Cross jurisdictional collaboration efforts and emergency vaccine plans that are consistent with Tribal sovereignty are essential to public health emergency preparedness. The widespread adoption of clearly written federal, state, and local vaccine plans that address fundamental assumptions in vaccine distribution to Tribal nations is imperative for future pandemic response.

This note introduces a framework incorporating multiple sources of evidence into the response to COVID-19 to overcome the neglect of social and psychological causes of illness. By using the example of psychological research on loneliness and its effects on physical and mental health with particular focus on aging and disability, I seek to open further inquiry into how relevant psychological and social aspects of health can be addressed at policy level.

Following the COVID-19 pandemic, many countries worldwide have put lockdowns in place to prevent the virus from spreading. Evidence shows that lockdown measures can affect mental health; it is, therefore, important to identify the psychological characteristics making individuals more vulnerable. The present study aimed, first, to identify, through a cluster analysis, the psychological attributes that characterize individuals with similar psychological responses to the COVID-19 home confinement; second, to investigate whether different psychological characteristics, such as personality traits, alexithymia, and (...) resilience, specifically influence anxiety, stress, and depression, depending on the scope of the confinement. We analyzed data from 393 participants who completed an online survey on their experiences during two different phases of the Italian lockdown, characterized by more or less strict measures of confinement. Two clusters were identified which included participants reporting a better (+ER) and worse (−ER) emotional response to the lockdown, respectively. Individuals in the −ER group showed lower emotional stability, resilience, and higher alexithymia. Moreover, even if lifting part of the restrictions decreased psychological distress among all participants, a reduction in perceived stress was observed only among individuals with high resilience. Finally, personality traits, alexithymia, and resilience differently affected depression, anxiety, and stress. Our results suggest that different psychological interventions should be planned depending on the context: mental health professionals should focus on enhancing the individuals’ coping strategies to alleviate stress in emergencies, while long-term intervention aiming at alleviating anxiety and depressive symptoms should focus on alexithymic tendencies and personality constructs. (shrink)

The new Coronavirus (COVID-19) has been declared a global pandemic by the World Health Organization (WHO). The sudden outbreak of this new virus and the measure of lockdown adopted to contain the epidemic have profoundly changed the lifestyles of the Italian population, with an impact on people’s quality of life and on their social relationships. In particular, due to forced and prolonged cohabitation, couples may be subject to specific stressors during the epidemic. In addition, living with a chronic health (...) condition may add specific challenges to the ones posed by the epidemic itself. The present cross-sectional study aimed to provide a picture of the challenges as well as the resources for both individual and relational well-being of Italian individuals in a couple relationship (N= 1921), with a specific attention to the comparison between individuals living with and without a chronic disease. Results showed that people with a chronic disease had lower psychological well-being and more fears and worries about the COVID-19. People with a chronic disease perceived fewer resources than healthy people. Moreover, the challenges are shown to be associated with less psychological well-being and high pessimism about the future. Instead individual, relational, and social resources play a protective role during the pandemic for both healthy and chronically ill people. (shrink)

In a crisis, societal needs take precedence over a patient’s best interests. Triage guidelines, however, differ on whether limited resources should focus on maximizing lives or life-years. Choosing between these two approaches has implications for neonatology. Neonatal units have ventilators, some adaptable for adults. This raises the question of whether, in crisis conditions, guidelines for treating extremely premature babies should be altered to free-up ventilators. Some adults who need ventilators will have a survival rate higher than some extremely premature babies. (...) But surviving babies will likely live longer, maximizing life-years. Empiric evidence demonstrates that these babies can derive significant survival benefits from ventilation when compared to adults. When “triaging” or choosing between patients, justice demands fair guidelines. Premature babies do not deserve special consideration; they deserve equal consideration. Solidarity is crucial but must consider needs specific to patient populations and avoid biases against people with disabilities and extremely premature babies. (shrink)

The urgent drive for vaccine development in the midst of the current COVID-19 pandemic has prompted public and private organisations to invest heavily in research and development of a COVID-19 vaccine. Organisations globally have affirmed the commitment of fair global access, but the means by which a successful vaccine can be mass produced and equitably distributed remains notably unanswered. Barriers for low-income countries include the inability to afford vaccines as well as inadequate resources to vaccinate, barriers that are (...) exacerbated during a pandemic. Fair distribution of a pandemic vaccine is unlikely without a solid ethical framework for allocation. This piece analyses four allocation paradigms: ability to develop or purchase; reciprocity; ability to implement; and distributive justice, and synthesises their ethical considerations to develop an allocation model to fit the COVID-19 pandemic. (shrink)

