Influenza and Other Respiratory Viruses: Knowledge brokering on infectious diseases for public health

The National Collaborating Centres (NCCs) for Public Health (NCCPH) were established in 2005 as part of the federal government’s commitment to renew and strengthen public health following the severe acute respiratory syndrome (SARS) epidemic. They were set up to support knowledge translation for more timely use of scientific research and other knowledges in public health practice, programs and policies in Canada. Six centres comprise the NCCPH, including the National Collaborating Centre for Infectious Diseases (NCCID). The NCCID works with public health practitioners to find, understand and use research and evidence on infectious diseases and related determinants of health. The NCCID has a mandate to forge connections between those who generate and those who use infectious diseases knowledge.As the first article in a series on the NCCPH, we describe our role in knowledge brokering and the numerous methods and products that we have developed. In addition, we illustrate how NCCID has been able to work with public health to generate and share knowledge during the coronavirus disease 2019 (COVID-19) pandemic.     

Parada Cardiorrespiratória Extra-Hospitalar durante a Pandemia da Doença por Coronavírus 2019 (COVID-19) no Brasil: A Mortalidade Oculta

The world changed in just a few months after the emergence of the novel coronavirus disease 2019 (COVID-19), caused by a beta coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Brazil currently has the world’s second-highest COVID-19 death toll, second only to the USA. The COVID-19 pandemic is spreading fast in the world with more than 181 countries affected. This editorial refers to the article published in Arquivos Brasileiros de Cardiologia: “Increase in home deaths due to cardiorespiratory arrest in times of COVID-19 pandemic.”¹ Their main results show a gradual increase in the rate of out-of-hospital cardiac arrest during the Coronavirus disease 2019 (COVID-19) pandemic in the city of Belo Horizonte, Minas Gerais, Brazil. Their data demonstrate a proportional increase of 33% of home deaths in March 2020 compared to previous periods. Their study is the first Brazilian paper to demonstrate the same trend observed in other countries.     

COVID-19疫苗保护效力及挑战

由严重急性呼吸综合征冠状病毒-2(SARS-CoV-2)感染引起的2019冠状病毒病(COVID-19)为全球流行病,安全、有效的疫苗接种对结束COVID-19流行至关重要。随机临床试验被认为是评价疫苗干预效果的“金标准”,但也存在明显局限性。随着全球大规模人群接种COVID-19疫苗,需要在非受控条件下跨越不同人群对疫苗保护效力进行评估。同时SARS-CoV-2变异株不断出现,变异病毒可能逃逸现有疫苗免疫保护。因此,COVID-19疫苗面临诸多挑战, 如疫苗对特殊人群的免疫原性、有效性和安全性,疫苗效力持久性,病毒变异与突破感染,抗体依赖增强效应及致病性自身免疫等。本文对目前已发表文献进行综述,这对疫情防控具有重要参考价值。     

Brief Report: Effect of “finite pool of worry” and COVID-19 on UK climate change perceptions

Research reveals that a “finite pool of worry” constrains concern about and action on climate change. Nevertheless, a longitudinal panel survey of 1,858 UK residents, surveyed in April 2019 and June 2020, reveals little evidence for diminishing climate change concern during the COVID-19 pandemic. Further, the sample identifies climate change as a bigger threat than COVID-19. The findings suggest climate change has become an intransigent concern within UK public consciousness.     

Changes in healthcare workers’ knowledge,attitudes, practices,and stress during the COVID-19 pandemic

