Investigating the 'Bolsonaro effect' on the spread of the Covid-19 pandemic: An empirical analysis of observational data in Brazil.

Brazil counts among the countries the hardest hit by the Covid-19 pandemic. A great deal has been said about the negative role played by President Bolsonaro's denialism, but relatively few studies have attempted to measure precisely what impact it actually had on the pandemic. Our paper conducts econometric estimates based on observational data at municipal level to quantitatively assess the 'Bolsonaro effect' over time from March 2020 to December 2022. To our knowledge, this paper presents the most comprehensive investigation of Bolsonaro's influence in the spread of the pandemic from two angles: considering Covid-19 mortality and two key transmission mitigation channels (social distancing and vaccination); and exploring the full pandemic cycle (2020-2022) and its dynamics over time. Controlling for a rich set of relevant variables, our results find a strong and persistent 'Bolsonaro effect' on the death rate: municipalities that were more pro-Bolsonaro recorded significantly more fatalities. Furthermore, evidence suggests that the president's attitude and decisions negatively influenced the population's behaviour. Firstly, pro-Bolsonaro municipalities presented a lower level of compliance with social distancing measures. Secondly, vaccination was relatively less widespread in places more in favour of the former president. Finally, our analysis points to longer-lasting and damaging repercussions. Regression results are consistent with the hypothesis that the 'Bolsonaro effect' impacted not only on Covid-19 vaccination, but has affected vaccination campaigns in general thereby jeopardizing the historical success of the National Immunization Program in Brazil.

Effect of face-covering use on adherence to other COVID-19 protective behaviours: A systematic review.

During the COVID-19 pandemic, concerns were raised that face covering use may elicit risk compensation; a false sense of security resulting in reduced adherence to other protective behaviours such as physical distancing. This systematic review aimed to investigate the effect of face covering use on adherence to other COVID-19 related protective behaviours. Medline, Embase, PsychInfo, EmCare, medRxiv preprints, Research Square and WHO COVID-19 Research Database were searched for all primary research studies published from 1st January 2020 to 17th May 2022 that investigated the effect of face covering use on adherence to other protective behaviours in public settings during the COVID-19 pandemic. Papers were selected and screened in accordance with the PRISMA framework. Backwards and forwards citation searches of included papers were also conducted on 16th September 2022, with eligible papers published between 1st January 2020 and that date being included. A quality appraisal including risk of bias was assessed using the Academy of Nutrition and Dietetics' Quality Criteria Checklist. This review is registered on PROSPERO, number CRD42022331961. 47 papers were included, with quality ranging from low to high. These papers investigated the effects of face covering use and face covering policies on adherence to six categories of behaviour: physical distancing; mobility; face-touching; hand hygiene; close contacts; and generalised protective behaviour. Results reveal no consistent evidence for or against risk compensation, with findings varying according to behaviour and across study types, and therefore confident conclusions cannot be made. Any policy decisions related to face coverings must consider the inconsistencies and caveats in this evidence base.

Lockdown, Curfew, and Social Distancing.

People worldwide have been affected by coronavirus disease 2019 (COVID-19), which was the fifth pandemic after the 1918 flu pandemic. People have had their sense of normality torn apart, and these changes have taken a toll on their mental health.

Morocco's population contact matrices: A crowd dynamics-based approach using aggregated literature data.

Estimation of contact patterns is often based on questionnaires and time-use data. The results obtained using these methods have been used extensively over the years and recently to predict the spread of the COVID-19 pandemic. They have also been used to test the effectiveness of non-pharmaceutical measures such as social distance. The latter is integrated into epidemiological models by multiplying contact matrices by control functions. We present a novel method that allows the integration of social distancing and other scenarios such as panic. Our method is based on a modified social force model. The model is calibrated using data relating to the movements of individuals and their interactions such as desired walking velocities and interpersonal distances as well as demographic data. We used the framework to assess contact patterns in different social contexts in Morocco. The estimated matrices are extremely assortative and exhibit patterns similar to those observed in other studies including the POLYMOD project. Our findings suggest social distancing would reduce the numbers of contacts by 95%. Further, we estimated the effect of panic on contact patterns, which indicated an increase in the number of contacts of 11%. This approach could be an alternative to questionnaire-based methods in the study of non-pharmaceutical measures and other specific scenarios such as rush hours. It also provides a substitute for estimating children's contact patterns which are typically assessed through parental proxy reporting in surveys.

