The impact of national culture on COVID-19 pandemic outcomes

PurposeThis study aims to uncover the extent to which cultural traits may explain the puzzling international divergence in COVID-19 outcomes, and how those traits interact with state action to produce compliance with pandemic health policy.Design/methodology/approachA theoretical framework illustrates the surprising possibility that culture and state action may not reinforce each other but rather act as substitutes in eliciting anti-pandemic behavior. This possibility is tested empirically in two specifications: a cross-sectional regression that includes several novel COVID-related measures, and a panel model that controls for contemporaneous disease burden. Across these models, we use the measures of national culture developed by Hofstede (1984) and a newer metric developed by Schwartz (1990).FindingsIndividualism and egalitarianism have a positive effect on disease prevalence, while cultural heterogeneity was associated with a more robust public health response. Consistent with our model, we find that culture and state action served as substitutes in motivating compliance with COVID-19 policy.Practical implicationsThe results of this study imply that culture and state interact in determining the effectiveness of public health measures aimed at combating COVID-19; these results recommend culturally aware state intervention when combating pandemics.Originality/valueThis study offers several new contributions. First, it proposes a model to help contextualize the empirical analysis. Second, it examines a wider range of traits than previous studies, including cultural homogeneity and the Schwartz variables. Third, it employs a richer econometric specification that explores the interaction between state and culture in a panel context.

Evaluation of an optimized protocol and Illumina ARTIC V4 primer pool for sequencing of SARS-CoV-2 using COVIDSeq™ and DRAGEN™ COVID Lineage App workflow

Next-Generation Sequencing based genomic surveillance has been widely implemented for identification and tracking of emerging SARS-CoV-2 variants to guide the Public Health response to the COVID-19 pandemic. Amplicon-based assays, such as the Illumina® COVIDSeq™ Test (RUO) and COVIDSeq Assay (RUO), enable scalable sequencing of SARS-CoV-2, leveraging V3 and V4 primer designs from the ARTIC community and DRAGEN™ COVID Lineage App analysis available on Illumina BaseSpace™. We report here a comparison of COVIDSeq performance for SARS-CoV-2 genome reporting using the ARTIC V3 based primer pool (including primers for human control genes) that is provided with the COVIDSeq kit versus the ARTIC V4 based Illumina COVIDSeq V4 primer pool, using an optimized protocol and DRAGEN COVID Lineage App analysis. The data indicates that both primer pools enable robust reporting of SARS-CoV-2 variants. The Illumina COVIDSeq V4 primer pool has superior performance for SARS-CoV-2 genome reporting, particularly in samples with low virus load, and is therefore the recommended primer pool for genomic surveillance of SARS-CoV-2 for research use using COVIDSeq.

VarLOCK - sequencing independent, rapid detection of SARS-CoV-2 variants of concern for point-of-care testing, qPCR pipelines and national wastewater surveillance

The COVID-19 pandemic continues to pose a threat to the general population. The ongoing vaccination programs provide protection to individuals and facilitate the opening of society and a return to normality. However, emergent and existing SARS-CoV-2 variants capable of evading the immune system endanger the efficacy of the vaccination strategy. To preserve the efficacy of SARS-CoV-2 vaccination globally, aggressive and effective surveillance for known and emerging SARS-CoV-2 Variants of Concern (VOC) is required. Rapid and specific molecular diagnostics can provide speed and coverage advantages compared to genomic sequencing alone, benefitting the public health response and facilitating VOC containment. In this work, we expand the recently developed SARS-CoV-2 CRISPR-Cas detection technology (SHERLOCK) to allow rapid and sensitive discrimination of VOCs, that can be used at point of care and/or implemented in the pipelines of small or large testing facilities, and even determine proportion of VOCs in pooled population-level wastewater samples. This technology aims to complement the ongoing sequencing efforts to allow facile and, crucially, rapid identification of individuals infected with VOCs to help break infection chains. Here, we show the optimisation of our VarLOCK assays (Variant-specific SHERLOCK) for multiple specific mutations in the S gene of SARS-CoV-2 and validation with samples from the Cardiff University Testing Service. We also show the applicability of VarLOCK to national wastewater surveillance of SARS-CoV-2 variants. In addition, we show the rapid adaptability of the technique for new and emerging VOCs such as Omicron.

A survey of current activities and technologies used to detect carbapenem resistance in bacteria isolated from companion animals at veterinary diagnostic laboratories—United States, 2020

Carbapenems are antimicrobial drugs reserved for the treatment of severe multidrug-resistant Gram-negative bacterial infections. Carbapenem-resistant organisms (CROs) are an urgent public health threat and have been made reportable to public health authorities in many jurisdictions. Recent reports of CROs in companion animals and veterinary settings suggest that CROs are a One Health problem. However, standard practices of U.S. veterinary diagnostic laboratories (VDLs) to detect CROs are unknown. We assessed the capacity of VDLs to characterize carbapenem resistance in isolates from companion animals. Among 74 VDLs surveyed in 42 states, 23 laboratories (31%) from 22 states responded. Most (22/23, 96%) include ≥1 carbapenem on their primary antimicrobial susceptibility testing panel; approximately one-third (9/23, 39%) perform phenotypic carbapenemase production testing or molecular identification of carbapenemase genes. Overall, 35% (8/23) of VDLs across eight states reported they would notify public health if a CRO was detected. Most (17/21, 81%) VDLs were not aware of CRO reporting mandates; some expressed uncertainty about whether the scope of known mandates included CROs from veterinary sources. Although nearly all surveyed VDLs tested for carbapenem resistance, fewer had capacity for mechanism testing or awareness of public health reporting requirements. Addressing these gaps is critical to monitoring CRO incidence and trends in veterinary medicine, preventing spread in veterinary settings, and mounting an effective One Health response. Improved collaboration and communication between public health and veterinary medicine is critical to inform infection control practices in veterinary settings and conduct public health response when resistant isolates are detected.

