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Relational Mobility Predicts Faster Spread of COVID-19: A 39-Country Study

It has become increasingly clear that COVID-19 is transmitted between individuals. It stands to reason that the spread of the virus depends on sociocultural ecologies that facilitate or inhibit social contact. In particular, the community-level tendency to engage with strangers and freely choose friends, called relational mobility, creates increased opportunities to interact with a larger and more variable range of other people. It may therefore be associated with a faster spread of infectious diseases, including COVID-19. Here, we tested this possibility by analyzing growth curves of confirmed cases of and deaths due to COVID-19 in the first 30 days of the outbreaks in 39 countries. We found that growth was significantly accelerated as a function of a country-wise measure of relational mobility. This relationship was robust either with or without a set of control variables, including demographic variables, reporting bias, testing availability, and cultural dimensions of individualism, tightness, and government efficiency. Policy implications are also discussed.
covid-19
transmission
epidemiology
case number
mortality
international comparison
social contact
positive link
culture
social norm
mobility, crime, gdp, employment, restriction
political, attitude, partisan, democracy, ideology
SARS-CoV-2 transmission via speech-generated respiratory droplets

The medical community has long acknowledged infection via speech-generated respiratory droplets, including droplet nuclei that might stay airborne for an extended time.5Gralton J Tovey E McLaws ML Rawlinson WD The role of particle size in aerosolised pathogen transmission: a review.J Infect. 2011; 62: 1-13Summary Full Text Full Text PDF PubMed Scopus (155) Google Scholar The importance of symptomless transmission of SARS-CoV-2 (ie, in the absence of coughing or sneezing), whether retrospectively identified as asymptomatic, presymptomatic, or even oligosymptomatic, has also been well established,6Greenhalgh T Face coverings for the public: laying straw men to rest.J Eval Clin Pract. 2020; 26: 1070-1077Crossref Scopus (3) Google Scholar,  7Oran DP Topol EJ Prevalence of asymptomatic SARS-CoV-2 infection: a narrative review.Ann Intern Med. 2020; 173: 362-367Crossref Scopus (23) Google Scholar despite claims to the contrary by Abbas and Pittet. With high viral titres in the oral fluid of such carriers well documented and a substantial proportion of speech droplets of oral fluid now shown to remain airborne for many minutes, inhalation of such particles represents a direct route to the nasopharynx. Retrospective analyses of indoor superspreader events further support the role of speech droplets in airborne transmission.
covid-19
analysis
transmission
asymptomatic infection
droplet
criticism
airborne
response
sars, respiratory, clinical, cov, syndrome
airborne, air, wear, mask, aerosol
60 seconds on . . . jargon

Terms that used to be the preserve of scientists are suddenly being bandied around by politicians on national television, brought up over a coffee with friends, or appearing in the family WhatsApp group. Flattening the curve to the R number and contact tracing have all entered the general lexicon since SARS-CoV-2 emerged.
covid-19
risk
general public
language
misinterpretation
cdc, doctor, trump, eviction, official
like, ease, stop, critic, away
Cities count cost of lasting exodus from offices
Sept. 14, 2020 · · Original resource · news

Companies prepare plans for a more permanent flexible way of working following pandemic
covid-19
uk
uncertainty
economy
cost
post-pandemic
business
remote work
city
public transport
workplace
office
firm
school, bar, nhs, urge, reopen
business, remote, tourism, market, job
More than 100 scientific journals have disappeared from the Internet

Researchers have identified dozens of open-access journals that went offline between 2000 and 2019, and hundreds more that could be at risk.
availability
metascience
accessibility
open access
journal
loss
knowledge management
peer, publish, publication, review, preregistration
library, open, preservation, psa, tool
Use of “normal” risk to improve understanding of dangers of covid-19

Accumulating data on deaths from covid-19 show an association with age that closely matches the “normal” risk we all face. Explaining risk in this way could help people understand and manage their response, says David Spiegelhalter
covid-19
big data
communication
risk
epidemiology
risk perception
mortality
framing
visualization
death, england, estimate, excess, wale
bayesian, causal, measurement, replication, statistical
Risk stratification of patients admitted to hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: development and validation of the 4C Mortality Score

Objective To develop and validate a pragmatic risk score to predict mortality in patients admitted to hospital with coronavirus disease 2019 (covid-19).Design Prospective observational cohort study.Setting International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) World Health Organization (WHO) Clinical Characterisation Protocol UK (CCP-UK) study (performed by the ISARIC Coronavirus Clinical Characterisation Consortium—ISARIC-4C) in 260 hospitals across England, Scotland, and Wales. Model training was performed on a cohort of patients recruited between 6 February and 20 May 2020, with validation conducted on a second cohort of patients recruited after model development between 21 May and 29 June 2020.Participants Adults (age ≥18 years) admitted to hospital with covid-19 at least four weeks before final data extraction.Main outcome measure In-hospital mortality.Results 35 463 patients were included in the derivation dataset (mortality rate 32.2%) and 22 361 in the validation dataset (mortality rate 30.1%). The final 4C Mortality Score included eight variables readily available at initial hospital assessment: age, sex, number of comorbidities, respiratory rate, peripheral oxygen saturation, level of consciousness, urea level, and C reactive protein (score range 0-21 points). The 4C Score showed high discrimination for mortality (derivation cohort: area under the receiver operating characteristic curve 0.79, 95% confidence interval 0.78 to 0.79; validation cohort: 0.77, 0.76 to 0.77) with excellent calibration (validation: calibration-in-the-large=0, slope=1.0). Patients with a score of at least 15 (n=4158, 19%) had a 62% mortality (positive predictive value 62%) compared with 1% mortality for those with a score of 3 or less (n=1650, 7%; negative predictive value 99%). Discriminatory performance was higher than 15 pre-existing risk stratification scores (area under the receiver operating characteristic curve range 0.61-0.76), with scores developed in other covid-19 cohorts often performing poorly (range 0.63-0.73).Conclusions An easy-to-use risk stratification score has been developed and validated based on commonly available parameters at hospital presentation. The 4C Mortality Score outperformed existing scores, showed utility to directly inform clinical decision making, and can be used to stratify patients admitted to hospital with covid-19 into different management groups. The score should be further validated to determine its applicability in other populations.
covid-19
development
who
hospitalization
patient
protocol
validation
death, england, estimate, excess, wale
patient, hydroxychloroquine, cohort, mortality, observational
Moral Choice When Harming Is Unavoidable