Coronavirus disease 2019 (COVID-19) has caused an unprecedented health crisis around the world, not least because of its heterogeneous clinical presentation and course. The new information on the pandemic emerging daily has made it challenging for healthcare workers (HCWs) to stay current with the latest knowledge, which could influence their attitudes and practices during patient care.This study is a follow-up evaluation of changes in HCWs’ knowledge, attitudes, and practices as well as anxiety levels regarding COVID-19 since the beginning of the pandemic. Data were collected through an anonymous, predesigned, self-administered questionnaire that was sent online to HCWs in Saudi Arabia.The questionnaire was sent to 1500 HCWs, with a 63.8% response rate (N = 957). The majority of respondents were female (83%), and the most common age group was 31 to 40 years (52.2%). Nurses constituted 86.3% of the respondents. HCWs reported higher anxiety during the COVID-19 pandemic which increased from 4.91 ± 2.84 to 8.6 ± 2.27 on an 11-point Likert scale compared to other viral outbreaks. HCWs believed that their own preparedness as well as that of their hospital''s intensive care unit or emergency room was higher during the COVID-19 pandemic than during the Middle East respiratory syndrome coronavirus pandemic (2012–2015). About 58% of HCWs attended one or more simulations concerning the management of COVID-19 patients in their intensive care unit/emergency room, and nearly all had undergone N95 mask fit testing. The mean score of HCWs’ knowledge of COVID-19 was 9.89/12. For most respondents (94.6%), the perception of being at increased risk of infection was the main cause of anxiety related to COVID-19; the mean score of anxiety over COVID-19 increased from 4.91 ± 2.84 before to 8.6 ± 2.27 during the pandemic in Saudi Arabia.HCWs’ anxiety levels regarding COVID-19 have increased since a pandemic was declared. It is vital that healthcare facilities provide more emotional and psychological support for all HCWs.     

COVID-19 and Peripheral Artery Thrombosis: A Mini Review

For more than 2 years, health care systems have been floundering in a massive crisis of coronavirus disease 2019 (COVID-19) pandemic. While acute respiratory distress syndrome is the main complication in patients with COVID-19, as the pandemic continues, more data about the nonrespiratory effects of the coronavirus is obtained, including developing Coagulopathy-related manifestations, in the form of venous and arterial thromboembolism. Although arterial thrombosis a rare complication of this disease, it proves to be an effective factor in the mortality and morbidity of COVID-19 patients. The pathophysiology of thrombosis reveals a complex relation between hemostasis and immune system that can be disrupted by COVID-19. Thrombectomy, anticoagulant therapy, and thrombolysis are the main treatments in these patients. In addition, appropriate thromboprophylaxis treatment should be considered in COVID-19 patients. In this article, we have successfully reviewed the arterial thrombotic events in patients reported around the world, including the diagnostic and management method of choice.     

Novel and Evolving Therapies for COVID-19 Related Pulmonary Complications,

Coronaviruses disease 2019 (COVID-19) is the most crucial threat, the world has ever witnessed. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of this disease pandemic. The World Health Organization has confirmed the continuing epidemic as a worldwide public health crisis. Presently, the research on COVID-19 is even in the primitive stage. Studies on unveiling the natural route of COVID-19 infection and related pathophysiology, the biology of pulmonary airways pose a more rational restorative approach in the management of COVID-19. Thus, based on the existing facts, we methodically reviewed the efforts put forth by various research institutes, pharmaceutical companies and biotechnology firms in pulmonary delivery to prevent and control the COVID-19. This article would be valuable for the healthcare community, which is efficiently dealing with the SARS-CoV-2 crisis.     

COVID-19: A year later: COVID-19 outbreak in a personal service setting in Kingston,Ontario, 2020

BackgroundDuring the coronavirus disease 2019 (COVID-19) pandemic, Ontario created a three-phase reopening framework for the economy. Outbreaks were expected at each phase. One week after Phase Two of reopening in the provincial public health administration region of Kingston, Frontenac, Lennox and Addington (KFL&A), a positive case was reported after three weeks of zero new COVID-19 cases. The objective of this report is to describe this COVID-19 outbreak, linked to a personal service setting (PSS), and the public health response to contain the outbreak.MethodsThe outbreak investigation included all COVID-19 cases in KFL&A between June 20, 2020 and July 3, 2020. Public health inspectors and nurses were rapidly deployed to inspect the PSS. A multimodal approach to high-volume testing involved fixed assessment centres, drive-through testing capacity and targeted testing at the outbreak site. Testing was conducted through a real-time polymerase chain reaction assay at the local Public Health Ontario laboratory.ResultsThirty-seven cases were associated with the outbreak: 38% through direct PSS exposure; 32% through household contact; and 30% through social and workplace contact. A superspreading event contributed to 38% of total cases. The majority of cases were in the low to mid-quintiles when analyzed for material deprivation. Testing rates increased four-fold compared to the prior baseline weeks in response to media attention and public health messaging, resulting in a low percent positivity.ConclusionThe interplay of aggressive accessible testing, quick lab turnaround time, contact tracing within 24 hours of positive laboratory results as per provincial standards, frequent public communication, rapid inspections, mandatory self-isolation and face coverings were measures successful in halting the outbreak. Inspections or self-audits should be required at all PSSs prior to reopening and outbreak management must work with PSSs to reduce the possibility of superspreading events.     

