Democratic quality and excess mortality during the COVID-19 pandemic.

The aim of this study is to analyse the relationship between democratic quality and excess mortality produced in the year 2020 before COVID-19 vaccinations were generalised. Using cross-sectional data from 80 countries on five continents, multiple linear regression models between excess mortality, the general democracy index and its disaggregation into five categories: electoral process and pluralism, government functioning, political participation, political culture and civil liberties were estimated. The analysis also considered, public health spending per capita, overweight inhabitants, the average temperature of the country, population over 65 years of age, The KOF Globalisation Index, and the Gross National Income per capita as control variables. It was possible to establish a strong inverse association between excess mortality per million inhabitants and the general democracy index and four of its five categories. There was a particularly strong relationship between excess mortality and the political culture dimension (-326.50, p < 0.001). The results suggest that the higher the democratic quality of the political institutions of a State and particularly of their political culture the more improved the response and management of the pandemic was in preventing deaths and protecting their citizens more effectively. Conversely, countries with lower democracy index values have higher excess mortality. Quality democratic political institutions provide more effective public health policies in the face of the COVID-19 pandemic.

The politics of disease.

The COVID-19 pandemic highlights a long-known but often neglected aspect of international relations: the ability of disease to challenge and change all aspects of security, as well as the ability of public policies to change the course of disease progression. Diseases, especially mass epidemics like COVID-19, clearly affect political, economic, and social structures, but they can also be ameliorated or exacerbated by political policies, including public health policies. The threat of pandemic disease poses a widespread and increasing threat to international stability. Indeed, the political implications of pandemic disease have become increasingly evident as COVID-19 has precipitated death, economic collapse, and political instability around the globe. Any pandemic disease can precipitate catastrophes, from increasing health care costs to decreased productivity. This theoretical discussion highlights the intertwined interactions between social, political, and economic forces and the emergence and evolution of pandemic disease, with widespread implications for governance and international security.

How COVID-19 affects voting for incumbents: Evidence from local elections in France.

How do voters react to an ongoing natural threat? Do voters sanction or reward incumbents even when incumbents cannot be held accountable because an unforeseeable natural disaster is unfolding? We address this question by investigating voters' reactions to the early spread of COVID-19 in the 2020 French municipal elections. Using a novel, fine-grained measure of the circulation of the virus based on excess-mortality data, we find that support for incumbents increased in areas that were particularly hard hit by the virus. Incumbents from both left and right gained votes in areas more strongly affected by COVID-19. We provide suggestive evidence for two mechanisms that can explain our findings: an emotional channel related to feelings of fear and anxiety, and a prospective-voting channel, related to the ability of incumbents to act more swiftly against the diffusion of the virus than challengers.

From an election to an insurrection: Investigating differential engagement and sentiment in the #defundthepolice and #defendthepolice network on Twitter.

Social movements and their respective countermovements have evolved to use online social media platforms to recruit followers, share pertinent information, discuss relevant issues, and draw the attention of political figures. Movements' strategic use of Twitter has increasingly been studied, though there are relatively few studies that compare social movements and their corresponding countermovements simultaneously. We examine engagement in the #DefundthePolice social movement and #DefendthePolice countermovement in a Twitter network comprised of retweets using both hashtags from August 2020 to January 2021. Text and sentiment analysis as well as a content analysis of a random sample of retweets in the network's 20 largest subgroups reveal four key patterns. First, information commonly communicated in historical social movements is communicated in the online, Twitter network. Second, the use of movement and countermovement hashtags to criticize is common, suggesting Twitter engagement with the movement/countermovement is not a sufficient indicator of support for the movement. Third, social movements are inextricably embedded in politics, with political discourse present in all the 20 largest subgroups. Finally, though we do not include geo-tagged tweets in the analysis, physical geography is key theme in multiple subgroups. Broadly, our findings demonstrate the breadth of topics communicated within movement networks and highlight the importance of qualitatively examining Twitter data in the study of social movements.

Reports of COVID-19 Vaccine Adverse Events in Predominantly Republican vs Democratic States.

