At height of COVID-19, nurses and doctors reported high levels of distress

COLUMBIA UNIVERSITY IRVING MEDICAL CENTER

 

NEW YORK, NY (June 23, 2020) -- During the height of the COVID-19 pandemic in New York City, health care workers on the front lines had high levels of acute stress, anxiety, and depression, a study by researchers at Columbia University Irving Medical Center and NewYork-Presbyterian has found.

Levels of stress, anxiety and depression were particularly high among those with the greatest amount of patient contact and interaction.

Among the findings:

• More than half had high levels of acute stress.
• Nearly half screened positive for depressive symptoms.
• One-third had anxiety.
• Most had insomnia symptoms and experienced loneliness.

The findings were published online in the journal General Hospital Psychiatry.

"This is the largest study in the United States to document the psychological impact among clinicians working on the front lines at the height of the NYC COVID-19 pandemic," says Marwah Abdalla, MD, assistant professor of medicine in the Center for Behavioral Cardiovascular Health at Columbia University, cardiac intensivist at NewYork-Presbyterian/Columbia University Irving Medical Center, and study leader.

"Our findings confirm what we suspected: Clinicians working in this environment experienced significant levels of acute stress and other psychological effects."

Nurses had highest stress levels

The researchers analyzed data from 657 clinicians at NewYork-Presbyterian/Columbia University Irving Medical Center who were screened for stress, anxiety, and depression symptoms between April 9 and April 24 during the peak of the pandemic in New York City. More than half (375) of respondents were nurses and advanced practice providers.

Overall, 57% of participants -- and 64% of nurses and advanced practice providers -- said they had experienced symptoms of acute stress, such as nightmares, an inability to stop thinking about COVID-19, a feeling of being constantly on guard, and numbness or detachment from people or their surroundings. Acute stress symptoms that persist for more than a month can lead to post-traumatic stress syndrome (PTSD).

Although the environment took a psychological toll on all healthcare workers, nurses were particularly affected. The different responsibilities of nurses may partly explain the higher rates of positive acute stress screens and other impacts, as nurses spend more time delivering direct patient care.

Nearly half (48%) of all participants screened positive for depressive symptoms and one-third (33%) for anxiety.

Loneliness was pervasive

Insomnia and loneliness were also pervasive in this group (71% and 65%, respectively). "These were essential workers who were still going to work and interacting with patients and colleagues throughout the day," Abdalla says, "so the high prevalence of loneliness is striking."

Three out of four participants were highly distressed about the possibility of transmitting COVID-19 to loved ones. Most were highly distressed about the need to maintain social distance from family and friends and a lack of control and uncertainty during the pandemic.

"The health care workers had the double burden of caring for patients with COVID-19 and worrying about the possibility of getting loved ones sick," says Abdalla. "The high prevalence of insomnia and loneliness among clinicians suggests that the acute stress of working in this environment was physically and emotionally exhausting and isolating, but we don't know yet if this stress will have long-term consequences, and if so, whether the feeling that they were doing something meaningful and purposeful helps insulate them from this stress."

Most engaged in stress-reducing behaviors

Most respondents reported the use of stress-reducing behaviors, most commonly physical exercise but also talk therapy, virtual support groups, and religious/spiritual practices. Most expressed interest in having access to an individual therapist.

"Our findings highlight the need to study the effectiveness of the wellness resources that were available to the health care workers during the study period and determine if additional resources may be needed to better protect them during the next health crisis that may arise in New York City," Abdalla says.

Abdalla and her colleagues are currently doing a follow-up survey to see if these clinicians' psychological symptoms, coping strategies, and sense of optimism change over time.

###

More Information

The paper is titled, "Psychological Distress, Coping Behaviors, and Preferences for Support among New York Healthcare Workers during the COVID-19 Pandemic."

The other authors (all from NewYork-Presbyterian/Columbia University Irving Medical Center except where indicated) are Ari Shechter, Franchesca Diaz, Nathalie Moise, D. Edmund Anstey, Siqin Ye, Sachin Agarwal, Jeffrey L. Birk, Daniel Brodie, Diane E. Cannone, Bernard Chang, Jan Claassen, Talea Cornelius, Lilly Derby, Melissa Dong, Raymond C. Givens, Beth Hochman, Shunichi Homma, Ian M. Kronish, Sung A.J. Lee, Wilhelmina Manzano, Laurel E.S. Mayer, Cara L. McMurry, Vivek Moitra, Patrick Pham, LeRoy Rabbani, Reynaldo R. Rivera, Allan Schwartz, Joseph Schwartz (Stony Brook University, Stony Brook, NY), Peter Shapiro, Kaitlin Shaw, Alexandra M. Sullivan, Courtney Vose, Lauren Wasson, and Donald Edmondson.

Author funding includes grants from the American Heart Association, the Agency for Healthcare Research and Quality, and the National Institutes of Health (18AMFDP34380732, K23HL141682-01A1, R01HL146636-01A1, R01HL141494, R01HL146911, U24AG052175, P30AG064198, NHLBI R01HL132347, R01HL141811, R01HL146911, P30AG064198, R01-HL123368, R01-HL117832, R21 HL 145970).

The authors report no financial or other conflicts of interest.

Columbia University Irving Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the Vagelos College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Irving Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit cuimc.columbia.edu or columbiadoctors.org.