Effects of social distancing provoked by COVID-19 pandemic in the functional capacity and cognitive function in nonagenarians and centenarians.

INTRODUCTION: Due to the rapid advance of coronavírus SARS-CoV-2 (COVID-19) pandemic in 2020, social distancing was the main way to reduce the transmission of the virus. Although this measure was efficient and necessary, the social distancing had severe consequences for physical function, mainly in older individuals. Thus, the aim of this study was to investigate the effects of social distancing in the functional and cognitive capacity of community-dwelling oldest-old adults. METHODS: The present study is part of a larger prospective cohort study. Fifteen participants aged 90 years old or older were assessed in the 8-foot-timed-up-and-go test (8-footTUG), sit-to-stand-up test (STS), handgrip strength test (HGS), Mini Mental State Examination (MMSE), Katz Index and Lawton Scale before and after one year of social distancing. RESULTS: A significant worsening in the 8-footTUG and MMSE score was observed, while there were no significant changes in the other variables. When analyzing the decreases in relation to previous functional capacity, it was observed that individuals categorized as dependent by STS cut-off points had the worst decreases in functional capacity. CONCLUSION: The social distancing provoked by COVID-19 pandemic negatively affected the 8-footTUG and cognition. Moreover, individuals dependents showed greater decline in their functional capacity.

Factors associated with compliance with barrier gestures and social distancing measures in France.

BACKGROUND: The COVID-19 pandemic led many countries to drastically limit social activities. The objective of this study is to describe the factors associated with compliance with protective measures and social distancing in the general adult population in France, between March and December 2020 (first and second waves of the epidemic), before vaccination began at the end of December 2020. METHOD: The data come from the CoviPrev repeated cross-sectional descriptive survey, conducted between March 2020 and December 2022 in metropolitan France. The data collected from March to December 2020 (19 survey waves), from a panel representative of the general population, were used. Three periods were defined: the first epidemic wave (March-April), the inter-wave period (May-June) and the second epidemic wave (November-December). A compliance score was constructed to measure systematic compliance with the five main measures. The association between systematic compliance and different variables (sociodemographic, mental health, level of health literacy, perceived severity of COVID-19, confidence in government, perceived effectiveness of the measures) was described using bivariate and multivariate logistic regression models, using the statistical software R. RESULTS: Systematic compliance with the preventive measures changed over time. Regardless of the period, being a woman, being over 50, perceiving COVID-19 as severe, having a high level of health literacy or anxiety were positively associated with compliance. Having a child under 16 years of age and perceiving the measures as effective were positively associated with compliance with the protective measures during the epidemic waves; conversely, having a high level of depression, living alone, not working were negatively associated in the first epidemic wave. Finally, during the inter-wave period, living in an area heavily affected during the first wave and having a high level of education were positively and negatively associated with systematic compliance with the preventive measures, respectively. CONCLUSION: The factors associated with compliance with the protective measures and social distancing evolved during the epidemic. Monitoring this evolution, in order to adapt communication and awareness strategies, is essential in the context of pandemic response.

Optimal social distancing in epidemic control: cost prioritization, adherence and insights into preparedness principles.

The COVID-19 pandemic experience has highlighted the importance of developing general control principles to inform future pandemic preparedness based on the tension between the different control options, ranging from elimination to mitigation, and related costs. Similarly, during the COVID-19 pandemic, social distancing has been confirmed to be the critical response tool until vaccines become available. Open-loop optimal control of a transmission model for COVID-19 in one of its most aggressive outbreaks is used to identify the best social distancing policies aimed at balancing the direct epidemiological costs of a threatening epidemic with its indirect (i.e., societal level) costs arising from enduring control measures. In particular, we analyse how optimal social distancing varies according to three key policy factors, namely, the degree of prioritization of indirect costs, the adherence to control measures, and the timeliness of intervention. As the prioritization of indirect costs increases, (i) the corresponding optimal distancing policy suddenly switches from elimination to suppression and, finally, to mitigation; (ii) the "effective" mitigation region-where hospitals' overwhelming is prevented-is dramatically narrow and shows multiple control waves; and (iii) a delicate balance emerges, whereby low adherence and lack of timeliness inevitably force ineffective mitigation as the only accessible policy option. The present results show the importance of open-loop optimal control, which is traditionally absent in public health preparedness, for studying the suppression-mitigation trade-off and supplying robust preparedness guidelines.

