How governments address COVID-19 misinformation–for better or for worse

As COVID-19 spread across the world, so did conspiracy theories and false information about the virus. This proliferation of misinformation–labeled an “infodemic” by the World Health Organization (WHO)–makes it difficult to identify trustworthy sources and can threaten public health by undermining confidence in science, governments, and public health recommendations.

The consequences of misinformation can be tragic: hundreds died and thousands were poisoned in Iran after consuming toxic methanol alcohol, falsely believing it could cure COVID-19.

In a new article in the Journal of Public Health Policy, legal scholars at NYU School of Global Public Health and the global health organization Vital Strategies identify five approaches countries have taken to address misinformation about COVID-19. Their tactics ranged from helpful practices like creating media campaigns sharing accurate information to harmful practices like suppressing whistleblowers and factual information, or disseminating disinformation (the intentional spread of false information) on their own. Several approaches criminalized expression, eliciting human rights concerns, given that international law protects freedom of expression.

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COVID-19 warnings were on Twitter well before the outbreak of the pandemic

New Release:

Even before public announcements of the first cases of COVID-19 in Europe were made, at the end of January 2020, signals that something strange was happening were already circulating on social media. A new study of researchers at IMT School for Advanced Studies Lucca, published in Scientific Reports, has identified tracks of increasing concern about pneumonia cases on posts published on Twitter in seven countries, between the end of 2019 and the beginning of 2020. The analysis of the posts shows that the “whistleblowing” came precisely from the geographical regions where the primary outbreaks later developed.

To conduct the research, the authors first created a unique database with all the messages posted on Twitter containing the keyword “pneumonia” in the seven most spoken languages of the European Union – English, German, French, Italian, Spanish, Polish, and Dutch – from December 2014 until 1 March 2020. The word “pneumonia” was chosen because the disease is the most severe condition induced by the SARS-CoV-2, and also because the 2020 flu season was milder than the previous ones, so there was no reason to think it to be responsible for all the mentions and worries. The researchers then made a number of adjustments and corrections to the posts in the database to avoid overestimating the number of tweets mentioning pneumonia between December 2019 and January 2020, that is to say in the weeks between the World Health Organization (WHO) announcement that the first “cases of pneumonia of unknown etiology” had been identified – on 31 December 2019 – and the official recognition of COVID19 as a serious transmissible disease, on 21 January 2020. In particular, all the tweets and retweets containing links to news about the emerging virus were eliminated from the database to exclude from the count the mass media coverage of the emerging pandemic.

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Continued strict control measures needed to reduce new COVID-19 strains

Press release:

A group of scientists is calling on governments to consider the continued use of strict control measures as the only way to reduce the evolution and spread of new COVID-19 variants.

The experts in evolution, virology, infectious disease and genomics – at the University of East Anglia (UEA), Earlham Institute and University of Minnesota – warn that while governments are negotiating a “precarious balance” between saving the economy and preventing COVID-19 fatalities, stronger action now is the best way to mitigate against more serious outcomes from such virulent strains later.

While COVID-19 vaccine deployment is now underway, a threat to vaccine effectiveness comes from other emerging strains, both existing – such as the UK, South Africa and Brazil variants – and those yet to come.

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New analysis shows hydroxychloroquine does not lower mortality in COVID-19 patients, and is associated with increased mortality when combined with the antibiotic azithromycin

Press release:

A new meta-analysis of published studies into the drug hydroxychloroquine shows that it does not lower mortality in COVID-19 patients, and using it combined with the antibiotic azithromycin is associated with a 27% increased mortality. The study is published in Clinical Microbiology and Infection, the official journal of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).

“This meta-analysis shows that hydroxychloroquine alone is not effective for the treatment of COVID-19 patients and that the combination of hydroxychloroquine and azithromycin increases the risk of mortality,” say the authors who include Thibault Fiolet, Center for Research in Epidemiology and Population Health, INSERM, Institut Gustave Roussy and Paris-Sud 11 University/Paris-Saclay University, Paris, France. “These data support current clinical recommendations such as those of the US National Institutes of Health (NIH) which do not recommend the use of hydroxychloroquine alone or in combination with azithromycin for COVID-19 patients.”

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New trial finds arthritis drug no better than standard care for severe covid-19

Adding the arthritis drug tocilizumab to standard care for patients in hospital with severe or critical covid-19 is no better than standard care alone in improving clinical outcomes at 15 days, finds a new trial published by The BMJ today.

There was an increased number of deaths at 15 days in patients receiving tocilizumab, resulting in the trial being stopped early.

Today’s results contradict earlier observational studies suggesting a benefit of tocilizumab. However, observational effects are limited by a high risk that they may be due to other unknown (confounding) factors – and some studies have not yet been peer reviewed or published in a medical journal.