Universal right to health could inspire people, organizations to make real change

BINGHAMTON UNIVERSITY

 

Acknowledging health as a universal human right could galvanize people and organizations to make major improvements in health worldwide, according to new research from faculty at Binghamton University, State University of New York.

"In the U.S., few people think that everyone has a right to health or universal health care. I think that if we commit to protecting everyone's rights to health, and think creatively about how to do so, we can help a lot of people," said Nicole Hassoun, professor of philosophy at Binghamton University, State University of New York.

The human right to health is important for protecting everyone's ability to live minimally good lives, in part, because it gives rise to what Hassoun calls the virtue of creative resolve - a fundamental commitment to overcoming apparent tragedy. That is, those committed to fulfilling the right often refuse to accept that doing so is impossible, and come up with creative ways of fulfilling the right, and act to fulfill it. Those who lead efforts to improve public health often exhibit the virtue.

"Consider how human rights advocates galvanized a global effort to extend access to essential medicines for HIV around the world," said Hassoun. "Activists simply refused to accept pharmaceutical companies' claim that it was impossible to lower prices and educated patients to demand access to treatment. Mass protests shifted public opinion and generic completion brought prices down from $12,000 per patient per year to $350. Similar efforts have transformed the global health landscape helping us eliminate smallpox and reduce the prevalence of many other devastating diseases."

Hassoun believes that the human right to health could guide national and international policy.

"Committing to fulfilling everyone's human right to health can help us overcome the need to ration: it can help us find the resources we need to fulfill the right when it seems that we lack them. It can help us criticize existing policies and support proposals for positive change," said Hassoun. "People need many things for health, but that is not a reason to reject the right. By fulfilling everyone's right to health, we may also fulfill many other rights (e.g. rights to clean water, education, and food). Moreover, the human right to health can require protecting public health with things like vaccines. Doing so is important for protecting communities as well as individuals."

###

The paper, "The Human Right to Health: A Defense," was published in the Journal of Social Philosophy.

The Lancet Child & Adolescent Health: First Europe-wide study of children confirms COVID-19 predominately causes mild disease in children and fatalities are very rare

First multinational study of 582 children and adolescents with COVID-19 confirms majority of patients under 18 years old experience a mild disease and fatalities are extremely rare (4 deaths /582 patients, below 1%).

THE LANCET

 

Children with COVID-19 generally experience a mild disease and fatalities are very rare, according to a study of 582 patients from across Europe published today in The Lancet Child & Adolescent Health journal.

The study, which included children and adolescents aged from 3 days up to 18 years old, found that although the majority were admitted to hospital (62%, 363/582), fewer than one in ten patients required treatment in intensive care (8%, 48/582).

The researchers note that their study only involved patients who had sought medical help and been tested for COVID-19, and so milder cases would not have been included. They advise against extrapolating the numbers observed in their study to the wider population. However, they say their findings should be taken into consideration when planning for demand on intensive care services as the pandemic progresses.

Dr Marc Tebruegge, lead author from the UCL Great Ormond Street Institute of Child Health in London, UK, said: "Our study provides the most comprehensive overview of COVID-19 in children and adolescents to date. We were reassured to observe that the case fatality rate in our cohort was very low and it is likely to be substantially lower still, given that many children with mild disease would not have been brought to medical attention and therefore not included in this study. Overall, the vast majority of children and young people experience only mild disease. Nevertheless, a notable number of children do develop severe disease and require intensive care support, and this should be accounted for when planning and prioritising healthcare resources as the pandemic progresses." [1]

The study was carried out over a 3.5 week period from 1st to 24th April 2020, during the initial peak of the European COVID-19 pandemic. It involved 82 specialist healthcare institutions across 25 European countries. All of the 582 patients included in the study were confirmed to be infected with the SARS-CoV-2 virus by a PCR test. Only a quarter (25%, 145/582) had pre-existing medical conditions. This contrasts with adult studies where the proportion of patients with co-morbidities is typically far higher, but likely reflects that children have fewer chronic medical problems than adults overall in the general population, the authors say.

The researchers found that the most common symptom reported was fever (65%, 379/582). Around half of the patients had signs of upper respiratory tract infection (54%, 313/582) and a quarter had evidence of pneumonia (25%, 143/582). Gastrointestinal symptoms were reported in around a quarter of the children (22%, 128/582), 40 of whom did not have any respiratory symptoms. Some 92 children, most of whom were tested due to close contact with a known COVID-19 case, had no symptoms at all (16%, 92/582).

The vast majority of patients did not require oxygen or any other support to help them breathe at any stage (87%, 507/582). Only 25 children needed mechanical ventilation (4%, 25/582), but when they did need it, that support was typically required for a prolonged period, often for a week or more (range 1-34 days).

The number of patients receiving antiviral or immunomodulatory therapies were too low to draw conclusions about the efficacy of any of the treatments used. The authors say robust clinical trial data are urgently needed to help doctors make decisions regarding the best treatment strategy for children under their care.