Evaluating the dynamic interplay of social distancing policies regarding airborne pathogens through a temporal interaction-driven model that uses real-world and synthetic data.

OBJECTIVE: The recent SARS-CoV-2 pandemic has exhibited diverse patterns of spread across countries and communities, emphasizing the need to consider the underlying population dynamics in modeling its progression and the importance of evaluating the effectiveness of non-pharmaceutical intervention strategies in combating viral transmission within human communities. Such an understanding requires accurate modeling of the interplay between the community dynamics and the disease propagation dynamics within the community. METHODS: We build on an interaction-driven model of an airborne disease over contact networks that we have defined. Using the model, we evaluate the effectiveness of temporal, spatial, and spatiotemporal social distancing policies. Temporal social distancing involves a pure dilation of the timeline while preserving individual activity potential and thus prolonging the period of interaction; spatial distancing corresponds to social distancing pods; and spatiotemporal distancing pertains to the situation in which fixed subgroups of the overall group meet at alternate times. We evaluate these social distancing policies over real-world interactions' data and over history-preserving synthetic temporal random networks. Furthermore, we evaluate the policies for the disease's with different number of initial patients, corresponding to either the phase in the progression of the infection through a community or the number of patients infected together at the initial infection event. We expand our model to consider the exposure to viral load, which we correlate with the meetings' duration. RESULTS: Our results demonstrate the superiority of decreasing social interactions (i.e., time dilation) within the community over partial isolation strategies, such as the spatial distancing pods and the spatiotemporal distancing strategy. In addition, we found that slow-spreading pathogens (i.e., pathogens that require a longer exposure to infect) spread roughly at the same rate as fast-spreading ones in highly active communities. This result is surprising since the pathogens may follow different paths. However, we demonstrate that the dilation of the timeline considerably slows the spread of the slower pathogens. CONCLUSIONS: Our results demonstrate that the temporal dynamics of a community have a more significant effect on the spread of the disease than the characteristics of the spreading processes.

Too anthropomorphized to keep distance: The role of social psychological distance on meat inclinations.

Keeping a distance from food animals helps alleviate moral conflicts associated with meat consumption. Prior research on the 'meat paradox' has shown that physical distance from animals reduces negative emotional responses when consuming meat. However, even with physical distance, the presence of animals in meat advertisements and packaging can establish psychological contact. The impact of psychological distance on meat consumption and purchase inclinations has not been well explored. Through four experiments, we discovered that animal anthropomorphism psychologically brings consumers closer to food animals, resulting in reduced intentions to consume and purchase meat. Anthropomorphized animal images notably reduced social psychological distance for consumers with moderate to high (vs. lower) levels of anthropomorphic tendencies. Furthermore, the effect of anthropomorphism was influenced by moral self-efficacy. Specifically, when social psychological distance was reduced, consumers with higher (vs. lower) moral self-efficacy exhibited a significant decrease in their willingness to consume and purchase meat. These findings expand our understanding of the role of anthropomorphism in meat marketing, its limitations, and offer insights for sales strategies. Additionally, the research could inform public health policies on meat consumption, addressing environmental and ethical concerns tied to meat production amid growing worries about animal welfare.

An evaluation of the impact of mitigation policies on health and the economy by managing social distancing during outbreaks.

The COVID-19 pandemic has necessitated various unavoidable social restrictions, leading to questions about the effectiveness of public emergency interventions and their impact economic growth. Block et al. (2020) conducted a notably study using an agent-based model to evaluate policies for reducing contact and demonstrated how choices in contact behavior can influence the rate and spread of the virus. However, their approach did not consider the economic consequences of these social restrictions. In response, we propose a set of strategies for governments to plan and evaluate policies during emergencies, aiming to contain infections while minimizing negative economic consequences. Our results indicate that there is no trade-off between containment strategies and economic output loss, making containment measures necessary policy instruments. However, potential trade-offs do emerge when selecting the most effective strategy. In this context, we propose and evaluate various policy alternatives to extreme "social distancing" measures, which can partially restore essential social interactions while preventing economic disasters induced by productivity losses.