The impact of COVID-19 on mentoring early-career investigators: “Everything can wait. Listen more than usual and share your own struggles”

The COVID-19 pandemic disrupted almost all sectors of academic training and research, but the impact on human immunodeficiency virus (HIV) research mentoring has yet to be documented. We present the perspectives of diverse, experienced mentors in a range of HIV research disciplines on the impact of COVID-19 on mentoring the next generation of HIV researchers.In November to December, 2020, we used an online data collection platform to cross-sectionally query previously-trained HIV mentors on the challenges related to mentoring during the pandemic, surprising/positive aspects of mentoring in that context, and recommendations for other mentors. Data were coded and analyzed following a thematic analysis approach.Respondents (180 of 225 mentors invited [80% response]) reported challenges related to relationship building/maintenance, disruptions in mentees’ training and research progress, and mentee and mentor distress, with particular concerns regarding mentees who are parents or from underrepresented minority backgrounds. Positive/surprising aspects included logistical ease of remote mentoring, the relationship-edifying result of the shared pandemic experience, mentee resilience and gratitude, and increased enjoyment of mentoring. Recommendations included practical tips, encouragement for patience and persistence, and prioritizing supporting mentees’ and one''s own mental well-being.Findings revealed gaps in HIV mentors’ competencies, including the effective use of remote mentoring tools, how to work with mentees in times of distress, and the prioritization of mentor well-being. Mentors are in a unique position to identify and potentially address factors that may lead to mentees leaving their fields, especially parents and those from underrepresented backgrounds. We discuss implications beyond the COVID-19 pandemic.     

Reverse quarantine and COVID-19

BackgroundCOVID-19 is a pandemic, resulting in large number of deaths all over the world. Lack of effective antiviral agents and vaccines pose a major challenge to control this pandemic.MethodsReview the role of reverse quarantine in the control of COVID-19.ResultsPublic health measures like social distancing, wearing face mask and hand hygiene along with quarantine measures form important steps to control the disease. Reverses quarantine is a useful strategy to reduce morbidity and mortality associated with COVID-19.ConclusionsReverse quarantine is a promising public health measure to reduce the morbidity and mortality associated with COVID-19.     

Neutralizing Antibody Therapeutics for COVID-19

The emergence of SARS-CoV-2 and subsequent COVID-19 pandemic has resulted in a significant global public health burden, leading to an urgent need for effective therapeutic strategies. In this article, we review the role of SARS-CoV-2 neutralizing antibodies (nAbs) in the clinical management of COVID-19 and provide an overview of recent randomized controlled trial data evaluating nAbs in the ambulatory, hospitalized and prophylaxis settings. Two nAb cocktails (casirivimab/imdevimab and bamlanivimab/etesevimab) and one nAb monotherapy (bamlanivimab) have been granted Emergency Use Authorization by the US Food and Drug Administration for the treatment of ambulatory patients who have a high risk of progressing to severe disease, and the European Medicines Agency has similarly recommended both cocktails and bamlanivimab monotherapy for use in COVID-19 patients who do not require supplemental oxygen and who are at high risk of progressing to severe COVID-19. Efficacy of nAbs in hospitalized patients with COVID-19 has been varied, potentially highlighting the challenges of antiviral treatment in patients who have already progressed to severe disease. However, early data suggest a promising prophylactic role for nAbs in providing effective COVID-19 protection. We also review the risk of treatment-emergent antiviral resistant “escape” mutants and strategies to minimize their occurrence, discuss the susceptibility of newly emerging SARS-COV-2 variants to nAbs, as well as explore administration challenges and ways to improve patient access.     