Importance: Antivaccine sentiment is increasingly associated with conservative political positions. Republican-inclined states exhibit lower COVID-19 vaccination rates, but the association between political inclination and reported vaccine adverse events (AEs) is unexplored. Objective: To assess whether there is an association between state political inclination and the reporting rates of COVID-19 vaccine AEs. Design, Setting, and Participants: This cross-sectional study used the AE reports after COVID-19 vaccination from the Vaccine Adverse Event Reporting System (VAERS) database from 2020 to 2022, with reports after influenza vaccines from 2019 to 2022 used as a reference. These reports were examined against state-level percentage of Republican votes in the 2020 US presidential election. Exposure: State-level percentage of Republican votes in the 2020 US presidential election. Main Outcomes and Measures: Rates of any AE among COVID-19 vaccine recipients, rates of any severe AE among vaccine recipients, and the proportion of AEs reported as severe. Results: A total of 620 456 AE reports (mean [SD] age of vaccine recipients, 51.8 [17.6] years; 435 797 reports from women [70.2%]; a vaccine recipient could potentially file more than 1 report, so reports are not necessarily from unique individuals) for COVID-19 vaccination were identified from the VAERS database. Significant associations between state political inclination and state AE reporting were observed for all 3 outcomes: a 10% increase in Republican voting was associated with increased odds of AE reports (odds ratio [OR], 1.05; 95% CI, 1.05-1.05; P < .001), severe AE reports (OR, 1.25; 95% CI, 1.24-1.26; P < .001), and the proportion of AEs reported as severe (OR, 1.21; 95% CI, 1.20-1.22; P < .001). These associations were seen across all age strata in stratified analyses and were more pronounced among older subpopulations. Conclusions and Relevance: This cross-sectional study found that the more states were inclined to vote Republican, the more likely their vaccine recipients or their clinicians reported COVID-19 vaccine AEs. These results suggest that either the perception of vaccine AEs or the motivation to report them was associated with political inclination.

Detection and impact estimation of social bots in the Chilean Twitter network.

The rise of bots that mimic human behavior represents one of the most pressing threats to healthy information environments on social media. Many bots are designed to increase the visibility of low-quality content, spread misinformation, and artificially boost the reach of brands and politicians. These bots can also disrupt civic action coordination, such as by flooding a hashtag with spam and undermining political mobilization. Social media platforms have recognized these malicious bots' risks and implemented strict policies and protocols to block automated accounts. However, effective bot detection methods for Spanish are still in their early stages. Many studies and tools used for Spanish are based on English-language models and lack performance evaluations in Spanish. In response to this need, we have developed a method for detecting bots in Spanish called Botcheck. Botcheck was trained on a collection of Spanish-language accounts annotated in Twibot-20, a large-scale dataset featuring thousands of accounts annotated by humans in various languages. We evaluated Botcheck's performance on a large set of labeled accounts and found that it outperforms other competitive methods, including deep learning-based methods. As a case study, we used Botcheck to analyze the 2021 Chilean Presidential elections and discovered evidence of bot account intervention during the electoral term. In addition, we conducted an external validation of the accounts detected by Botcheck in the case study and found our method to be highly effective. We have also observed differences in behavior among the bots that are following the social media accounts of official presidential candidates.

Decentralisation in Clinical Trials and Patient Centricity: Benefits and Challenges.

Decentralised clinical trials (DCTs) encompass various terms such as virtual, home-based, remote and siteless trials. The objectives of DCTs are to enhance the ease of participation for patients in clinical trials by minimising or removing the necessity for trial subjects to travel to the trial sites. This approach has been shown to reduce drop-out rates, increase study effectiveness and ultimately get life-altering drugs to market faster-saving sponsors billions. At the outset, DCTs deploy a wide range of digital technologies to collect safety and efficacy data from study participants, providing study treatments and performing investigations from the comfort of the patient's own home. The aim of decentralised trials includes patient centricity, enhanced efficacy in clinical trial conduct and generating real-world data. This is done by not only making it convenient for the patient to participate in the trial execution, but also involving them from the planning stage and taking their inputs during designing of trials and consenting documentation, understanding their treatment requirements and designing the studies accordingly. Various regulatory authorities have published guidelines governing DCT principles, especially after the coronavirus disease 2019 (COVID-19) experience of undertaking multicentric clinical trials. Both United States Food and Drug Administration (USFDA) and European Medicines Agency (EMA) have newer, recently updated guidelines to capture this growing reality to undertake clinical trials using patient technology or patient-centric technologies. Other regulatory agencies are accepting data generated using decentralised and patient-centric technologies and making an effort to include elements of decentralised trials in their regulatory guidelines. Decentralised trials follow a hybrid approach to have a balanced mix of remote and in-person data collection and trial procedures. Decentralised and patient-centric approaches are the future of any organisation for the conduct of clinical trials. Globally, all sponsor pharmaceutical companies must start undertaking drug development and clinical trials using a decentralised approach while keeping patient centricity in mind.

