greater propensity to resume social lives at schools and in other venues.

Among the young are a subset of highly social people with wide circles of friends who become the most fertile ground for the spread of COVID-19. These young people also have a much lower risk of death or even severe symptoms, which also means they are more likely to infect others.

Cases have been spiking in the 15- to 25-year-old age group, another likely sign that they are propelling the spread of the virus. A recent outbreak on the University of Southern California’s fraternity row infected at least 40 people.

Several universities cancelled in-person classes after a spike in cases. AP Photo/Gerry Broome

The American Academy of Pediatrics and the Children’s Hospital Association reports that at least 338,000 children have tested positive for the virus through July 30, with more than a quarter of that number having tested positive in just the last two weeks of that month.

More broadly, younger residents in the virus hot spot of Los Angeles County make up the majority of positive new cases. In California, young people between 18 to 34 years of age account for more than one-third of cases.

Young versus old

Anticipating that young people will engage in activities that spread the virus, many universities put their fall classes exclusively online. Some that decided to go in-person had to close after as little as a week on campus.

With or without a vaccine, the best strategy for older Americans, especially those with underlying medical conditions, is avoiding contact with potential carriers.

Optimally, older people will drive down deaths by staying home in large numbers, and younger people will drive down infections by getting vaccinated in even larger numbers. It all works if the vaccine is effective and enough people take it.

We predict the pressures and politics around prioritizing vaccine distribution will be intense. We argue that they key will be to take the most beneficial route, not the most obvious one. With a full-scale public health campaign behind it, that will mean prioritizing those who are driving transmission, not those who are most vulnerable.

As counterintuitive as such a strategy may appear, plenty of evidence shows this would be the right approach.The Conversation

Dana Goldman, Leonard D. Schaeffer Chair and Distinguished Professor of Public Policy, Pharmacy, and Economics, University of Southern California; David Conti, Professor of Preventive Medicine and Associate Director for Data Science Integration, University of Southern California, and Matthew E. Kahn, Bloomberg Distinguished Professor of Economics and Business, Director of JHU’s 21st Century Cities Initiative, Johns Hopkins University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Watch ‘The Intersection of Two Pandemics: COVID-19 and Addiction’

Adam Leventhal and Rosalie Liccardo Pacula

On Thursday at 1 p.m., join Adam Leventhal, PhD, Director of the USC Institute for Addiction Science, and Rosalie Liccardo Pacula, PhD, Senior Fellow at the USC Schaeffer Center, for a discussion, “The Intersection of Two Pandemics: COVID-19 and Addiction.”

Their guest will be the 16th Assistant Secretary for Health, Admiral Brett P. Giroir, MD.

“Individuals who suffer from addiction may be especially vulnerable to serious complications if they contract COVID-19. Furthermore, the pandemic has caused unprecedented levels of stress and other life disruptions, which may exacerbate substance use disorders and interfere with individuals’ recovery. Policymakers are addressing barriers to care that individuals with substance use disorder are facing through innovative and flexible healthcare practices and other services. Join this discussion about how public health officials can mitigate the devastating effects of two intertwined pandemics — COVID-19 and addiction.”

Admiral Brett P. Giroir

See the flyer for more information. And register for the event on Zoom here.

USC REACH Lab examines the impact of COVID-19 on physical activity and mental health

How has COVID-19 affected your daily life REACH Lab study

The Real-time Eating, Activity, and Children’s Health (REACH) Lab in the Department of Preventive Medicine at Keck School of Medicine of USC has launched a study into how COVID-19 is impacting physical activity and mental health in US adults. Investigators are gathering real-time data on physical activity and mental health before, during, and after the pandemic, by prompting participants to complete short, twice daily surveys via a smartphone app.

USC's REACH Lab is currently recruiting for a study on how physical activity and mental health is being affected by COVID-19.
USC’s REACH Lab is currently recruiting for a study on how physical activity and mental health are affected by COVID-19.