No Populations Left Behind: Vaccine Hesitancy and Equitable Diffusion of Effective COVID-19 Vaccines

Racial/ethnic minority communities are experiencing an undue burden from coronavirus disease 2019 (COVID-19), and the availability of Food and Drug Administration (FDA) authorized vaccines is critical for improving population health. National surveys assessing vaccination willingness and reports of vaccination administration by race/ethnicity indicate at least two areas that warrant attention: elevated vaccine hesitancy among African American and Latino adults, and the need to ensure equitable access to vaccination. COVID-19 vaccine hesitancy is not uniform within racial/ethnic minority populations; yet, given the disproportionate impact, understandable distrust, and widespread misinformation, there is an imperative to overcome challenges associated with vaccination willingness and uptake, as well as implementation and access. This Perspective discusses the complexity of drivers for each of these areas, which include individual, community, and structural factors. It also highlights two initiatives at the National Institutes of Health. One is focused on addressing misinformation and distrust through academic-community partnerships, and the other on community-engaged behavioral interventions to address the population-specific reasons for COVID-19 vaccine hesitancy, support informed decision-making, and promote equitable access among populations with health disparities. For the foreseeable future, proactive and persistent efforts around COVID-19 mitigation strategies, including vaccination, will remain of paramount importance for health equity.KEY WORDS: Vaccine, vaccine hesitancy, COVID-19, Severe acute respiratory syndrome coronavirus 2, racial and ethnic disparities, African Americans, Latinos

The coronavirus disease 2019 (COVID-19) pandemic has exacerbated long-standing health disparities, as racial/ethnic minority populations have an undue burden in rates of infection, hospitalizations, and mortality.¹ In December 2020, two vaccines were granted Food and Drug Administration (FDA) emergency use authorization (EUA) and a third vaccine was recently granted EUA. If ongoing trials are successful in obtaining EUAs, additional vaccines will be available within months. While many individuals have been waiting with bated breath for the availability of a safe and effective vaccine as a primary mechanism to end the pandemic, there are at least two significant areas that warrant attention. First, not everyone shares this elation—and vaccine hesitancy or suboptimal public willingness to accept the vaccine(s) among underserved populations may limit uptake even with widespread availability. Second, ensuring equitable access to COVID-19 vaccines is needed to end the pandemic and to provide much needed relief, particularly among populations affected disproportionately.     

COVID-19: A year later: Rapid disappearance of influenza following the implementation of COVID-19 mitigation measures in Hamilton,Ontario

BackgroundPublic health measures, such as physical distancing and closure of schools and non-essential services, were rapidly implemented in Canada to interrupt the spread of the coronavirus disease 2019 (COVID-19). We sought to investigate the impact of mitigation measures during the spring wave of COVID-19 on the incidence of other laboratory-confirmed respiratory viruses in Hamilton, Ontario.MethodsAll nasopharyngeal swab specimens (n=57,503) submitted for routine respiratory virus testing at a regional laboratory serving all acute-care hospitals in Hamilton between January 2010 and June 2020 were reviewed. Testing for influenza A and B, respiratory syncytial virus, human metapneumovirus, parainfluenza I–III, adenovirus, and rhinovirus/enterovirus was done routinely using a laboratory-developed polymerase chain reaction multiplex respiratory viral panel. A Bayesian linear regression model was used to determine the trend of positivity rates of all influenza samples for the first 26 weeks of each year from 2010 to 2019. The mean positivity rate of Bayesian inference was compared with the weekly reported positivity rate of influenza samples in 2020.ResultsThe positivity rate of influenza in 2020 diminished sharply following the population-wide implementation of COVID-19 interventions. Weeks 12–26 reported 0% positivity for influenza, with the exception of 0.1% reported in week 13.ConclusionPublic health measures implemented during the COVID-19 pandemic were associated with a reduced incidence of other respiratory viruses and should be considered to mitigate severe seasonal influenza and other respiratory virus pandemics.     

COVID-19, chronic inflammatory rheumatic disease and anti-rheumatic treatments

Clinical Rheumatology - Since December 2019, the pandemic caused by coronavirus disease 2019 (COVID-19) raises a real public health problem. COVID-19 appeared in Wuhan (Hubei province) in China....     