Dr Florian Götzinger, from Wilhelminenspital in Vienna, Austria, said: "Although COVID-19 affects children less severely than adults overall, our study shows that there are severe cases in all age groups. Those who have pre-existing health issues and children under one month of age were more likely to be admitted to intensive care. Well-designed, randomised controlled studies on antiviral and immunomodulatory drugs in children are needed to enable evidence-based decisions regarding treatment for children with severe COVID-19." [1]

29 children were found to be infected with one or more additional respiratory viruses at the same time as SARS-CoV-2, such as cold or flu viruses. Of these, 24% required intensive care (7/29) compared with 7% of children with no additional viruses detected, (41/553).

Dr Begoña Santiago-Garcia, one of the lead authors from University Hospital Gregorio Marañón in Madrid, Spain, said: "This is the first study of children with COVID-19 to include data from multiple countries and multiple centres. Of note, we found that children in whom additional viruses were detected in the respiratory tract at the same time as SARS-CoV-2 were more likely to be admitted to intensive care. This could have important implications for the upcoming winter season, when cold and flu infections will be more common." [1]

Four patients died during the study period, two of whom had pre-existing medical conditions. All of the patients who died were older than 10 years of age. However, the overwhelming majority of patients were alive when the study closed (99%, 578/582) with only 25 (4%) still experiencing symptoms or needing support for their breathing.

At the time the study was conducted, testing capacity in many European countries was lower than demand, and so many children with COVID-19 and mild symptoms would not have been tested or diagnosed. Different countries were using different criteria to screen for the SARS-CoV-2 virus. Some were screening all children admitted to hospital while others were more selective in which patients were offered a test. This lack of standardisation makes it difficult to generalise the findings to the wider population, the authors say, but the true case fatality rate in children is likely substantially lower than that observed in this study (0.69%, 4/582).

###

NOTES TO EDITORS

The study was carried out by the Paediatric Tuberculosis Network European Trials Group (ptbnet) COVID-19 Study Group, which comprises clinicians and researchers across 82 paediatric healthcare institutions in 25 European Countries. It was led by researchers at the UCL Great Ormond Street Institute of Child Health, London, UK; the Wilhelminenspital, the National Reference Centre for Childhood Tuberculosis, Vienna, Austria; and the University Hospital Gregorio Marañón and Gregorio Marañón Research Institute (IiSGM), Madrid, Spain. Ptbnet is supported by Deutsche Gesellschaft für Internationale Zusammenarbeit.

The labels have been added to this press release as part of a project run by the Academy of Medical Sciences seeking to improve the communication of evidence. For more information, please see: http://www.sciencemediacentre.org/wp-content/uploads/2018/01/AMS-press-release-labelling-system-GUIDANCE.pdf if you have any questions or feedback, please contact The Lancet press office pressoffice@lancet.com

[1] Quote direct from author and cannot be found in the text of the Article.

Peer reviewed / Observational / People

Two-thirds of Americans think government should do more on climate

Bipartisan backing for carbon capture tax credits, extensive tree-planting efforts

PEW RESEARCH CENTER

WASHINGTON, D.C. (June 23, 2020) - A majority of Americans (63%) continue to say they see the effects of climate change in their own communities, and 65% believe that the federal government is doing too little to reduce the impacts of climate change, according to a new Pew Research Center survey.

At a time when partisanship colors most views of policy, broad majorities of the public - including more than half of Republicans and overwhelming shares of Democrats - say they would favor a range of initiatives to reduce the impacts of climate change, including large-scale tree planting efforts (90%), tax credits for businesses that capture carbon emissions (84%) and tougher fuel efficiency standards for vehicles (71%.)

The new national survey by Pew Research Center, conducted April 29 to May 5, 2020 among 10,957 U.S. adults using the Center's online American Trends Panel, finds that partisans remain far apart on several overarching questions about climate change. Much larger shares of Democrats than Republicans say human activity is contributing a great deal to climate change (72% vs. 22%), that it is impacting their own local community (83% to 37%) and that the government is doing too little to reduce the effects of climate change (89% to 35%).

However, there is bipartisan support for several policy options to reduce the effects of climate change. Large shares of Democrats and Democratic-leaning independents (92%) and Republicans and Republican-leaning independents (88%) favor planting about a trillion trees around the world to absorb carbon emissions in the atmosphere. Majorities of Democrats and Republicans also support providing a business tax credit for carbon capture technology that can store carbon emissions before they enter the atmosphere (90% and 78%, respectively). Partisan divides are wider on policies related to tougher restrictions on power plant emissions, taxing corporations based on the amount of carbon emissions they produce and tougher fuel-efficiency standards for automobiles and trucks. Still, about half or more Republicans say they would favor each of these policies, including 64% who back tougher emission standards for power plants.

While partisanship remains the predominant dividing line in many views of climate and the environment, there are meaningful differences within party coalitions. In particular, Republicans and Republican leaners who describe their political views as moderate or liberal (roughly a third of all Republicans and leaners) are much more likely than conservative Republicans to see local impacts of climate change, support policies to address it and say the federal government is doing too little in areas of environmental protection. Further, younger generations and women in the GOP tend to be more critical of government action on the environment than their older and male counterparts. Republican women also are more supportive of polices aimed at reducing the impacts of climate change than GOP men.