Background In the course of the COVID-19 pandemic, the biomedical research community’s attempt to focus the attention on fighting COVID-19, led to several challenges within the field of research ethics. However, we know little about the practical relevance of these challenges for Research Ethics Committees. Methods We conducted a qualitative survey across all 52 German RECs on the challenges and potential solutions with reviewing proposals for COVID-19 studies. We de-identified the answers and applied thematic text analysis for (...) the extraction and synthesis of challenges and potential solutions that we grouped under established principles for clinical research ethics. Results We received an overall response rate of 42%. The 22 responding RECs reported that they had assessed a total of 441 study proposals on COVID-19 until 21 April 2020. For the review of these proposals the RECs indicated a broad spectrum of challenges regarding social value, scientific validity, favourable risk–benefit ratio, informed consent, independent review, fair selection of trial participants, and respect for study participants. Mentioned solutions ranged from improved local/national coordination, over guidance on modified consent procedures, to priority setting across clinical studies. Conclusions RECs are facing a broad spectrum of pressing challenges in reviewing COVID-19 studies. Some challenges for consent procedures are well known from research in intensive care settings but are further aggravated by infection measures. Other challenges such as reviewing several clinical studies at the same time that potentially compete for the recruitment of in-house COVID-19 patients are unique to the current situation. For some of the challenges the proposed solutions in our survey could relatively easy be translated into practice. Others need further conceptual and empirical research. Our findings together with the increasing body of literature on COVID-19 research ethics, and further stakeholder engagement should inform the development of hands-on guidance for researchers, funders, RECs, and further oversight bodies. (shrink)

While COVID-19 spreads aggressively and rapidly across the globe, many societies have also witnessed the spread of other viral phenomena like misinformation, conspiracy theories, and general mass suspicions about what is really going on. This study investigates how exposure to and trust in information sources, and anxiety and depression, are associated with conspiracy and misinformation beliefs in eight countries/regions during the COVID-19 pandemic. Data were collected in an online survey fielded from May 29, 2020 to June 12, 2020, (...) resulting in a multinational representative sample of 8,806 adult respondents. Results indicate that greater exposure to traditional media is associated with lower conspiracy and misinformation beliefs, while exposure to politicians and digital media and personal contacts are associated with greater conspiracy and misinformation beliefs. Exposure to health experts is associated with lower conspiracy beliefs only. Higher feelings of depression are also associated with greater conspiracy and misinformation beliefs. We also found relevant group- and country differences. We discuss the implications of these results. (shrink)

The COVID-19 emergency has hit the whole world, finding all countries unprepared to face it. The first studies focused on the medical aspects, neglecting the psychological dimension of the populations that were forced to face changes in everyday life and in some cases to stay forcedly at home in order to reduce contagion. The present research was carried out in Italy, one of the countries hardest hit by the pandemic. The aim was to analyze the perception of happiness, mental (...) health, and the sense of loneliness experienced by adults during the lockdown due to the COVID pandemic. Specifically, the variables will be examined in relation to gender difference, living alone, with partner, or with partner and children. The research followed a quantitative approach using an online questionnaire. The project involved 1100 subjects from whom 721 participants were extrapolated. Of them, 17.3% claimed to live alone, 39.5% with their partner, and 43.1% with their partner and children. The results show that people in general experienced a lower level of happiness and mental health and higher levels of loneliness compared to normative sample. The lockdown and pandemic condition due to COVID-19 seems to have canceled the gender differences in the perception of happiness and mental health, while it seems to have increased the perception of loneliness experienced by males compared to the pre-pandemic condition. In addition, those who lived alone perceived a greater level of loneliness than those who lived with their partner or partner and children. Unexpectedly, no significant differences emerged regarding the level of happiness and mental health between those who had direct contact with the virus and those who did not. These data should make political decision-makers reflect on the need to pay more attention to the implications that such drastic measures as a lockdown can have on people’s psychological well-being. (shrink)