The Virtual Hospitalist: a Critical Innovation During the COVID-19 Crisis

A virtual hospitalist program expanded our ability to confront the challenges of the COVID-19 crisis at the epicenter of the pandemic in New York City. In concert with on-site hospitalists and redeployed physicians, virtual hospitalists aimed to expand capacity while maintaining high-quality care and communication. The program addressed multiple challenges created by our first COVID-19 surge: high patient census and acuity; limitations of and due to personal protective equipment; increased communication needs due to visitor restrictions and the uncertain nature of the novel disease, and limitations to in-person work for some physicians. The program created a mechanism to train and support new hospitalists and provide and expand palliative care services. We describe how our virtual hospitalist program operated during our COVID-19 surge in April and May 2020 and reflect on potential roles of virtual hospitalists after the COVID-19 crisis passes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-021-06675-y.KEY WORDS: COVID, telemedicine, hospitalist     

Novel coronavirus pneumonia (COVID-19) combined with Chinese and Western medicine based on ”Internal and External Relieving -Truncated Torsion” strategy

Introduction:The outbreak of novel coronavirus disease 2019 (COVID-19) has caused a global pandemic since December 2020. It has not only associated with physiological disorder but also with psychological distress and symptoms of mental illness. Whether the vaccines and antivirals can provide protects remains unknown. Traditional Chinese medicine (TCM) is recommended as an alternative and significant way of preventing and treating COVID-19 in China. However, few studies have assessed the benefits of this treatment and mental health after they recover. Our study is designed to investigate effects and safety when using TCM on the course of this disease and the impact of COVID-19 on pandemic-related anxiety.Method:For this prospective cohort study, we will enroll 300 COVID-19 patients aged 18 to 80 years at 4 centers. We divide them into 2 groups, according to whether they use Baidu Jieduan Granule at a ratio of 1:1. We will compare treatments combined Baidu Jieduan Granule with conventional Western medicine (experimental group) vs treatment of conventional Western medicine only (control group). The basic information of patients including demographic, general condition, primary diseases, and complications will be assessed. Related examines will be conducted at 1, 3, 5, 7, and 14 days. The primary outcomes are clinical outcome. A follow-up time of 1 year (to June 30, 2021) allow us to evaluate the psychiatric disorder after recovery. We will monitor adverse events throughout the trial.Discussion:It will be the first prospective cohort study which uses Baidu Jieduan Granule, based on the innovation traditional Chinese medicine strategy of “ Internal and External Relieving -Truncated Torsion ” to treat the common type of COVID-19. The result of this study may provide evidence-based recommendations of TCM for treatment and psychological distress or symptoms of mental illness of the common type of COVID-19.     

A retrospective analysis of 12,400 SARS-CoV-2 RNA tests in patients with COVID-19 in Wuhan

The outbreak and widely spread of coronavirus disease 2019 (COVID-19) has become a global public health concern. COVID-19 has caused an unprecedented and profound impact on the whole world, and the prevention and control of COVID-19 is a global public health challenge remains to be solved. The retrospective analysis of the large scale tests of SARS-CoV-2 RNA may indicate some important information of this pandemic. We selected 12400 SARS-CoV-2 tests detected in Wuhan in the first semester of 2020 and made a systematic analysis of them, in order to find some beneficial clue for the consistent prevention and control of COVID-19.SARS-CoV-2 RNA was detected in suspected COVID-19 patients with real-time fluorescence quantitative PCR (RT-qPCR). The patients’ features including gender, age, type of specimen, source of patients, and the dynamic changes of the clinical symptoms were recorded and statistically analyzed. Quantitative and qualitive statistical analysis were carried out after laboratory detection.The positive rate of SARS-CoV-2 was 33.02% in 12,400 suspected patients’ specimens in Wuhan at the first months of COVID-19 epidemics. SARS-CoV-2 RT-qPCR test of nasopharyngeal swabs might produce 4.79% (594/12400) presumptive results. The positive rate of SARS-CoV-2 RNA was significantly different between gender, age, type of specimen, source of patients, respectively (P < .05). The median window period from the occurrence of clinical symptom or close contact with COVID-19 patient to the first detection of positive PCR was 2 days (interquartile range, 1–4 days). The median interval time from the first SARS-CoV-2 positive to the turning negative was 14 days (interquartile range, 8–19.25 days).This study reveals the comprehensive characteristics of the SARS-CoV-2 RNA detection from multiple perspectives, and it provides important clues and may also supply useful suggestions for future work of the prevention and treatment of COVID-19.     