Other key findings include:

• Majorities of both Democrats and Republicans prioritize alternative over fossil fuel energy sources. A broad majority of Americans (79%) say the more important priority for the country is to develop alternative sources, such as wind and solar, over expanding the production of oil, coal and natural gas, including 91% of Democrats and 65% of Republicans.
• There is broad support for developing more solar and wind energy. Large shares say they would favor developing more solar panel farms (90%) and more wind turbine farms (83%). There is far less support for expanding fossil fuel energy sources. Majorities oppose expanding coal mining (65%), hydraulic fracturing (60%) and offshore oil and gas drilling (58%).
• Those living near the coast are most likely to say climate change is affecting their local community. Seven-in-ten Americans who live less than 25 miles from the coastline say climate change is affecting their local community a great deal or some. By comparison, 57% of those who live 300 miles or more from the coastline say climate change is affecting their local community at least some.

###

These are among the findings from the new report, which is based on a survey of 10,957 U.S. adults conducted online April 29 to May 5, 2020, using Pew Research Center's American Trends Panel. The margin of error for the full sample is plus or minus 1.4 percentage points.

Read the full report: https://www.pewresearch.org/science/2020/06/23/two-thirds-of-americans-think-government-should-do-more-on-climate

Methodology: https://www.pewresearch.org/science/2020/06/23/government-and-climate-methodology/

Survey topline: https://www.pewresearch.org/science/wp-content/uploads/sites/16/2020/06/PS_2020.06.23_government-climate_TOPLINE.pdf

For more information or to arrange an interview email Haley Nolan at hnolan@pewresearch.org.

Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping America and the world. It does not take policy positions. The Center is a subsidiary of The Pew Charitable Trusts, its primary funder. Subscribe to our daily and weekly email newsletters or follow us on our Fact Tank blog.

COVID-19 pandemic has unleashed unique worldwide wave of anti-semitism

Kantor Center at Tel Aviv University releases special report

AMERICAN FRIENDS OF TEL AVIV UNIVERSITY

The Kantor Center for the Study of Contemporary European Jewry at Tel Aviv University, published a special report, a summary of worldwide anti-Semitic phenomena associated with the COVID-19 pandemic. The report relies on hundreds of accounts from different locations around the globe from March-June.

• The new wave of anti-Semitism includes a range of libels that have one common element: The Jews, the Zionists and/or the State of Israel are to blame for the pandemic and/or stand to gain from it.
• The anti-Semitism generated by the coronavirus is intensive and fierce, has continued unremittingly for several months and reflects a high level of anxiety and fear in many populations.
• Coronavirus-related anti-Semitism is manifested throughout Europe, in the Americas and in the Muslim world. This new type of anti-Semitism, which partly reiterates classic anti-Semitic themes, includes conspiracy theories alongside medieval blood libels, now renewed in a 21st century format.
• Coronavirus-related anti-Semitism is propagated mostly by right-wing extremists, ultra-conservative Christians and Islamists, through their own media in various languages.
• Islamists describe Israel as the COVID-1948 virus -- after the year in which the Jewish state was established, declaring that this is the most dangerous virus of all.
• Activists in movements for delegitimizing Israel use the same argument. In addition, they accuse Israel of using the coronavirus as ammunition against the Palestinians.
• An Oxford University study revealed that 19.1% of the British public believes that the Jews caused the pandemic.

The reports come from an international network of volunteers, living in 35 countries, who are trained to identify and classify acts of anti-Semitism and add the material to The Moshe Kantor Database on Anti-Semitism. The network was established by the Kantor Center over 30 years ago and today numbers 60 participants. The database is a real-time collection of materials and resources on trends and events related to contemporary anti-Semitism, which includes English summaries based on source materials in all languages and formats including texts, visuals and audiovisuals.

Professor Dina Porat, Head of the Kantor Center, says, "These common motifs perpetuate anti-Semitic accusations from previous generations and other global catastrophes, once again presenting the well-known image of the Jew. However, the anti-Semitism generated by the coronavirus is fiercer and more intensive, has continued unremittingly for several months, and reflects a high level of anxiety and fear in many populations. This having been said, the situation should be seen in its overall context -- in which others are also blamed for spreading the virus: first of all, the Chinese, 5G antennas and the authorities who allegedly are not doing enough to stop the epidemic. Countries close down their borders, every foreigner is a suspect, and no new immigrants are allowed."

Coronavirus-related anti-Semitism is manifested in many parts of the world: A significant portion comes from the US and from Middle Eastern countries such as Iran, Turkey and the Palestinian Authority, but also from Europe and South America. In the US, accusations come mainly from white supremacists and ultraconservative Christians, pointing the finger at Jews in general and Haredi Jews in particular, while accusers in the Middle East mostly blame Israel, Zionism and the Mossad for creating and spreading the virus and intending to make a vast fortune from medications and the vaccine they are already developing.

In the western world, the main elements promoting anti-Semitic discourse are civil society groups with various ideologies, while in the Middle East some of this discourse is put forth by the regimes themselves.

Dr. Giovanni Quer, director of the Kantor Center, adds, "Universal disasters have been attributed to the Jews and to Israel before, giving rise to anti-Semitic discourse -- such as conspiracy theories blaming Israel for 9/11, or false reports accusing Israeli soldiers of harvesting organs from the bodies of dead Palestinians. The current wave of anti-Semitism is unprecedented, however, because, spreading very swiftly through the social media, it focused at first on the COVID-19 crisis and then quickly moved on because of social and political changes: Just a few days passed between the coronavirus crisis and the racism-related social crisis in the US, but anti-Semitic discourse remained just as fierce, with its proponents simply adapting their anti-Semitic narratives to the changing social contexts."

