Perceptions of the seriousness of major public health problems during the COVID-19 pandemic in seven middle-income countries.

INTRODUCTION: Public perception of the seriousness of the COVID-19 pandemic compared to six other major public health problems (alcoholism and drug use, HIV/AIDS, malaria, tuberculosis, lung cancer and respiratory diseases caused by air pollution and smoking, and water-borne diseases like diarrhea) is unclear. We designed a survey to examine this issue using YouGov's internet panels in seven middle-income countries in Africa, Asia, and Latin America in early 2022. METHODS: Respondents rank ordered the seriousness of the seven health problems using a repeated best-worst question format. Rank-ordered logit models allow comparisons within and across countries and assessment of covariates. RESULTS: In six of the seven countries, respondents perceived other respiratory illnesses to be a more serious problem than COVID-19. Only in Vietnam was COVID-19 ranked above other respiratory illnesses. Alcoholism and drug use was ranked the second most serious problem in the African countries. HIV/AIDS ranked relatively high in all countries. Covariates, particularly a COVID-19 knowledge scale, explained differences within countries; statistics about the pandemic were highly correlated with differences in COVID-19's perceived seriousness. CONCLUSIONS: People in the seven middle-income countries perceived COVID-19 to be serious (on par with HIV/AIDS) but not as serious as other respiratory illnesses. In the African countries, respondents perceived alcoholism and drug use as more serious than COVID-19. Our survey-based approach can be used to quickly understand how the threat of a newly emergent disease, like COVID-19, fits into the larger context of public perceptions of the seriousness of health problems.

We were curious what people in different countries thought about the seriousness of COVID-19 compared to other health problems. We designed a survey, and hired YouGov, a survey research firm, to administer it in seven countries in Africa, Asia, and Latin America in early 2022. Respondents answered the questions on their computer, tablets, or smart phones. Their answers revealed that in most countries respiratory illnesses were perceived to be a more serious problem than COVID-19. In Africa people felt that alcoholism and drug use were also more serious than COVID-19. These findings are important because they show that people still care about the health problems they were facing before the pandemic, which is useful information for healthcare providers.

Support for regulation versus compliance: Face masks during COVID-19.

Objectives: Wearing masks could still be one of the few non-pharmaceutical interventions for controlling the pandemic. There are people who wear them and people who don't, but this framing is overly simplistic. We aim to chart the contradictions in attitudes and behavior regarding mask wearing and describe the messaging challenge that these generate. Study design: Our data come from a survey administered to a nationally representative sample of 2000 respondents from the YouGov panel of US households in August-September 2020. Methods: Respondents were asked whether they wear a facemask when they go outside their home since the COVID-19 epidemic began and whether they support or oppose your municipal government passing mask wearing regulation. We also collected respondents' demographic and economic characteristics, knowledge regarding the facts of COVID-19 and political ideology. Results: A substantial majority of Americans (60%) both favor a masking requirement and are themselves wearing masks, while 13% oppose a mask mandate and do not wear masks. In contrast, 17% of Americans oppose a mask mandate but are currently wearing one, while 10% do not wear a mask but favor a mask mandate. These two groups are distinctively different from one another and the other groups in their socioeconomic characteristics, risk perception and political beliefs. Conclusions: Our study offers a better understanding of the mismatch between mask wearing behavior and attitude toward the mask mandate, which will help the public health authorities to devise policies regarding mask wearing as an effective intervention to manage the pandemic.

Who should get the scarce ICU bed? The US public's view on triage in the time of COVID-19.

OBJECTIVE: To determine the relative importance members of the US public place on different patient attributes in triage decisions about who should receive the last available intensive care unit (ICU) bed. METHODS: A discrete choice experiment was conducted with a nationally representative sample of 2000 respondents from the YouGov internet panel of US households. Respondents chose which of three hypothetical patients with COVID-19 should receive an ICU bed if only one were available. The three patients differed in age, gender, Alzheimer's-like disability and probability of survival if the patient received the ICU bed. An experimental design varied the values of the four attributes of the three hypothetical patients with COVID-19 that a respondent saw in four choice tasks. RESULTS: The most important patient attribute to respondents was the probability the patient survives COVID-19 if they get the ICU bed (OR CI: 4.41 to 6.91). There was heterogeneity among different age groups of respondents about how much age of the patient mattered. Respondents under 30 years of age were more likely to choose young patients and old patients, and less likely to select patients aged 40-60 years old. For respondents in the age group 30-49 years old, as the age of the patient declined, their preference for saving the patient declined modestly in a linear fashion. CONCLUSIONS: Respondents favoured giving the last ICU bed available to the patient with the highest probability of surviving COVID-19. Public opinion suggests a simple guideline for physician choices based on likelihood of survival as opposed to the number of life-years saved. There was heterogeneity among respondents of different age groups for allocating the last ICU bed, as well as to the importance of the patient having an Alzheimer's-like disability (where religion of the respondent is important) and the gender of the patient (where the gender and racial identity are important).