Technology innovation has changed the patterns with its advanced features for travel and tourism industry during the outbreak of COVID-19 pandemic, which massively hit tourism and travel worldwide. The profound adverse effects of the coronavirus disease resulted in a steep decline in the demand for travel and tourism activities worldwide. This study focused on the literature based on travel and tourism in the wake global crisis due to infectious virus. The study aims to review the emerging literature critically to (...) help researchers better understand the situation. It valorizes transformational affordance, tourism, and travel industries impacts posed by the virus COVID-19. The study proposed a research model on reviving the international tourism activities post COVID-19 pandemic to gain sustainable development and recovery. The scholars have debated seeking the best possible ways to predict a sustainable recovery of travel, tourism, and leisure sectors from the devastating consequences of coronavirus COVID-19. In the first phase, the study describes how the current pandemic can become transformational opportunities. It debates the situation and questions related to the emergence of the COVID-19 outbreak. The present research focuses on identifying fundamental values, organizations, and pre-assumptions related to travel and tourism revival and help academia and researchers to a breakthrough in initiating the frontiers based on research and practice. This study aims at exploring the role of technological innovation in the crisis management of COVID-19 tourism impacts, tourists’ behavior, and experiences. The travel and tourism industry’s main stakeholders include tourism demand and organizations that manage tourists’ destinations and policymakers. They have already experienced the stages of responses, recovery, and resetting tourism recovery strategies. The study provides valuable insight into the coronavirus consequences on travel and tourism and practical implications for global tourism and academic research revitalization. (shrink)

Background: While employers are increasingly considering and implementing COVID-19 vaccination requirements, little is known about the reasons offered by employees seeking religious exemptions.Methods: We conducted a mixed methods analysis of all the requests for religious exemptions submitted during the initial implementation of a COVID-19 vaccination requirement at a single academic medical center in the United States.Results: Five hundred sixty-five (3.4%) employees requested religious exemptions. At least 305 (54.0%) requesters had job titles suggesting that they had direct patient contact. (...) Four hundred ninety-nine (88.3%) of requesters self-identified as Christian, of whom 120 (21.2%) identified as Roman Catholic. Requesters offered 0 to 8 (mean 2.7) categories of reasons for their request. The most frequently stated reasons pertained to the use of fetal cell lines in vaccine development and manufacturing (382, 67.6%), interest in maintaining purity (221, 39.1%), or belief in divine healing (172, 30.4%). Some requesters also volunteered evidence of the sincerity of their beliefs including examples of their religious practices (116, 20.5%), other practices (66, 11.7%), and emotional states (32, 5.7%). One hundred fifty-two applications (26.9%) contained text copied without attribution, primarily from sample religious exemption request letters available on the Internet.Conclusions: Most requesters focused on the use of fetal cell lines in the development or manufacturing of the vaccines as the justification for their request. The development of vaccines that are not reliant on fetal cell lines may increase vaccination rates. Understanding reasons for religious exemption requests may inform vaccine education and vaccination policies. (shrink)

Purpose The COVID-19 pandemic broke out at the end of 2019, and throughout 2020 there were intensive international efforts to find a vaccine for the disease, which had already led to the deaths of some five million people. In December 2020, several pharmaceutical companies announced that they had succeeded in producing an effective vaccine, and after approval by the various regulatory bodies, countries started to vaccinate their citizens. With the start of the global campaign to vaccinate the world’s population (...) against COVID-19, debates over the prioritization of different sections of the population began around the world, but the prison population has generally been absent from these discussions. Approach and Findings This article presents the approach of Jewish ethics regarding this issue, that is, that there is a religious and a moral obligation to heal the other and to take care of his or her medical well-being and that this holds true even for a prisoner who has committed a serious crime. Hence, prisoners should be vaccinated according to the same priorities that govern the administration of the vaccine among the general public. Originality The originality of the article is in a comprehensive and comparative reference between general ethics and Jewish ethics on a subject that has not yet received the proper attention. (shrink)

Coronavirus disease 2019 (COVID-19) is likely to have long-term mental health effects on individuals who have recovered from COVID-19. Rightly, there is a global response for recognition and planning on how to deal with mental health problems for everyone impacted by the global pandemic. This does not just include COVID-19 patients but the general public and health care workers as well. There is also a need to understand the role of the virus itself in the pathophysiology of (...) mental health disorders and longer-term mental health sequelae. Emerging evidence suggests that COVID-19 patients develop neurological symptoms such as headache, altered consciousness, and paraesthesia. Brain tissue oedema and partial neurodegeneration have also been observed in an autopsy. In addition, there are reports that the virus has the potential to cause nervous system damage. Together, these findings point to a possible role of the virus in the development of acute psychiatric symptoms and long-term neuropsychiatric sequelae of COVID-19. The brain pathologies associated with COVID-19 infection is likely to have a long-term impact on cognitive processes. Evidence from other viral respiratory infections, such as severe acute respiratory syndrome (SARS), suggests a potential development of psychiatric disorders, long-term neuropsychiatric disorders, and cognitive problems. In this paper, we will review and evaluate the available evidence of acute and possible long-term neuropsychiatric manifestations of COVID-19. We will discuss possible pathophysiological mechanisms and the implications this will have on preparing a long-term strategy to monitor and manage such patients. (shrink)