The Kantor Center for the Study of Contemporary European Jewry, inaugurated in 2010 at Tel Aviv University, provides an academic framework for the interdisciplinary research of European Jewry from the end of World War II until the present day. The center offers a platform for the diverse needs of researchers, students, governmental and civil service personnel, professionals, activists, and the public at large, both in Israel and abroad, and cooperates with European Jewish communities and their leaders. For more information, visit https://en-humanities.tau.ac.il/kantor.

###

American Friends of Tel Aviv University supports Israel's most influential, comprehensive and sought-after center of higher learning, Tel Aviv University (TAU). TAU is recognized and celebrated internationally for creating an innovative, entrepreneurial culture on campus that generates inventions, startups and economic development in Israel. TAU is ranked ninth in the world, and first in Israel, for producing start-up founders of billion-dollar companies, an achievement that surpassed several Ivy League universities. To date, 2,500 US patents have been filed by Tel Aviv University researchers -- ranking TAU #1 in Israel, #10 outside of the US and #66 in the world.

Ideologically extreme Facebook users spread the most fake news

Those who lack trust in media, and one another, also share it

UNIVERSITY OF COLORADO AT BOULDER

Facebook is a more fertile breeding ground for fake news than Twitter, and those on the far ends of the liberal-conservative spectrum are most likely to share it, according to new CU Boulder research.

The paper, in the journal Human Communication Research, also found that people who lack trust in conventional media, and in one another, post misinformation more often.

"We found that certain types of people are disproportionally responsible for sharing the false, misleading, and hyper-partisan information on social media," said lead author Toby Hopp, an assistant professor in the Department of Advertising, Public Relations and Media Design. "If we can identify those types of users, maybe we can get a better grasp of why people do this and design interventions to stem the transfer of this harmful information."

The paper comes at a time when, amid a global pandemic and contentious run-up to a presidential election, social media companies are grappling with how to curb so-called fake news.

In the past month, Twitter, Facebook and Google began labeling misleading, disputed or unverified posts about coronavirus, vowing to delete those that threaten public health.

Twitter has also slapped labels on President Donald Trump's tweets, dubbing them as inaccurate or glorifying violence. Trump responded by accusing Twitter of silencing conservative speech. Meanwhile, Facebook employees staged a virtual walk-out saying their company wasn't doing enough to address suspect posts.

"A decade or two ago, traditional news organizations played a key gatekeeping role in determining what was true or not true," said Hopp. "Now, with the proliferation of social media and with traditional news organizations under financial distress, there is a sea change occurring in the way that information flows through society."

Previous research has shown that older adults and those who identify as Republican are more likely to share fake news. But Hopp wanted to go beyond demographic or political labels.

"We wanted to look at more nuanced factors indicating how these people see the world around them," Hopp said.

To do so, his team recruited 783 regular Facebook and Twitter users over the age of 18 and, with their permission, collected and analyzed all of their posts for the period between August 1, 2015, and June 6, 2017 (before, during, and after the 2016 election). Participants also took a lengthy survey to assess their ideological conservatism vs. liberalism and identify how much they trusted friends, family and community members, and mainstream media.

The researchers then looked at who shared content from 106 websites identified as fake news or "countermedia" sites by watchdog groups or legacy news organizations like NPR or U.S. News & World Report.

"Despite the fact that we tend to call it 'fake' news, a lot of this stuff is not completely false," said Hopp, who prefers the term "countermedia." "Rather, it is grossly biased, misleading and hyper-partisan, omitting important information."

The good news: 71% of Facebook users and 95% of Twitter users shared no countermedia posts. The bad news: 1,152 pieces of fake news were shared via Facebook, with a single user responsible for 171. On Twitter, 128 pieces of countermedia were shared.

"We found that Facebook is the central conduit for the transfer of fake news," said Hopp.

In the Facebook sample, those self-identified as extremely conservative--7 on a scale of 1 to 7--accounted for the most fake news shared, at 26%. In the Twitter sample, 32% of fake news shares came from those who scored a 7.

But those who scored a 1, identifying as extremely liberal, also shared fake news frequently, accounting for 17.5% of shares on Facebook and 16.4% on Twitter.

In all, about one-fifth of users at the far ideological extremes were responsible for sharing nearly half of the fake news on the two platforms.

"It is not just Republicans or just Democrats, but rather, people who are--left or right--more ideologically extreme," said Hopp.

Those in the ideological middle and those with high levels of media and social trust were--generally speaking--the least likely to share fake news.

"People with high levels of social trust are more likely to compile online social networks comprised of diverse individuals, and this can hamper the spread of fake news," said Hopp, noting that when a fellow user calls out a post as inaccurate, others may be less likely to share it. "If someone posts something that is incorrect, false or misleading, I don't think it hurts for individual users to provide a factual rebuttal."

The authors note that the sample is not necesarily representative of the general population of all social media users nationwide, and more research is necessary.

With several other papers in the works, the authors, including Assistant Professor of Journalism Pat Ferucci and Assistant Professor of Advertising Chris Vargo, hope to provide insight to lawmakers, companies and individual users hoping to stem the fake news tide.