Untapped Potential of Unobtrusive Observation for Studying Health Behaviors.

Improving the environment is an important upstream intervention to promote population health by influencing health behaviors such as physical activity, smoking, and social distancing. Examples of promising environmental interventions include creating high-quality green spaces, building active transport infrastructure, and implementing urban planning regulations. However, there is little robust evidence to inform policy and decision makers about what kinds of environmental interventions are effective and for which populations. In this viewpoint, we make the case that this evidence gap exists partly because health behavior research is dominated by obtrusive methods that focus on studying individual behavior and that are less suitable for understanding environmental influences. In contrast, unobtrusive observation can assess how behavior varies in different environmental contexts. It thereby provides valuable data relating to how environments affect the behavior of populations, which is often useful knowledge for effectively and equitably tackling population health challenges such as obesity and noncommunicable diseases. Yet despite a long history, unobtrusive observation methods are currently underused in health behavior research. We discuss how developing the use of video technology and automated computer vision techniques can offer a scalable solution for assessing health behaviors, facilitating a more thorough investigation of how environments influence health behaviors. We also reflect on the important ethical challenges associated with unobtrusive observation and the use of these emerging video technologies. By increasing the use of unobtrusive observation alongside other methods, we strongly believe this will improve our understanding of the influences of the environment on health behaviors.

The paradox of pandemic mitigation? Moderating role of pandemic severity on the impact of social distancing policies: a cultural value perspective.

BACKGROUND: Social distancing policies were of utmost importance during the early stages of the COVID-19 pandemic. These policies aimed to mitigate the severity of local outbreaks by altering public behavior. However, if the severity of the pandemic reduces, the impact of these policies on actual behavior may decrease. This study aims to examine, from a global perspective, whether the impact of social distancing policies on actual mobility is moderated by local pandemic severity and whether this moderating effect varies across cultural value contexts. METHODS: We combined multiple publicly available global datasets for structural equation model analysis. 17,513 rows of data from 57 countries included in all databases were analyzed. Multilevel moderated moderation models were constructed to test the hypotheses. RESULTS: More stringent policies in a region mean less regional mobility (ß = -0.572, p < 0.001). However, the severity of local outbreaks negatively moderated this effect (ß = -0.114, p < 0.001). When the pandemic was not severe, the influence of policy intensity on mobility weakened. Furthermore, based on Schwartz's cultural values theory, cultural values of autonomy (ß = -0.109, p = 0.011), and egalitarianism (ß = -0.108, p = 0.019) reinforced the moderating effect of pandemic severity. On the other hand, cultural values of embeddedness (ß = 0.119, p = 0.006) and hierarchy (ß = 0.096, p = 0.029) attenuated the moderating effect. CONCLUSIONS: Social distancing policies aim to reduce the severity of local pandemics; however, the findings reveal that mitigating local pandemics may reduce their impact. Future policymakers should be alert to this phenomenon and introduce appropriate incentives to respond. The results also show that the moderating role of pandemic severity varies across cultures. When policies are promoted to deal with global crises, policymakers must seriously consider the resistance and potential incentives of cultural values.

Perception of interpersonal distance and social distancing before and during COVID-19 pandemic.

Since COVID-19 is easily transmitted among people in close physical proximity, the focus of epidemiological policy during the COVID-19 crisis included major restrictions on interpersonal distance. However, the way in which distance restrictions affected spatial perception is unclear. In the current study, we examined interpersonal distance preferences and perceptions at three time points: pre-pandemic, early post-pandemic, and late post-pandemic. The results indicate that following the pandemic outbreak, people perceived others as farther away than they actually were, suggesting that the distance restrictions were associated with an enlargement of perceived interpersonal distance. Interestingly, however, people maintained the same distance from one another as before the outbreak, indicating no change in actual distance behavior due to the risk of infection. These findings suggest that COVID-19 was associated with a change in the way distance is perceived, while in practice, people maintain the same distance as before. In contrast, COVID-related anxiety predicted both a preference for maintaining a greater distance and a bias toward underestimating perceived distance from others. Thus, individuals who were highly fearful of COVID-19 perceived other people to be closer than they actually were and preferred to maintain a larger distance from them. The results suggest that subjective risk can lead to an increased perception of danger and a subsequent change in behavior. Taken together, even when behaviors should logically change, the decision-making process can be based on distorted perceptions. This insight may be used to predict public compliance.