Suddenly, COVID-19 has changed the world and the way people work. Companies had to accelerate something they knew was imminent in the future, but not immediate and extremely humongous. This situation poses a huge challenge for companies to survive and thrive in this complex business environment and for employees, who must adapt to this new way of working. An effective e-leadership, which promotes companies’ adaptability, is needed. This study investigates the existing knowledge on teleworking and e-leadership; and analyzes the (...) supposed challenges. The literature review shows that companies with effective e-leadership can view teleworking as an opportunity. It is advantageous for not only companies’ productivity but also the environment and people who work remotely. However, a traditional or no leadership can result in some risks. Thriving in remote work environments implies that managers must adjust the companies’ structure, making them less hierarchical, and developing new abilities to establish a strong and trustworthy relationship with their employees to maintain their competitiveness, while retaining a genuine concern for their employees’ well-being. Similarly, successful e-leadership must be able to consolidate and lead effective virtual teams to accomplish organizational goals. This study contributes to the literature and leaders during the pandemic. (shrink)

The COVID-19 outbreak has placed extraordinary demands upon healthcare systems worldwide. Italy's hospitals have been among the most severely overwhelmed, and as a result, Italian healthcare workers' well-being has been at risk. The aim of this study is to explore the relationships between dimensions of burnout and various psychological features among Italian healthcare workers during the COVID-19 emergency. A group of 267 HCWs from a hospital in the Lazio Region completed self-administered questionnaires online through Google Forms, including the (...) Maslach Burnout Inventory, Resilience Scale, and Intolerance of Uncertainty Scale Short Form. Cluster analysis highlighted two opposite burnout risk profiles: low burnout and high-risk burnout. The high-risk group had lower resilience and greater difficulties in tolerating the uncertainty than the low-burnout group. A set of general linear models confirmed that both IU subscales, prospective and inhibition, moderated the relationship between resilience and burnout. In conclusion, the results showed that individual levels of resilience and one's ability to tolerate uncertainty have been significant factors in determining the impact of the COVID-19 emergency on HCWs. The use of emotional strategies that allow individuals to stay in a critical situation without the need to control it appears to protect against burnout in these circumstances. (shrink)

Evolutionary game theory and public goods games offer an important framework to understand cooperation during pandemics. From this perspective, the COVID-19 situation can be conceptualized as a dilemma where people who neglect safety precautions act as free riders, because they get to enjoy the benefits of decreased health risk from others’ compliance with policies despite not contributing to or even undermining public safety themselves. At the same time, humans appear to carry a suite of evolved psychological mechanisms aimed at (...) curbing free riding in order to ensure the continued provision of public goods, which can be leveraged to develop more effective measures to promote compliance with regulations. We also highlight factors beyond free riding that reduce compliance rates, such as the emergence of conspiratorial thinking, which seriously undermine the effectiveness of measures to suppress free riding. Together, the current paper outlines the social dynamics that occur in public goods dilemmas involving the spread of infectious disease, highlights the utility and limits of evolutionary game-theoretic approaches for COVID-19 management, and suggests novel directions based on emerging challenges to cooperation. (shrink)

The Fear of COVID-19 Scale (FCV-19S) is a new one-dimensional scale used to measure fear of an individual about the COVID-19. Given the seriousness of the COVID-19 situation in China when our study was taking place, our aim was to translate and examine the applicability of the FCV-19S in Chinese students. The sample used for validation comprised 2,445 Chinese students. The psychometrical characteristics of the Chinese FCV-19S (FCV-19S-C) were tested using Rasch analysis. Principal component analysis (PCA) proved (...) the unidimensional structure of the model. Both infit and outfit mean square (MNSQ) values (0.69–1.31) and point-measure correlations (0.82–0.86) indicated a good model fit. Person-item separation and reliability values indicated good reliability of the scale. The person-item map revealed an acceptable level of match between the persons and the items. Differential item functioning of the FCV-19S-C showed no differences with respect to age or gender. FCV-19S-C scores were significantly associated with anxiety, stress, depression, ego-resilience, and general health. The FCV-19S-C was proven to be effective in measuring fear of Chinese students about the COVID-19. (shrink)