Health emergencies, science contrarianism and populism: A scoping review.

Populism has emerged as a central explanation employed by both media outlets and scholars for the mishandling of the COVID-19 crisis. Nonetheless, the relationship between public health and populism extends before and beyond the pandemic. This paper offers a comprehensive overview of existing evidence and theoretical conceptualisations on the intersection of populism, health emergencies, and contrarian scientific positions, drawing from a diverse range of disciplines. I conducted a scoping review of 283 original studies, analysing their analytical framework, geographic focuses, and methodological approaches. Employing quantitative text analysis, I summarised the research field into 18 common topics, organised into five coherent categories: citizen's perspective, political elites, political communication, pandemic consequences, and non-COVID-related issues. While the scholarly interest in this area has surged since the onset of the pandemic, it has predominantly concentrated on specific cases, such as Brazil and the US, often conflating different policy types. The evidence summary elucidates that populism assumes varying roles within distinct contexts, and there is no linear relationship between political populism and specific approaches to health crises and science. I further compare definitions of populism within the context of health and scientific positions. I propose that future research should employ a policy typology for health emergency responses, assessing political positions based on policy arenas. This paper contributes to the understanding of the complex interplay between political populism, contrarian scientific perspectives, and public health.

Politics and confidence toward the COVID-19 vaccination: A Brazilian cross-sectional study.

This study has the aim of assessing the Brazilian perceptions, influencing factors and political positioning on the confidence concerning COVID-19 vaccination. To achieve the objective, the methods rely on a cross-sectional survey of Brazilian citizens, distributed through different social networks. The sample is composed of 1,670 valid responses, collected from almost all Brazilian states and state capitals. To analyze the data and give a clear view of the variables' relationship, the study used bivariate and comparative graphs. Results show a higher level of confidence in vaccines from Pfizer and AstraZeneca, while the lower level of confidence is associated with vaccines from Sinopharm and Sputinik5. Vaccine efficacy is the most significant influencing factor that helps in the decision to get vaccinated. Also, individuals are less willing to get vaccinated if their political preferences are related to the right-wing. The results led to three main health and social implications: i) the vaccination strategy campaigns should take in count vaccine efficacy and political aspects; ii) the vaccination process should be adapted to regions with different political positions; and iii) a reinforcement in the educational policies of the vaccine's importance to the public health, to avoid the politization of a health issue.

HIV/AIDS, SARS, and COVID-19: the trajectory of China's pandemic responses and its changing politics in a contested world.

The COVID-19 pandemic has revealed the contested politics of global health governance, though we still don't know enough about the dynamics of domestic pandemic responses, or about the relationship between the politics of those responses and the politics of global health governance, both of which have changed significantly in recent decades. Focusing on three cases (HIV/AIDS, SARS, and COVID-19) of cross-border infectious diseases, this article explores the trajectory of China's pandemic responses in the context of globalization. Attending to changing politics at domestic, international, and global levels, I argue that those responses have been a complex combination of China's domestic politics (e.g., priorities, institutions, leadership, and timing), its international relations (especially with the US), and its engagements with global health governance. It is concluded that the increasing divergence of pandemic responses in a time of ubiquitous global health crisis demands urgent attention to the connections (including contestations) between domestic pandemic responses and the evolvement of global health governance from a broader perspective that considers changes in geopolitics.

Comparing the language style of heads of state in the US, UK, Germany and Switzerland during COVID-19.

The COVID-19 pandemic posed a global threat to nearly every society around the world. Individuals turned to their political leaders to safely guide them through this crisis. The most direct way political leaders communicated with their citizens was through official speeches and press conferences. In this report, we compare psychological language markers of four different heads of state during the early stage of the pandemic. Specifically, we collected all pandemic-related speeches and press conferences delivered by political leaders in the USA (Trump), UK (Johnson), Germany (Merkel), and Switzerland (Swiss Federal Council) between February 27th and August 31st, 2020. We used natural language analysis to examine language markers of expressed positive and negative emotions, references to the community (we-talk), analytical thinking, and authenticity and compare these language markers across the four nations. Level differences in the language markers between the leaders can be detected: Trump's language was characterized by a high expression of positive emotion, Merkel's by a strong communal focus, and Johnson's and the Swiss Federal Council by a high level of analytical thinking. Overall, these findings mirror different strategies used by political leaders to deal with the COVID-19 pandemic.