COVID-19's U.S. Temperature Response Profile.

We estimate the U.S. temperature response profile (TRP) for COVID-19 and show it is highly sensitive to temperature variation. Replacing the erratic daily death counts U.S. states initially reported with counts based on death certificate date, we build a week-ahead statistical forecasting model that explains most of their daily variation (R2 = 0.97) and isolates COVID-19's TRP (p < 0.001). These counts, normalized at 31 °C (U.S. mid-summer average), scale up to 160% at 5 °C in the static case where the infection pool is held constant. Positive case counts are substantially more temperature sensitive. When temperatures are declining, dynamic feedback through a growing infection pool can substantially amplify these temperature effects. Our estimated TRP can be incorporated into COVID-related planning exercises and used as an input to SEIR models employed for longer run forecasting. For the former, we show how our TRP is predictive of the realized pattern of growth rates in per capita positive cases across states five months after the end of our sample period. For the latter, we show the variation in herd immunity levels implied by temperature-driven, time-varying R0 series for the Alpha and Delta variants of COVID-19 for several representative states. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10640-021-00603-8.

Coastal wetlands reduce property damage during tropical cyclones.

Coastal wetlands dampen the impact of storm surge and strong winds. Studies on the economic valuation of this protective service provided by wetland ecosystems are, however, rare. Here, we analyze property damage caused by 88 tropical storms and hurricanes hitting the United States between 1996 and 2016 and show that counties with more wetland coverage experienced significantly less property damage. The expected economic value of the protective effects of wetlands varies widely across coastal US counties with an average value of about $1.8 million/km2 per year and a median value of $91,000/km2 Wetlands confer relatively more protection against weaker storms and in states with weaker building codes. Recent wetland losses are estimated to have increased property damage from Hurricane Irma by $430 million. Our results suggest the importance of considering both natural and human factors in coastal zone defense policy.

Tropical countries may be willing to pay more to protect their forests.

Inadequate funding from developed countries has hampered international efforts to conserve biodiversity in tropical forests. We present two complementary research approaches that reveal a significant increase in public demand for conservation within tropical developing countries as those countries reach upper-middle-income (UMI) status. We highlight UMI tropical countries because they contain nearly four-fifths of tropical primary forests, which are rich in biodiversity and stored carbon. The first approach is a set of statistical analyses of various cross-country conservation indicators, which suggests that protective government policies have lagged behind the increase in public demand in these countries. The second approach is a case study from Malaysia, which reveals in a more integrated fashion the linkages from rising household income to increased household willingness to pay for conservation, nongovernmental organization activity, and delayed government action. Our findings suggest that domestic funding in UMI tropical countries can play a larger role in (i) closing the funding gap for tropical forest conservation, and (ii) paying for supplementary conservation actions linked to international payments for reduced greenhouse gas emissions from deforestation and forest degradation in tropical countries.

Conceptual issues in designing a policy to phase out metal-based antifouling paints on recreational boats in San Diego Bay.

In marine areas throughout the world where recreational boats are densely located, concentrations of copper in the water are being found to be in excess of government standards, due to the hull coatings used on these boats. Copper-based hull coatings are intended to be antifouling in that they retard the growth of algae, barnacles and tubeworms; but alternatives exist that can eliminate the harm that copper contamination does to marine organisms. A variety of policy options are available to mandate or provide economic incentives to switch to these less harmful alternatives. This paper puts forth a conceptual framework for thinking about how to design and evaluate alternative policies to transition to nontoxic boat hulls, drawing from the authors' experience designing a policy for use in San Diego Bay. Many of the issues raised are broadly applicable to environmental problems where the solution involves a large-scale replacement of durable consumer goods.