Containment of a multi-index B.1.1.7 outbreak on a university campus through a genomically-informed public health response

The first cluster of SARS-CoV-2 cases with lineage B.1.1.7 in the state of Michigan was identified through intensive university-led surveillance sampling and targeted sequencing. A collaborative investigation and response was conducted by the local and state health departments, and the campus and athletic medicine COVID-19 response teams, using S-gene target failure screening and rapid genomic sequencing to inform containment strategies. A total of 50 cases of B.1.1.7-lineage SARS-CoV-2 were identified in this outbreak, which was due to three coincident introductions of B.1.1.7-lineage SARS-CoV-2, all of which were genetically distinct from lineages which later circulated in the broader community. This investigation demonstrates the successful implementation of a genomically-informed outbreak response which can be extended to university campuses and other settings at high risk for rapid emergence of new variants.

A Review of Heat Stress Policies in the Context of Climate Change and Its Impacts on Outdoor Workers

Record-breaking summer heat events are increasing in frequency in Zimbabwe and 2016 was a particularly hot year with the country experiencing its worst heat wave event in decades. Currently, Zimbabwe has no coordinated public health response to deal with heat wave events and no specific data on heat-related morbidity and mortality. The country has no legislation for protecting workers against environmental heat exposure, particularly those most vulnerable who are employed in the informal sector. These workers are also at risk due to their outdoor work environments. The article outlines the state of climate and heat stresses in Zimbabwe, as benchmarked against other African countries and France. It further summarizes outdoor workers' susceptibility to heat exposure and the need for the Zimbabwean Government to develop policies to ensure the health and safety of an increasing population of outdoor workers in Zimbabwe.

Racial/Ethnic and Age Differences in the Direct and Indirect Effects of the COVID-19 Pandemic on US Mortality

Objectives. To estimate the direct and indirect effects of the COVID-19 pandemic on overall, race/ethnicity‒specific, and age-specific mortality in 2020 in the United States. Methods. Using surveillance data, we modeled expected mortality, compared it to observed mortality, and estimated the share of “excess” mortality that was indirectly attributable to the pandemic versus directly attributed to COVID-19. We present absolute risks and proportions of total pandemic-related mortality, stratified by race/ethnicity and age. Results. We observed 16.6 excess deaths per 10 000 US population in 2020; 84% were directly attributed to COVID-19. The indirect effects of the pandemic accounted for 16% of excess mortality, with proportions as low as 0% among adults aged 85 years and older and more than 60% among those aged 15 to 44 years. Indirect causes accounted for a higher proportion of excess mortality among racially minoritized groups (e.g., 32% among Black Americans and 23% among Native Americans) compared with White Americans (11%). Conclusions. The effects of the COVID-19 pandemic on mortality and health disparities are underestimated when only deaths directly attributed to COVID-19 are considered. An equitable public health response to the pandemic should also consider its indirect effects on mortality. (Am J Public Health. 2022;112(1):154–164. https://doi.org/10.2105/AJPH.2021.306541 )

A Review of Heat Stress Policies in the Context of Climate Change and Its Impacts on Outdoor Workers

Record-breaking summer heat events are increasing in frequency in Zimbabwe and 2016 was a particularly hot year with the country experiencing its worst heat wave event in decades. Currently, Zimbabwe has no coordinated public health response to deal with heat wave events and no specific data on heat-related morbidity and mortality. The country has no legislation for protecting workers against environmental heat exposure, particularly those most vulnerable who are employed in the informal sector. These workers are also at risk due to their outdoor work environments. The article outlines the state of climate and heat stresses in Zimbabwe, as benchmarked against other African countries and France. It further summarizes outdoor workers' susceptibility to heat exposure and the need for the Zimbabwean Government to develop policies to ensure the health and safety of an increasing population of outdoor workers in Zimbabwe.

Are People Optimistically Biased about the Risk of COVID-19 Infection? Lessons from the First Wave of the Pandemic in Europe

Unrealistic optimism, the underestimation of one’s risk of experiencing harm, has been investigated extensively to understand better and predict behavioural responses to health threats. Prior to the COVID-19 pandemic, a relative dearth of research existed in this domain regarding epidemics, which is surprising considering that this optimistic bias has been associated with a lack of engagement in protective behaviours critical in fighting twenty-first-century, emergent, infectious diseases. The current study addresses this gap in the literature by investigating whether people demonstrated optimism bias during the first wave of the COVID-19 pandemic in Europe, how this changed over time, and whether unrealistic optimism was negatively associated with protective measures. Taking advantage of a pre-existing international participative influenza surveillance network (n = 12,378), absolute and comparative unrealistic optimism were measured at three epidemic stages (pre-, early, peak), and across four countries—France, Italy, Switzerland and the United Kingdom. Despite differences in culture and health response, similar patterns were observed across all four countries. The prevalence of unrealistic optimism appears to be influenced by the particular epidemic context. Paradoxically, whereas absolute unrealistic optimism decreased over time, comparative unrealistic optimism increased, suggesting that whilst people became increasingly accurate in assessing their personal risk, they nonetheless overestimated that for others. Comparative unrealistic optimism was negatively associated with the adoption of protective behaviours, which is worrying, given that these preventive measures are critical in tackling the spread and health burden of COVID-19. It is hoped these findings will inspire further research into sociocognitive mechanisms involved in risk appraisal.