Political ideology shapes risk and benefit judgments of COVID-19 vaccines.

In April 2021, the use of the Johnson & Johnson COVID-19 vaccine was paused to investigate whether it had caused serious blood clots to a small number of women (six out of 6.8 million Americans who had been administered that vaccine). As these events were unfolding, we surveyed a sample of Americans (N = 625) to assess their reactions to this news, whether they supported the pausing of the vaccine, and potential psychological factors underlying their decision. In addition, we employed automated text analyses as a supporting method to more classical quantitative measures. Results showed that political ideology influenced the support for the pausing of the vaccine; liberals were more likely to oppose it than conservatives. In addition, the effect of political ideology was mediated by the difference between perceived benefit and risk and the language style used to produce reasons in support (or against) the decision to pause the vaccine. Liberals perceived the benefit of vaccines higher than the risk, used a more analytic language style when stating their reasons, and had a more positive attitude toward the vaccine. We discuss the implications of our findings considering vaccine hesitancy and risk perception during the COVID-19 pandemic.

Political partisanship, laissez-faire attitudes, and COVID-19 behaviours and viewpoints in Canada and the United States.

OBJECTIVE: In the United States, clear partisan differences in responses to COVID-19 have been shown in leadership and elite cueing at the state level as well as in perspectives and behaviours of the citizenry. This study probes differences in political values-particularly the prevalence of laissez-faire attitudes-that might explain the stronger social consensus on pandemic countermeasures seen in Canada. METHODS: Data were obtained from temporally aligned waves of cross-sectional surveys of Canadian and US adults in the first year of the pandemic. Survey questions were used to construct an index of laissez-faire attitudes (LFA) which, along with demographic variables and measures of partisanship, was incorporated into regression models to predict three outcomes: practice of personal mitigation measures (e.g. mask wearing), level of worry about the pandemic, and likeliness to get a vaccine. RESULTS: LFA scores had a strong negative relationship to all three outcomes for Canadians and Americans, albeit with larger effects among the Americans on two outcomes. Overall differences in LFA scores between Americans and Canadians were modest (0.04 on a 0-1 scale). However, Republican Party stalwarts had considerably higher LFA scores and were proportionally more numerous than Conservative loyalists in Canada. While there were partisan differences in LFA scores within Canada, the largest gap by far was between Republicans and Democrats in the USA. Respondents from Canada's Prairie provinces had slightly higher average LFA scores but there were no significant residence effects on outcomes. CONCLUSION: Laissez-faire attitudes that may conflict with public health values and measures are much more prevalent in the USA than in Canada. This difference underpins the limited effects of political partisanship and broad consensus in the Canadian public's responses to the pandemic.

RéSUMé: OBJECTIF: Aux États-Unis, des différences partisanes évidentes au niveau des réactions face au COVID-19 ont été mises en évidence pour ce qui est du leadership et des indications données par l'élite au niveau de l'État, ainsi que des perspectives et des comportements des citoyens. Cette étude examine les différences de valeurs politiques, en particulier la prévalence de comportements de type « laissez-faire ¼, susceptibles d'expliquer le consensus social plus fort observé au Canada concernant les contre-mesures à prendre en cas de pandémie. MéTHODES: Les données ont été obtenues à partir de séries d'enquêtes transversales alignées temporellement auprès d'adultes canadiens et américains durant la première année de la pandémie. Les questions de l'enquête ont été utilisées pour élaborer un indice de laissez-faire (LFA) qui, avec des variables démographiques et des indicateurs de partisanerie, a été incorporé dans des modèles de régression pour prédire trois résultats : la mise en œuvre de mesures d'atténuation personnelles (par exemple, le port d'un masque), le niveau d'inquiétude face à la pandémie et la probabilité de se faire vacciner. RéSULTATS: Les scores LFA ont une forte relation négative avec les trois résultats pour les Canadiens et les Américains, bien qu'avec des effets plus importants chez les Américains pour deux résultats. Les différences globales dans les scores LFA entre les Américains et les Canadiens étaient modestes (0,04 sur une échelle de 0 à 1). Toutefois, les fervents du parti républicain ont obtenu des scores nettement plus élevés au niveau du LFA et étaient proportionnellement plus nombreux que les partisans du parti conservateur au Canada. S'il existe des différences partisanes dans les scores du LFA au sein du Canada, l'écart le plus important, et de loin, se situe entre les républicains et les démocrates aux États-Unis. Les répondants des provinces des Prairies au Canada ont obtenu des scores moyens légèrement plus élevés pour le LFA, mais il n'y a pas eu d'effets significatifs du lieu de résidence sur les résultats. CONCLUSION: Les attitudes de « laissez-faire ¼ pouvant entrer en conflit avec les valeurs et les mesures de santé publique sont beaucoup plus répandues aux États-Unis qu'au Canada. Cette différence explique les effets limités de la partisanerie politique et du consensus général quant aux réactions du public canadien face à la pandémie.