Abl激酶抑制剂治疗新型冠状病毒肺炎的研究进展

目前,新型冠状病毒肺炎疫情已经构成全球大流行,严重影响世界公共卫生安全,但仍无有效抗病毒药物。Abl激酶参与体内一系列病理生理变化,在病毒感染中发挥重要作用。Abl激酶抑制剂能够在体外抑制冠状病毒,并具有广泛抗病毒活性和促进肺损伤后肺泡上皮修复等功能。本文介绍Abl激酶抑制剂治疗新型冠状病毒肺炎的相关研究进展。     

Collectivism predicts mask use during COVID-19

Since its outbreak, COVID-19 has impacted world regions differentially. Whereas some regions still record tens of thousands of new infections daily, other regions have contained the virus. What explains these striking regional differences? We advance a cultural psychological perspective on mask usage, a precautionary measure vital for curbing the pandemic. Four large-scale studies provide evidence that collectivism (versus individualism) positively predicts mask usage—both within the United States and across the world. Analyzing a dataset of all 3,141 counties of the 50 US states (based on 248,941 individuals), Study 1a revealed that mask usage was higher in more collectivistic US states. Study 1b replicated this finding in another dataset of 16,737 individuals in the 50 US states. Analyzing a dataset of 367,109 individuals in 29 countries, Study 2 revealed that mask usage was higher in more collectivistic countries. Study 3 replicated this finding in a dataset of 277,219 Facebook users in 67 countries. The link between collectivism and mask usage was robust to a host of control variables, including cultural tightness–looseness, political affiliation, demographics, population density, socioeconomic indicators, universal health coverage, government response stringency, and time. Our research suggests that culture fundamentally shapes how people respond to crises like the COVID-19 pandemic. Understanding cultural differences not only provides insight into the current pandemic, but also helps the world prepare for future crises.

“It appears as though many Americans have maximized their psychological welfare by not covering their mouths. This behavior, however, has come at a grave cost for the collective. Each individual is protected as long as many others in the community wear masks. If a majority choose not to wear a mask, then you may not be protected even if you wear a mask. Unfortunately, again and again, many Americans prioritized their personal convenience or preference while ignoring the collective consequences of doing so.”

—Shinobu Kitayama, President of the Association for Psychological Science (1)