"We can disagree, but when we have fundamentally different views about what information is true and what is not, democracy becomes very difficult to maintain," said Hopp.

###

Confrontation may reduce white prejudices, Rutgers study finds

Researchers examine the power of confronting biased statements

RUTGERS UNIVERSITY

 

Confronting a white person who makes a racist or sexist statement can make them reflect on their words and avoid making biased statements about race or gender in the future, Rutgers researchers find.

The study, published in the journal Social Psychological and Personality Science, suggests that when white men and women are confronted after expressing a bias about African Americans, Latinos, and women, they seek to identify and regulate their own biases about multiple groups of people.

"Many people are reluctant to confront instances of bias because they worry about backlash from others," said Kimberly Chaney, a doctoral graduate student in social psychology at Rutgers University-New Brunswick's School of Arts and Sciences. "But we found that confronting prejudice can be a powerful way to reduce not just one but multiple types of prejudice. We all have the ability to make a change and sometimes speaking out against small instances of bias may make a big change."

In the first part of the study, a group of 161 white college students was shown images of white and Black people accompanied with descriptive sentences, and then asked to draw inferences about the people pictured. Three photos of Black men included sentences intended to evoke a stereotypical response, such as "This man spends a lot of time behind bars." The task could draw the stereotypical response of "This man is a criminal" or a neutral response like "bartender," the researchers said.

Half of the participants were then randomly assigned to be verbally confronted for using a negative stereotype in their response. They then completed a similar task with different faces and sentences, including ones with women that could elicit stereotypical responses. For example, responses such as "This person works at a hospital" could elicit a stereotypical response of "nurse" instead of "doctor." Participants who were confronted for using a negative Black stereotype used significantly fewer stereotypes about women than participants who were not confronted for using a negative Black stereotype.

Another part of the study considered whether confrontation for using a stereotype about women reduces expressions of bias toward ethnic and racial minorities. Each white adult male participant believed he was interacting with another white adult male online to discuss moral dilemmas. One scenario involved a nurse who discovered an issue at a hospital and was asked to discuss with their partner what the nurse should do. Half of the participants who referred to the nurse as "she" during the online discussion were confronted by their online partner. Those participants were later asked to complete a task that could elicit negative stereotypes about Black and Latinx Americans. Participants who were confronted for using a negative stereotype about women used significantly fewer stereotypes about Black and Latinx Americans than participants who were not confronted for using a negative stereotype about women.

"There is still a lot more to understand about confronting prejudice, including how it should be done, what you should say and when it will be most effective," said study co-author Diana Sanchez, a professor of psychology. "Confronting someone is challenging, but we hope that knowing that it can be effective might make people more willing to step up."

###

Effects from low-level concentrations of harmful chemicals preserved in three generations of fish

OREGON STATE UNIVERSITY

 

IMAGE: AN INLAND SILVERSIDE FISH THREE DAYS AFTER HATCHING FROM THE EGG. view more 

CREDIT: NATHAN BURNS

CORVALLIS, Ore. - Fish exposed to very low levels of chemicals commonly found in waterways can pass the impacts on to future generations that were never directly exposed to the chemicals, according to Oregon State University researchers.

"What that gets at is something your grandparents may have come into contact with in their environment can still be affecting the overall structure of your DNA in your life today," said Kaley Major, a postdoctoral scholar at Oregon State and lead author of the paper published today in the journal Frontiers in Marine Science.

The study focused on synthetic (man-made) endocrine disrupting chemicals, which mimic the body's hormones. They are found in many household and industrial products including flame retardants, food, toys, cosmetics and pesticides. Previous research has shown exposures to the chemicals can lead to altered sex ratios, lower fertility rates and deformities in fish.

Endocrine disruptors can cause adverse biological effects in other animals, including humans, by altering natural hormones in the body that are responsible for development, behavior and fertility. Past research done elsewhere has shown that those adverse alterations in humans can be passed to future generations.

"It's really important to understand how animals can deal with stress in the environment, particularly when we are introducing new stressors on a daily basis," said Susanne Brander, an assistant professor and aquatic toxicologist in OSU's Department of Fisheries and Wildlife with whom Major worked.

"Our research helps show what animals do to respond to these changes and how quickly they can respond to them. That's going to help us understand our impact on the environment in the long run."

The researchers conducted the study with inland silversides, a fish found in estuaries that averages about 4 inches in length and is native in eastern North America and the Gulf of Mexico. They have also been introduced in California. They primarily feed on zooplankton and are an important prey species for birds and commercially valuable fish.

Previous research had shown negative impacts on fish exposed to high levels of endocrine disruptors, but little is known about fish exposed to low levels of the chemicals, Major said.

In the experiment, the inland silversides were exposed to the equivalent of a few drops of each endocrine disruptor in an Olympic-size swimming pool. The researchers studied three generations of fish over 21 months to see if the effects of endocrine disruptor exposure only to the parents were passed from generation to generation.

The experiment focused on methylation, a process by which a set of carbon and hydrogen atoms known as a methyl group is added to a DNA molecule. Methylation can be tracked and can be an important indicator of how an organism will develop.

Previous research with mammals and other species of fish has found that endocrine disruptors impact methylation. That led Brander, Major and their collaborators to wonder whether endocrine disruptors, particularly low concentrations, would impact methylation in fish that live in estuaries, ecosystems which are important for biodiversity and often impacted by nearby urban areas.