Hurt on Both Sides: Political Differences in Health and Well-Being during the COVID-19 Pandemic.

Republicans and conservatives report better self-rated health and well-being compared to Democrats and liberals, yet they are more likely to reside in geographic areas with heavy COVID-19 morbidity and mortality. This harmed health on "both sides" of political divides, occurring in a time of rapid sociopolitical upheaval, warrants the revisiting of psychosocial mechanisms linked to political health differences. Drawing on national Gallup data (early 2021), we find that predicted differences in health or well-being vary substantially by ideology, party, voting behavior, and policy beliefs, with model fit depending on how politics are measured. Differences in self-rated health, psychological distress, happiness, trouble sleeping, and delayed health care tend to reveal worse outcomes for Democrats or liberals. Such differences often are reduced to insignificance by some combination of mastery, meritocratic beliefs, perceived social support, and COVID-19-related exposures and attitudes. Policy beliefs predict health differences most robustly across outcomes and mechanism adjustments.

The politics of vaccination: a closer look at the beliefs, social norms, and prevention behaviors related to COVID-19 vaccine uptake within two US political parties.

COVID-19 vaccine hesitancy and suboptimal vaccine uptake rates are pressing public health challenges. Vaccine hesitancy has been observed for different vaccines. For COVID-19 vaccines, multiple factors influence vaccine uptake in the U.S. including political ideology. A more nuanced understanding of the factors influencing COVID-19 vaccine uptake within political parties is needed. This study assesses the relationship between known vaccine hesitancy factors and vaccine uptake within two major political parties. Data from 804 U.S. participants in an online survey from June 2021 was used to assess the association between COVID-19 vaccine uptake (no dose vs. any dose) and categories of factors thought to influence vaccine uptake (sociodemographic variables, COVID-19 disease and vaccine belief variables, belief in COVID-19 prevention behavior variables, and social network features variables) for Republicans and Democrats using bivariate and multivariate regression. 65.4% of the sample reported having received at least one dose of the COVID-19 vaccine (22.6% Republican and 52.1% Democrat). In the total sample bivariate model, Democrat participants had significantly greater odds of having received a dose of the vaccine as compared to Republican participants (OR = 2.51, 95%CI = 1.73-3.64). In adjusted models, the speed of vaccine development was negatively associated with vaccine uptake for both Republicans (aOR = 0.18, 95%CI = 0.06-0.57) and Democrats (aOR = 0.40, 95%CI = 0.19-0.86), as was concern about side effects from the vaccine (Republicans: aOR = 0.15; 95%CI = 0.05-0.47; Democrats: aOR = 0.14, 95%CI = 0.06-0.31). COVID-19 vaccine uptake among Republicans, but not Democrats, was associated with belief that the vaccine prevents COVID-19 (aOR = 3.29, 95%CI = 1.29-8.37) and belief about friends' vaccine intentions (aOR = 6.19, 95%CI = 2.39-16.05). There were no significant factors unique to Democrats. Concerns about aspects of COVID-19 vaccine safety for both political groups suggest that vaccine advocacy interventions should universally address these factors. However, Republican beliefs in vaccine efficacy and in friends' vaccine intentions suggest a need for Republican-specific messaging.