Since its outbreak, the novel coronavirus (COVID-19) has impacted world regions differentially. As of January 2021, the pandemic is still raging in countries like the United States, the United Kingdom, and South Africa, with tens of thousands of new infections recorded daily (2). By contrast, countries like Thailand and South Korea have contained the virus and recorded few new infections and deaths over the past several months. What explains these striking regional differences?We posit that culture fundamentally shapes people’s response to the pandemic and helps explain regional differences in the severity of COVID-19 infections. Specifically, we propose that, net of other factors, people in more collectivistic (versus individualistic) regions are more likely to wear masks, a precautionary measure vital for curbing the pandemic (3). Collectivism–individualism is one of the most established cultural dimensions in psychology (4). Collectivism (versus individualism) is characterized by the view of an interdependent (versus independent) self (5, 6). Collectivism captures “the tendency to be more concerned with the group’s needs, goals, and interests than with individualistic-oriented interests,” whereas individualism captures “the tendency to be more concerned with one’s own needs, goals, and interests than with group-oriented concerns” (7). People in collectivistic cultures are more likely to agree with statements like “I usually sacrifice my self-interest for the benefit of my group” and “My happiness depends very much on the happiness of those around me,” whereas people in individualistic cultures are more likely to agree with statements like “I often do my own thing” and “What happens to me is my own doing” (6, 8–11). As evidenced by widely used collectivism–individualism indices (12–15), collectivism–individualism varies both across countries and within countries (e.g., among the 50 US states).Based on the differences between collectivistic and individualistic cultures, we theorize that collectivism (versus individualism) positively predicts people’s mask usage during the COVID-19 pandemic. Although masks effectively protect against COVID-19 (3), they can create physical discomfort and inconvenience. Because people in collectivistic cultures are more concerned with the collective welfare, they may be more willing to tolerate such personal inconvenience and to wear masks (5, 16). By contrast, much as Kitayama lamented (1), people in individualistic cultures may be more apt to prioritize their personal convenience or preference over the collective welfare and therefore less willing to wear masks. A COVID-19 survey found that 64% of Americans who did not wear masks indicated “It’s my right as an American to not wear a mask” or “It is uncomfortable” (17). Related research has found that individualists are less likely than collectivists to engage in environmentally friendly behaviors that entail sacrificing personal convenience for the collective welfare (18, 19).Relatedly, a sizable number of people in individualistic cultures refuse to wear masks because they view masks as a symbolic infringement on their personal choice and freedom (1, 20). There have been many anti-mask protests in predominantly individualistic cultures like Germany and the United States, featuring signs such as “Masks are muzzles” (20, 21). Some protesters even asserted, “If I’m going to get COVID and die from it, then so be it” (20). This assertion epitomizes the values of personal choice and autonomy in individualism, but disregards the possibility that one may infect other people and harm the larger community. Indeed, culturally individualistic regions have witnessed a large number of “super-spreader” incidents, where people chose to gather or party without masks and consequently caused a massive number of infections (22). By contrast, because of collectivistic cultures’ emphasis on interdependence and shared goals, many people in such cultures consider wearing masks not only a civic responsibility but also a symbol of solidarity signaling that they are fighting the pandemic together (23).In light of the above reasoning, we hypothesize that people in culturally more collectivistic (versus individualistic) regions are more likely to wear masks during the COVID-19 pandemic. To test this hypothesis, we conducted four large-scale studies. In Study 1a, we constructed a dataset of mask usage in all 3,141 counties of the 50 US states (based on 248,941 individuals) to test whether mask usage was higher in more collectivistic states. In Study 1b, we sought to replicate this finding in a dataset of 16,737 individuals in the 50 US states. In Study 2, we constructed a dataset of mask usage of 367,109 individuals in 29 countries to test whether mask usage was higher in more collectivistic countries. In Study 3, we further tested the link between collectivism and mask usage in a dataset of 277,219 Facebook users in 67 countries. Across these four studies, we accounted for a broad set of control variables, including cultural tightness–looseness, political affiliation, demographics, population density, socioeconomic indicators, universal health coverage, government response stringency, and time.This research uncovers the role of culture in mask usage during the COVID-19 pandemic. Recent studies have examined factors that influence the macrolevel spread of COVID-19, such as demographics (24), socioeconomic variables (25), relational mobility (26), and personality (27). We extend this line of research by examining the microlevel behavior of mask usage, which is critical to curbing COVID-19 (28). By providing a cultural perspective on the pandemic, we shed light on the stark regional differences in the severity of COVID-19 infections around the world. More broadly, by examining how different cultures respond to the pandemic, our research highlights the importance of cultural psychology in understanding and fighting global crises.     

The impact of COVID-19 on college students’ physical activity: A protocol for systematic review and meta-analysis

Background:We aimed to conduct a meta-analysis to assess the impact of coronavirus disease 2019 (COVID-19) on college students’ physical activity.Methods:All cohort studies comparing college students undertaking physical exercise at school before the COVID-19 pandemic and physical exercise at home during the COVID-19 pandemic will be included in this review. We will use index words related to college students, physical exercise, and COVID-19 to perform literature searches in the PubMed, Medline, Embase, and CNKI databases, to include articles indexed as of June 20, 2021, in English and Chinese. Two reviewers will independently select trials for inclusion, assess trial quality, and extract information for each trial. The primary outcomes are exercise frequency, duration, intensity, and associated factors. Based on the Cochrane assessment tool, we will evaluate the risk of bias of the included studies. Revman 5.3 (the Cochrane collaboration, Oxford, UK) will be used for heterogeneity assessment, data synthesis, subgroup analysis, sensitivity analysis, and funnel plot generation.Result:We will discuss the impact of COVID-19 on college students’ physical activity.Conclusion:Stronger evidence about the impact of COVID-19 on college students’ physical activity will be provided to better guide teaching practice.Systematic review registration:PROSPERO CRD42021262390.