Past research suggests that actors often seek to minimize harm at the cost of maximizing social welfare. However, this prior research has confounded a desire to minimize the negative impact caused by one’s actions (harm aversion) with a desire to avoid causing any harm whatsoever (harm avoidance). Across six studies (N = 2,152), we demonstrate that these two motives are distinct. When decision-makers can completely avoid committing a harmful act, they strongly prefer to do so. However, harming cannot always be avoided. Often, decision-makers must choose between committing less harm for less benefit and committing more harm for more benefit. In these cases, harm aversion diminishes substantially, and decision-makers become increasingly willing to commit greater harm to obtain greater benefits. Thus, value trade-offs that decision-makers refuse to accept when it is possible to completely avoid committing harm can suddenly become desirable when some harm must be committed.
covid-19
morality
choice
harm
negative impact
decision making
benefit
trade-off
moral, belief, conspiracy, personality, trait
neural, accuracy, elusive, task, trade
Association of Mobile Phone Location Data Indications of Travel and Stay-at-Home Mandates With COVID-19 Infection Rates in the US

Importance  A stay-at-home social distancing mandate is a key nonpharmacological measure to reduce the transmission rate of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), but a high rate of adherence is needed.Objective  To examine the association between the rate of human mobility changes and the rate of confirmed cases of SARS-CoV-2 infection.Design, Setting, and Participants  This cross-sectional study used daily travel distance and home dwell time derived from millions of anonymous mobile phone location data from March 11 to April 10, 2020, provided by the Descartes Labs and SafeGraph to quantify the degree to which social distancing mandates were followed in the 50 US states and District of Columbia and the association of mobility changes with rates of coronavirus disease 2019 (COVID-19) cases.Exposure  State-level stay-at-home orders during the COVID-19 pandemic.Main Outcomes and Measures  The main outcome was the association of state-specific rates of COVID-19 confirmed cases with the change rates of median travel distance and median home dwell time of anonymous mobile phone users. The increase rates are measured by the exponent in curve fitting of the COVID-19 cumulative confirmed cases, while the mobility change (increase or decrease) rates were measured by the slope coefficient in curve fitting of median travel distance and median home dwell time for each state.Results  Data from more than 45 million anonymous mobile phone devices were analyzed. The correlation between the COVID-19 increase rate and travel distance decrease rate was –0.586 (95% CI, –0.742 to –0.370) and the correlation between COVID-19 increase rate and home dwell time increase rate was 0.526 (95% CI, 0.293 to 0.700). Increases in state-specific doubling time of total cases ranged from 1.0 to 6.9 days (median [interquartile range], 2.7 [2.3-3.3] days) before stay-at-home orders were enacted to 3.7 to 30.3 days (median [interquartile range], 6.0 [4.8-7.1] days) after stay-at-home social distancing orders were put in place, consistent with pandemic modeling results.Conclusions and Relevance  These findings suggest that stay-at-home social distancing mandates, when they were followed by measurable mobility changes, were associated with reduction in COVID-19 spread. These results come at a particularly critical period when US states are beginning to relax social distancing policies and reopen their economies. These findings support the efficacy of social distancing and could help inform future implementation of social distancing policies should they need to be reinstated during later periods of COVID-19 reemergence.
covid-19
compliance
social distancing
transmission
non-pharmaceutical intervention
epidemiology
case number
mobility
safety measure
transmission, cov-2, secondary, china, household
mobility, crime, gdp, employment, restriction
The automatic influence of advocacy on lawyers and novices

It has long been known that advocating for a cause can alter the advocate’s beliefs. Yet a guiding assumption of many advocates is that the biasing effect of advocacy is controllable. Lawyers, for instance, are taught that they can retain unbiased beliefs while advocating for their clients and that they must do so to secure just outcomes. Across ten experiments (six preregistered; N = 3,104) we show that the biasing effect of advocacy is not controllable but automatic. Merely incentivizing people to advocate altered a range of beliefs about character, guilt and punishment. This bias appeared even in beliefs that are highly stable, when people were financially incentivized to form true beliefs and among professional lawyers, who are trained to prevent advocacy from biasing their judgements.
bias
behavior change
advocacy
belief change
control
stability
judgement
moral, belief, conspiracy, personality, trait
political, attitude, partisan, democracy, ideology