The results were surprising, the researchers said. They found consistent patterns of methylation across the three generations of fish they studied, even though only the first generation was exposed to endocrine disruptors for a few weeks in early life.

The researchers believe the methylation patterns they observed across the three generations may influence expression of genes associated with the skewed sex ratios, reduced hatching and developmental defects observed by Ph.D. student Bethany DeCourten as part of the larger study. Future research will help the scientists understand more about what the methylation markers mean and what that says about how pollutants may affect evolution of inland silversides.

###

In addition to Brander, who is also part of the Coastal Oregon Marine Experiment Station, Major and DeCourten, authors of the paper were Jie Li, Monica Britton, Matthew Settles and Richard Connon, all of the University of California, Davis; and Alvine Mehinto of the Southern California Coastal Water Research Project.

The study was funded by the Environmental Protection Agency, California Department of Fish and Wildlife and the Delta Stewardship Council.

Far-UVC light safely kills airborne coronaviruses

COLUMBIA UNIVERSITY IRVING MEDICAL CENTER

 NEW YORK, NY (June 24, 2020) -- More than 99.9% of seasonal coronaviruses present in airborne droplets were killed when exposed to a particular wavelength of ultraviolet light that is safe to use around humans, a new study at Columbia University Irving Medical Center has found.

"Based on our results, continuous rborne disinfection with far-UVC light at the current regulatory limit could greatly reduce the level of airborne virus in indoor environments occupied by people," says the study's lead author David Brenner, PhD, Higgins Professor of Radiation Biophysics at Columbia University Vagelos College of Physicians and Surgeons and director of the Center for Radiological Research at Columbia University Irving Medical Center.

The research was published today in Scientific Reports.

Background

Conventional germicidal UVC light (254 nm wavelength) can be used to disinfect unoccupied spaces such as empty hospital rooms or empty subway cars, but direct exposure to these conventional UV lamps is not possible in occupied public spaces, as this could be a health hazard.

To continuously and safely disinfect occupied indoor areas, researchers at Columbia University Irving Medical Center have been investigating far-UVC light (222 nm wavelength). Far-UVC light cannot penetrate the tear layer of the eye or the outer dead-cell layer of skin so it cannot reach or damage living cells in the body.

The researchers had previously shown that far-UVC light can safely kill airborne influenza viruses.

The new paper extends their research to seasonal coronaviruses, which are structurally similar to the SARS-CoV-2 virus that causes COVID-19.

Study details

In the study, the researchers used a misting device to aerosolize two common coronaviruses. The aerosols containing coronavirus were then flowed through the air in front of a far-UVC lamp. After exposure to far-UVC light, the researchers tested to see how many of the viruses were still alive.

The researchers found that more than 99.9% of the exposed virus had been killed by a very low exposure to far-UVC light.

Based on their results, the researchers estimate that continuous exposure to far-UVC light at the current regulatory limit would kill 90% of airborne viruses in about 8 minutes, 95% in about 11 minutes, 99% in about 16 minutes, and 99.9% in about 25 minutes.

Using far-UVC light in occupied indoor spaces

The sensitivity of the coronaviruses to far-UVC light suggests that it may be feasible and safe to use overhead far-UVC lamps in occupied indoor public places to markedly reduce the risk of person-to-person transmission of coronaviruses, as well as other viruses such as influenza.

Ongoing studies in SARS-CoV-2

In a separate ongoing study, the researchers are testing the efficacy of far-UVC light against airborne SARS-CoV-2. Preliminary data suggest that far-UVC light is just as effective at killing SARS-CoV-2.

"Far-UVC light doesn't really discriminate between coronavirus types, so we expected that it would kill SARS-CoV-2 in just the same way," Brenner says. "Since SARS-CoV-2 is largely spread via droplets and aerosols that are coughed and sneezed into the air it's important to have a tool that can safely inactivate the virus while it's in the air, particularly while people are around."

Brenner continues, "Because it's safe to use in occupied spaces like hospitals, buses, planes, trains, train stations, schools, restaurants, offices, theaters, gyms, and anywhere that people gather indoors, far-UVC light could be used in combination with other measures, like wearing face masks and washing hands, to limit the transmission of SARS-CoV-2 and other viruses."

###

More information

The paper is titled, "Far-UVC light (222-nm) efficiently and safely inactivates airborne coronaviruses."

The other authors (all CUIMC) are Manuela Buonnano, David Welch, and Igor Shuryak.

The study was funded by the Shostack Foundation and the NIH (grant R42-AI125006-03).

The authors declare that the Trustees of Columbia University in the City of New York have a pending patent on the technology: "Apparatus, method and system for selectively affecting and/or killing a virus."

The authors declare no additional financial or other conflicts of interest.

Columbia University Irving Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the Vagelos College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Irving Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit cuimc.columbia.edu or columbiadoctors.org.

Race, rurality play prominently in Georgia areas hardest hit by COVID-19

MEDICAL COLLEGE OF GEORGIA AT AUGUSTA UNIVERSITY

 

IMAGE: DR. JUSTIN XAVIER MOORE, EPIDEMIOLOGIST IN THE DEPARTMENT OF POPULATION HEALTH SCIENCES AT THE MEDICAL COLLEGE OF GEORGIA view more 

CREDIT: PHIL JONES, SENIOR PHOTOGRAPHER, AUGUSTA UNIVERSITY

While counties in populous metropolitan Atlanta had the highest number of COVID-19 cases in the initial weeks following Georgia's first reported case, it was rural Southwest Georgia counties, with a higher number of black residents and lower number of ICU beds, experiencing the highest rates of infection and death per capita, investigators report.