REACH Lab Director, Genevieve Dunton, PhD, MPH, says they hope to discover both the short-term and long-term effects of COVID-19 and response measures on physical activity and mental health.”With restrictions on travel, and limited or no access to gyms, parks and trails, peoples’ ability to engage in physical activity certainly has changed over the past month,” says Dunton. “We’re really interested in trying to understand that, and, even more so, how these changes in their physical activity patterns are related to their mental health now and in the future.”

By utilizing real-time data collection methods, the team has already identified some preliminary patterns in physical activity among study participants. “We do see some declines as we would hypothesize,” says Dunton, citing that participants reported a decrease in vigorous and moderate-intensity physical activity, as well as the number of days they are walking, when comparing February to April. Researchers will have to gather more data to determine if and how this trend continues long-term. “One of the biggest questions,” according to Dunton, “is whether these initial changes we see in peoples’ physical activity are going to persist, or are people able to adjust and find new ways to maintain their activity. Do new habits form, good or bad?”

Woman using smartphone or mobile phone
Photo courtesy Porapak Apichodilok.

Researchers will also be looking at how this physical activity data correlates with mental health. “Rates of depression and anxiety were already at all-time highs before the COVID-19 pandemic. Fear of contracting the disease, loss of employment, disruption to daily routines, and loneliness may exacerbate underlying mental health issues. Whether mental health concerns brought on by the pandemic abate or persist after six to twelve months is what we’re looking into,” says Dunton.    

Ultimately the answers REACH Lab uncovers could implicate lasting physical and mental health changes in the United States. “So, what’s going to happen in terms of long-term physical activity trajectories? Physical activity we’re very interested in, because it’s tied very closely to reduced risks in a number of chronic diseases, including diabetes, cancer and heart disease,” says Dunton. “Physical activity may actually turn out to be an important protective factor against COVID-19 infection and mortality. Therefore, there are many reasons to understand how to promote and maintain physical activity during this crisis.”

— by Carolyn Barnes

REACH Lab is focused on understanding physical activity, eating, and obesity risk in children and families by utilizing real-time data capture methods. If you are over the age of 18, speak and read English, use an Android or iOS smartphone, and are interested in this study, please visit: https://is.gd/reachlab

Social media fuels wave of coronavirus misinformation as users focus on popularity, not accuracy

man wears mask on subway
Misinformation and unfounded claims about COVID-19 have flooded social media sites as the new coronavirus has spread. Alain Jocard/AFP via Getty Images

Jon-Patrick Allem, University of Southern California

Over the past few weeks, misinformation about the new coronavirus pandemic has been spreading across social media at an alarming rate. One video that went viral claimed breathing hot air from a hair dryer could treat COVID-19. A Twitter post touted injecting vitamin C to the bloodstream to treat the viral disease. Other threads hyped unfounded claims that vaping organic oregano oil is effective against the virus, as is using colloidal silver.

The sheer number of false and sometimes dangerous claims is worrying, as is the way people are unintentionally spreading them in ever wider circles.

In the face of this previously unknown virus, millions of people have been turning to social media platforms in an attempt to stay informed about the latest developments and connected to friends and family. Twitter reported having about 12 million more daily users in the first three months of 2020 than in the last three of 2019. Facebook also has reported unprecedented surges in user activity.

What people see, follow, express and repost on social media platforms are all communications that I study as the director of the Social Media Analytics Lab at the Keck School of Medicine of USC. My lab’s goal is to harness publicly accessible data from Twitter, Instagram, Reddit, YouTube and others to better understand health-related attitudes and behaviors.

We have spotted some troubling trends as the coronavirus pandemic spreads.

Why do people perpetuate misinformation online?

Initial evidence suggests that many people are unintentionally sharing misinformation about COVID-19 because they fail to stop and think sufficiently about whether the content is accurate.

There are many reliable sources on social media, such as the Centers for Disease Control and Prevention and the World Health Organization, but most social media platforms aren’t designed to prioritize the best information: They’re designed to show content most likely to be engaged with first, whether accurate or not. Content that keeps users on the platform gets priority.