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Rapid blood test identifies COVID-19 patients at high risk of severe disease

A new study from Washington University School of Medicine in St. Louis suggests that measuring mitochondrial DNA in the blood of patients with COVID-19 can help predict which patients are at highest risk of severe disease, requiring more intensive care. Mitochondrial DNA levels are a measure of tissue damage. Pictured are damaged mitochondria (dark grey areas) released from human lungs. The small dark dots surrounding the mitochondria are magnetic beads that carry antibodies used to isolate and study unhealthy mitochondria that have been released from dying tissues.

One of the most vexing aspects of the COVID-19 pandemic is doctors’ inability to predict which newly hospitalized patients will go on to develop severe disease, including complications that require the insertion of a breathing tube, kidney dialysis or other intensive care. Knowledge of a patient’s age and underlying medical conditions can help predict such outcomes, but there are still surprises when younger, seemingly healthier patients suffer severe complications that can lead to death.

Now, scientists at Washington University School of Medicine in St. Louis have shown that a relatively simple and rapid blood test can predict — within a day of a hospital admission — which patients with COVID-19 are at highest risk of severe complications or death.

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Large study finds higher burden of acute brain dysfunction for COVID-19 ICU patients

Media release:

COVID-19 patients admitted to intensive care in the early months of the pandemic were subject to a significantly higher burden of delirium and coma than is typically found in patients with acute respiratory failure. Choice of sedative medications and curbs on family visitation played a role in increasing acute brain dysfunction for these patients.

That’s according to an international study published Jan. 8 in The Lancet Respiratory Medicine, led by researchers at Vanderbilt University Medical Center in coordination with researchers in Spain.

The study, which is far the largest of its kind to date, tracks the incidence of delirium and coma in 2,088 COVID-19 patients admitted before April 28, 2020, to 69 adult intensive care units across 14 countries.

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Low risk of severe COVID-19 in children

Jonas F. Ludvigsson, paediatrician at Örebro University Hospital, Professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, and the first author of the study.

Press Release:

Sweden kept preschools, primary and lower secondary schools open during the spring of 2020. So far, little research has been done on the risk of children being seriously affected by COVID-19 when the schools were open. A study from Karolinska Institutet in Sweden has now shown that one child in 130,000 was treated in an intensive care unit on account of COVID-19 during March-June. The study has been published in New England Journal of Medicine.

So far, more than 80 million people have become ill with COVID-19 and globally, almost two million people have died from the disease. Many countries have closed down parts of society in order to reduce the spread of infection. One such measure has been to close schools.

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Study reports patient-reported loss of smell in 86% of mild COVID-19 cases

News Release:

A reduced sense of smell, or olfactory dysfunction, is one of the most common symptoms of COVID-19. A recent study published the Journal of Internal Medicine has examined it prevalence and recovery in patients with varying degrees of severity of COVID-19.

In the study of 2,581 patients from 18 European hospitals, the patient-reported prevalence of olfactory dysfunction was 85.9% in mild cases of COVID-19, 4.5% in moderate cases, and 6.9% in severe-to-critical cases. The average duration of olfactory dysfunction reported by patients was 21.6 days, but nearly one-quarter of affected patients reported that they did not recover their sense of smell 60 days after losing it.

Objective clinical evaluations identified olfactory dysfunction in 54.7% of mild cases of COVID-19 and 36.6% of moderate-to-critical cases of COVID-19. At 60 days and 6 months, 15.3% and 4.7% of these patients did not objectively recover their sense of smell, respectively.

“Olfactory dysfunction is more prevalent in mild COVID-19 forms than in moderate-to-critical forms, and 95% of patients recover their sense of smell at 6-months post-infection,” said lead author Jerome R. Lechien, MD, PhD, MS, of Paris Saclay University.

Smoking associated with increased risk of COVID-19 symptoms

Press release:

Smoking is associated with an increased risk of COVID-19 symptoms and smokers are more likely to attend hospital than non-smokers, a study has found.

The study published today in Thorax, by researchers from King’s College London, investigates the association between smoking and the severity of the COVID-19.

Researchers analysed data from the ZOE COVID Symptom Study App. Of the participants of the app, 11% were smokers. This is a lower proportion than the overall UK population of 14.7%, however, it reflects the demographics of the self-selected sample of the ZOE COVID Symptom Study.

While more than a third of users reported not feeling physically well during the period of study (24th March and April 2020), current smokers were 14% more likely to develop the classic triad of symptoms suggesting diagnosis of COVID-19: fever, persistent cough and shortness of breath – compared to non-smokers.

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