Among those counties with more than 10 cases, Terrell and Dougherty counties, both included in the Albany, Georgia Metropolitan Statistical Area, along with the Southwest Georgia counties of Randolph and Early, had the highest mortality rates in those first seven weeks ending April 24. By the end of their assessment period, Georgia counties with 50% or greater black residents had a 79% higher incidence rate than those with less than a 50% black population, and twice the mortality rate.

These more rural Georgia counties also had a lower number of intensive care beds and primary care physicians per 100,000 population, Dr. Justin Xavier Moore and his colleagues report in the Journal of the American College of Emergency Physicians. They also had more individuals age 60 and older earning under $20,000 compared to counties experiencing lower mortality rates.

It's likely that higher death rates in counties with less ICU beds are tied to treatment delays resulting from the need to transport patients elsewhere, investigators say. These counties identified as hotspots for COVID-19 are known as well for higher death rates from diseases like stroke and sepsis, corresponding author Moore and his colleagues say.

"Hospital critical care capacity represents the most important medical care factor for preventing deaths from COVID-19," they write. "Understanding the geographic areas that have the highest disease burden and morbidity will allow policy makers, public health professionals and critical care providers to appropriately allocate resources and adequately prepare for the disease pandemic for specific populations."

Race and rurality often are connected in disease, as they are in COVID-19, says Moore, epidemiologist in the Department of Population Health Sciences at the Medical College of Georgia at Augusta University. "It's like these are different ingredients of a horrible recipe."

That recipe also consistently includes poor social determinants of health, such as the conditions where you live, learn and work, mixed with a low proportion of health care services in many of these areas, which tends to have a multiplier effect that can overwhelm health services that are available and enable disease, Moore notes. An established history of distrust of health care systems by blacks, resulting from realities like the 40-year Public Health Service/Tuskegee Institute study in which black men with and without syphilis were followed for decades with some care but no actual treatment for syphilis, make some hesitant to seek care, Moore adds. Conflicting information that emerged and continues to emerge about COVID-19 likely also fuels that flame.

MCG investigators and their colleagues at Kaiser Permanente in Oakland, California, encouraged state and local governments to strongly support the southwestern portion of the state with more ICU beds, ventilators and emergency medical staff. "We can't just take our foot off the gas pedal," says Moore.

"As a nation, we need to really rethink how we approach public health," he says to dramatically reduce lost lives and to prevent already struggling economies from being decimated by disease. Systemic racism plays a huge role and work must be done to repair relationships, he says.

"I honestly believe a lot of people are afraid to seek certain care because of discrimination," so people may present with more advanced cases of all kinds of diseases, including COVID-19. Now is a good time to make permanent change, rather than a trend that passes like a hashtag, he says.

Initially one out of every two people who got seriously ill with COVID-19 died in Georgia's rural, largely black communities, he notes, while today death rates are closer to 10% and to those from other serious medical problems like sepsis in the rest of the country, he says.

"Lung cancer, sepsis, colorectal cancer, diabetes ... they all have a different pathophysiology in the sense of how they break down your body, but the problem is we have a persistent and long history of systemic racism disadvantages that have made it to where the social determinants of health are so heavily skewed in a negative way for blacks, Hispanics, the darker you are basically," Moore says. "It's not surprising; it's saddening and frustrating. The thing is, we just need better health care for people, period. I don't know how else to put it."

Through April 24, there were 22,147 confirmed cases and 892 confirmed fatalities from COVID-19 in Georgia. As of June 22, the Georgia Department of Public Health was reporting 64,701 cases and 2,643 deaths in the state; Moore is currently doing a data review to see if the clear disparities he saw early in the disease spread continue to hold. Looking at deaths per 100K population more recently, the Southwest Georgia counties of Turner, Terrell, Randolph and Early were leading the state in mortality rates, according to the Department of Public Health. In May, largely black and rural Hancock County in Central Georgia also emerged as a hotspot with high death rates.

Fulton County in metropolitan Atlanta --which has the largest population in Georgia and is about 45% black according the latest U.S. Census Bureau facts -- had the highest number of confirmed COVID-19 cases, in fact the first two cases reported in Georgia were in Fulton County, the Georgia Department of Public Health reported March 2. The two individuals lived in the same household and one had recently returned from Italy.

Georgia counties with a larger percentage of male residents also had significantly higher (19%) mortality rates from COVID-19 than those with higher percentages of females, investigators at MCG and their colleagues say. Other studies have suggested that males are more likely to have serious disease and to die.

The current study looked at the impact of COVID-19 in all 159 Georgia counties from March 3 through April 24 and got the county specific information on confirmed cases and deaths from the Johns Hopkins 2019 Novel Coronavirus Data Repository. Investigators then linked COVID-19 data with county-level data on related issues like socio-demographics, access to health care and hospital critical care infrastructures from sources like Centers for Medicare & Medicaid Services hospital reports, Moore says.

###

Read the full study here.