Self-quarantining, social distancing, and mental health during the COVID-19 pandemic: A multi wave, longitudinal investigation.

Social isolation and disconnectedness increase the risk of worse mental health, which might suggest that preventive health measures (i.e., self-quarantining, social distancing) negatively affect mental health. This longitudinal study examined relations of self-quarantining and social distancing with mental health during the COVID-19 pandemic. A U.S. national sample (N = 1,011) completed eight weekly online surveys from March 20, 2020 to May 17, 2020. Surveys assessed self-quarantining, social distancing, anxiety, and depression. Fixed-effect autoregressive cross-lagged models provided a good fit to the data, allowing for disaggregation of between-person and within-person effects. Significant between-person effects suggested those who engaged in more self-quarantining and social distancing had higher anxiety and depression compared to those who engaged in less social distancing and quarantining. Significant within-person effects indicated those who engaged in greater social distancing for a given week experienced higher anxiety and depression that week. However, there was no support for self-quarantining or social distancing as prospective predictors of mental health, or vice versa. Findings suggest a relationship between mental health and both self-quarantining and social distancing, but further longitudinal research is required to understand the prospective nature of this relationship and identify third variables that may explain these associations.

Predicting COVID-19 cases in Belo Horizonte-Brazil taking into account mobility and vaccination issues.

The pandemic caused millions of deaths around the world and forced governments to take drastic measures to reduce the spread of Coronavirus. Understanding the impact of social distancing measures on urban mobility and the number of COVID-19 cases allows governments to change public policies according to the evolution of the pandemic and plan ahead. Given the increasing rates of vaccination worldwide, immunization data may also represent an important predictor of COVID-19 cases. This study investigates the impact of urban mobility and vaccination upon COVID-19 cases in Belo Horizonte, Brazil using Prophet and ARIMA models to predict future outcomes. The developed models generated projections fairly close to real numbers, and some inferences were drawn through experimentation. Brazil became the epicenter of the COVID-19 epidemic shortly after the first case was officially registered on February 25th, 2020. In response, several municipalities adopted lockdown (total or partial) measures to minimize the risk of new infections. Here, we propose prediction models which take into account mobility and vaccination data to predict new COVID-19 cases.

The COVID-19 pandemic and changes in social behavior: Protective face masks reduce deliberate social distancing preferences while leaving automatic avoidance behavior unaffected.

Protective face masks were one of the central measures to counteract viral transmission in the COVID-19 pandemic. Prior research indicates that face masks impact various aspects of social cognition, such as emotion recognition and social evaluation. Whether protective masks also influence social avoidance behavior is less clear. Our project assessed direct and indirect measures of social avoidance tendencies towards masked and unmasked faces in two experiments with 311 participants during the first half of 2021. Two interventions were used in half of the participants from each sample (Experiment 1: protective face masks; Experiment 2: a disease prime video) to decrease or increase the salience of the immediate contagion threat. In the direct social avoidance measure, which asked for the deliberate decision to approach or avoid a person in a hypothetical social encounter, participants showed an increased willingness to approach masked as opposed to unmasked faces across experiments. This effect was further related to interindividual differences in pandemic threat perception in both samples. In the indirect measure, which assessed automatic social approach and avoidance tendencies, we neither observed an approach advantage towards masked faces nor an avoidance advantage for unmasked faces. Thus, while the absence of protective face masks may have led to increased deliberate social avoidance during the pandemic, no such effect was observed on automatic regulation of behavior, thus indicating the relative robustness of this latter behavior against changes in superordinate social norms.

Impact of social distancing from the COVID-19 pandemic on the immuno-inflammatory response of older adults.