My team’s research suggests that people’s motivations for sharing might also be part of the problem. We have found that Twitter users tend to retweet to show approval, argue, gain attention and entertain. Truthfulness of a post or accuracy of a claim was not an identified motivation for retweeting. That means people might be paying more attention to whether a tweet is popular or exciting than whether its message is true.

Artificial intelligence isn’t stopping it

Social media companies have been promising to combat misinformation on their platforms. However, they are relying on artificial intelligence more than ever to moderate content as concerns about coronavirus keep human reviewers at home, where they don’t have the support necessary to review sensitive content safely. This approach increases the chances of mistakes, such as when accurate content is accidentally flagged or cases where problematic content is not quickly detected.

Until misinformation can be identified in close to real time on social media platforms, everyone needs to be careful about where they get their news about coronavirus. Fact-checking organizations are available to help debunk false claims. But they, too, are getting overwhelmed battling the flood of coronavirus misinformation.

Even when the leading social media companies have plans of action to flag, curb and remove misinformation across their platforms, problematic content will slip through the cracks, exposing social media users to potentially dangerous information.

Social policing can backfire

Another troubling trend is a form of social policing on social media platforms that may have unintended consequences.

It is nothing new for social media users to try to shame people they don’t agree with and condemn them on social media for violating perceived social norms. During the current pandemic, people on social media have shamed others for socializing and ignoring social distancing recommendations, such as posting images of college students in bars or on crowded beaches.

However, when social media users seek to persuade their followers to behave in accordance with existing norms, they need to be aware of how they do it and the subliminal messages they might be sending.

Posting, forwarding or lamenting over captured moments of people ignoring social distancing measures is not the most effective way to curb these behaviors. The reason is that the underlying message one could walk away with is that people are still being social. This impression could lead people to continue being social, negating the intended effect of such social policing.

Research has shown that public officials often try to mobilize action against disapproved conduct by depicting it as distressingly frequent. As a result, they install a counterproductive descriptive norm in the minds of their audiences. In the case of social distancing, examples abound, including posts of crowded parks or markets or churches or hiking trails or backyards.

Instead, social media users attempting to reduce such conduct should focus attention on approved behavior. This could materialize with posts of people from home abiding by social distancing measures without mentioning others who are ignoring them.

What’s being done right?

Social media can be a powerful tool for behavior change when used wisely.

Intensive care unit doctors on the frontlines are sharing coronavirus information on social media well. They provide useful information on ways to protect ourselves and our families from this disease. Other leading physician scientists are taking to social media to debunk rumors.

Communication campaigns from public health officials could also start reinforcing normative behaviors by recommending healthy activities that can reduce the boredom or loneliness of social distancing measures. Social sharing and social policing are going to continue. How the public engages on social media could make a difference.

The Conversation

-Jon-Patrick Allem

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coronavirus could hit homeless hard, and that could hit everyone hard

Michael Cousineau, University of Southern California

As the number of cases of COVID-19, the illness caused by the coronavirus, continues to grow, the nation is on edge. Doctors and scientists do not know what percentage of the general population has been infected and what percentage of the infected develops symptoms.

State and local governments and the federal public health system are deploying strategies to contain the spread of the virus and consider ways to mitigate the effects of the disease on vulnerable groups, the health care system and the economy.

But amid all the planning, and a growing sense of panic, the impact of the spread of COVID-19 among homeless people is not being widely discussed. It should, however, be of special concern to local officials.

I am a professor of preventive medicine and health policy at the Keck School of Medicine at the University of Southern California. USC is in Los Angeles, which has one of the largest homeless populations in the nation. I am concerned about how infectious disease could undermine our efforts to provide humane care to homeless people and assist them to get off the streets and into stable housing.

I am also deeply concerned about infection rates and mortality more generally among vulnerable populations.

Biti Arelong, a man experiencing homelessness, rests before the start of tai chi, near the Salt Lake City Public Library, in Salt Lake City. AP Photo/Rick Bowme

A vulnerable group, even when the economy is humming

Over half a million people are homeless in the U.S. Their living conditions and poor health may place them at higher risk for contracting the disease and dying from it, although as of this writing, there have been no reported cases among homeless people.

High rates of infectious diseases among people experiencing homelessness is hardly new. Since those of us who work with the homeless have been keeping data, we know that homeless people have a higher risk of tuberculosis, hepatitis, HIV and pneumonia. This should give government officials and health providers cause for concern that coronavirus may also spread among the homeless.

While it’s too early for specific studies, the conditions of homelessness may increase the risk of transmitting the coronavirus to homeless people and ultimately its spread to others in the community.

COVID-19 is a respiratory illness. People get it when an infected person sneezes or coughs, spreading droplets in the air that could be transmitted to others. The Centers for Disease Control and Prevention has recommended staying away from others who are sick, avoiding crowds and proper hand-washing. The agency also suggests that since the virus lives on surfaces for at least several hours, people should avoid touching surfaces that others may have touched.

These practices, however, are nearly impossible for those living on the streets who have no way to bathe or wash hands. Few encampments have portable toilets or sinks. People eat, sleep and congregate close to each other.

Those in shelters may fare a little better, if the shelter does frequent cleaning or provides access to bathrooms and hot water and hand sanitizers, which many do not. Even so, in many shelters, people sleep, eat and participate in activities in groups, which increases the risk of an exposed person transmitting the virus to those nearby.

In addition, many shelters are large spaces with cots or beds placed in close proximity. In the winter months, homeless people are often transported by bus to winter shelters. Both the buses and mass shelters are almost designed to spread airborne droplets putting guests and those whom work there at risk for transmission.

Those working in shelters may have limited training in prevention, or a way to identify and isolate an individual showing signs and symptoms of COVID-19.

Many homeless people who do not stay in shelters may sleep in train or bus stations, ride subways or buses or go the waiting room of a hospital emergency department for the evening. These are places where an exposed person could contaminate doors and bathroom fixtures, chairs or other objects, providing opportunities for spreading the infection to others.

Once exposed, homeless people may have mortality risk due to other health conditions they may already have, such as diabetes, hypertension, cardiovascular disease and increased age. Many people living on the street already have diminished health, have higher rates of chronic illnesses or have compromised immune systems, all of which are risk factors for developing a more serious manifestation of the coronavirus infection. Those who suffer from mental illness may have difficulty recognizing and responding to the threat of infection.

Homeless people have less access to health care providers who could otherwise order diagnostic testing and, if confirmed, isolate them from others in coordination with local health departments.

Without access, ill homeless people may be living on the streets and virtually unknown to the health care system and possibly exposing others to the virus. Homeless persons showing symptoms of COVID-19 may go to a crowded hospital emergency department, which even before coronavirus, is where many homeless people go to for health care services. But if the epidemic continues to spread, these facilities will become even more crowded, and wait times will increase potentially exposing more people to an infected individual who has come seeking care.

Too important to be ignored

Prudent action to contain the virus that targets this population makes sense, given the risk that this population poses for the spread of the virus and the impact on the health care system.

A few communities are just beginning to put in place efforts to help prevent the spread of the coronavirus among the homeless population. In Seattle, officials are distributing hygiene kits and provide tips and checklists on prevention to shelter operators. Many of these activities are core public health functions that any local and state government agencies should be doing routinely as a part of their core surveillance and health assurance efforts.

But most localities do not have the resources available for new and widespread screening among homeless people or ways to locate and respond to an outbreak unless patients present in the hospital emergency department.

Public health agencies at all levels of government have a role to play in mitigating the effects of coronavirus. If public health agencies from local governments to the CDC do not have capacity because of budget cuts or a lack of commitment, local jurisdictions will not have the tools necessary to reach out to those at risk that will be necessary to contain the virus and mitigate its effects on our most vulnerable groups.

— Michael Cousineau

Also contributing to this are Gary Blasi, Paul Gregerson, Michelle Levander and Fareed Dibazar.

This article is republished from The Conversation under a Creative Commons license. Read the original article.