BACKGROUND: Older adults, as the population considered at increased risk for severe COVID-19, were the most impacted by social isolation. Thus, this study aimed to assess the salivary immune/inflammatory response of older adults before and during the COVID-19 pandemic. METHODS: A cohort of 11 older adults (mean age 66.8 ± 6.1) was followed at three different time points: before (S1) and after 6 (S2) and 20 months (S3) of the beginning of the COVID-19 pandemic in Brazil. Unstimulated saliva samples were obtained to assess the levels of antibodies (secretory IgA, IgG and IgM) by ELISA and cytokines (IL-2, IL-5, IL-6, IL-8 and IL-10, TSLP, IFN-γ, TNF-α) by multiplex analysis. Significant differences were evaluated using the Kruskal-Wallis test with Dunn's post-test. RESULTS: None volunteer presented periodontal disease or caries. All volunteers received at least two doses of the COVID-19 vaccines after S2 and before S3. A tendency to increase salivary levels of SIgA and IgM at S2 and of IgG at S3 were observed compared to the values found at S1 and S2. Significantly decreased levels of IL-2 and IL-5 were found at S2 and S3 (p < 0.001) time points. Lower levels of IFN-γ were found at S2 as compared to the values observed at S1 (p < 0.01). A significant decrease in the IFN-γ/IL-10 ratio was found at S2 (p < 0.01). When assessing the Th1/Th2 ratios, a significant decrease was found in the IFN-γ/TSLP ratio at S2 (p < 0.001) and S3 (p < 0.001) when compared to the values at S1. In addition, a significant increase was observed in the TNF-α/IL-5 ratio at S2 (p < 0.001) and S3 (p < 0.001) in comparison to the values at S1. In a similar way, an increase in the TNF-α/IL-6 ratio (Fig. 5E) was observed at S3 (p < 0.001) when compared to the values at S1. CONCLUSIONS: Overall, this study provides valuable insights into the impact of COVID-19-induced social isolation on immune/inflammatory responses in the upper airway mucosa, particularly those present in oral cavity, of older adults. It demonstrates that a controlled shift in Th1 and Th2 immune responses, both during infection and post-vaccination, can create favorable conditions to combat viral infections without exacerbating the immune response or worsening the pathology.

Health protective behaviours during the COVID-19 pandemic: Risk adaptation or habituation?

Many epidemiological works show that human behaviours play a fundamental role in the spread of infectious diseases. However, we still do not know much about how people modify their Health Protective Behaviours (HPB), such as hygiene or social distancing measures, over time in response to the health threat during an epidemic. In this study, we examined the role of the epidemiological context in engagement in HPB through two possible mechanisms highlighted by research into decision-making under risk: risk adaptation and risk habituation. These two different mechanisms were assumed to explain to a large extent the temporal variations in the public's responsiveness to the health threat during the COVID-19 pandemic. To test them, we used self-reported data collected through a series of 25 cross-sectional surveys conducted in France among representative samples of the adult population, from March 2020 to September 2021 (N = 50,019). Interestingly, we found that both mechanisms accounted relatively well for the temporal variation in the adoption of social distancing during the pandemic, which is remarkable given their different assumptions about the underlying social cognitive processes involved in response to a health threat. These results suggest that strengthening the incentives to encourage people to maintain health protective behaviours and to counter risk habituation effects is crucial to disease control and prevention over time.

Risk, sanctions and norm change: the formation and decay of social distancing norms.

Global challenges like the climate crisis and pandemic outbreaks require collective responses where people quickly adapt to changing circumstances. Social norms are potential solutions, but only if they themselves are flexible enough. The COVID-19 pandemic provided a unique opportunity to study norm formation and decay in real-world contexts. We tracked empirical and normative expectations about social distancing and empirical and normative expectations of sanctioning from June 2021 to February 2022 to explore how norms and meta norms evolved as COVID-19 risk decreased and increased. We found that norms and meta norms partially coevolve with risk dynamics, although they recover with some delay. This implies that norms should be enforced as soon as risk increases. We therefore tested how sanctioning intentions vary for different hypothetical norms and find them to increase with a clear meta norm of sanctioning, yet decrease with a clear social norm of distance. In conclusion, social norms evolve spontaneously with changing risk, but might not be adaptive enough when the lack of meta norms of sanctioning introduce tolerance for norm violations. Moreover, norm nudges can potentially have negative externalities if strengthening the social norm increases tolerance for norm violations. These results put some limits to social norms as solutions to guide behaviour under risk. This article is part of the theme issue 'Social norm change: drivers and consequences'.