While COVID-19 has generated a massive burden of illness worldwide, healthcare workers (HCWs) have been disproportionately exposed to SARS-CoV-2 coronavirus infection. During the so-called ‘first wave’, infection rates among this population group have ranged between 10% and 20%, raising as high as one in every four COVID-19 patients in Spain at the peak of the crisis. Now that many countries are already dealing with new waves of COVID-19 cases, a potential competition between HCW and non-HCW patients for (...) scarce resources can still be a likely clinical scenario. In this paper, we address the question of whether HCW who become ill with COVID-19 should be prioritised in diagnostic, treatment or resource allocation protocols. We will evaluate some of the proposed arguments both in favour and against the prioritisation of HCW and also consider which clinical circumstances might warrant prioritising HCW and why could it be ethically appropriate to do so. We conclude that prioritising HCW’s access to protective equipment, diagnostic tests or even prophylactic or therapeutic drug regimes and vaccines might be ethically defensible. However, prioritising HCWs to receive intensive care unit (ICU) beds or ventilators is a much more nuanced decision, in which arguments such as instrumental value or reciprocity might not be enough, and economic and systemic values will need to be considered. (shrink)

The context of Covid-19 has offered an unusual cultural landscape for examining how workers view their own position relative to others, and how individuals respond to prolonged exposure to workplace stress across different sectors and cultures. Through our recent work tracking the well-being of frontline workers in the UK and Ireland, we have uncovered additional psychological factors that have not been accounted for in previous models of occupational stress or burnout. In recent months, frontline workers have worked to protect (...) the community from the threat of SARS-CoV-2 and, simultaneously, have evaluated their perceptions of collective efforts of others as either congruent or incongruent with collective goals : we call this novel aspect solidarity appraisal. These frontline workers have been hailed as heroes, which we argue has led to the creation of an implicit psychological contract between frontline workers and the public. Here, the heroes are willing to “go above and beyond” for the greater good, with the expectation that we do our part by adhering to public health guidelines. Where frontline workers perceive incongruence between the words and actions of others in working toward collective goals this drives negative affect and subsequent burnout. In this perspective article, we evaluate the cultural context of the pandemic in the UK and Ireland and suggest important socio-cultural factors that contribute to perceptions of solidarity, and how this may relate to burnout and worker welfare during and beyond the pandemic context. (shrink)

BackgroundThe COVID-19 crisis has introduced a variety of stressors, while simultaneously decreasing the availability of strategies to cope with stress. In this context, it could be useful to understand issues that people find most concerning and ways in which they cope with stress. In this study, we explored these questions with a sample of graduate and professional students.MethodUsing open-ended assessments, we asked participants to identify their biggest challenge or concern, their most effective way of handling stress, and their most (...) common way of handling stress. We applied thematic analysis and evaluated whether participants’ strategies corresponded with evidence-based practices.ResultsParticipants frequently reported top problems relating to productivity, physical health, and emotional health. Distraction was the most frequently classified common strategy, whereas behavioral activation was the most frequently identified effective strategy. Participants who reported a common strategy classified as an EBP reported lower depressive and anxiety symptoms. In contrast, there was no evidence of an association between symptom levels and whether or not participants’ effective strategy was an EBP. Participants who reported the same strategy as both their common and effective strategy reported lower depressive symptoms than those whose common and effective strategies were different.ConclusionOur findings highlight stressors that students are experiencing and ways they are coping during the COVID-19 crisis. We discuss how these findings can inform mental health promotion efforts and future research on coping with stressors. (shrink)

In response to the COVID-19 pandemic, there has been a rapid growth in research focused on developing vaccines and therapies. In this context, the need for speed is taken for granted, and the scientific process has adapted to accommodate this. On the surface, attempts to speed up the research enterprise appear to be a good thing. It is, however, important to consider what, if anything, might be lost when biomedical innovation is sped up. In this article we use the (...) case of a study recently retracted from the Lancet to illustrate the potential risks and harms associated with speeding up science. We then argue that, with appropriate governance mechanisms in place, it should be quite possible to both speed up science and remain attentive to scientific quality and integrity. (shrink)

This work is focused on the rise of institutionalized information control exercised by governments in times of the Covid-19 crisis and the systematic removal or demonetization of content that contradicts or challenges the defined official narrative on influencial platforms like YouTube. With national authorities fragmenting reality into contradicitng national narratives of confinement/no confinement, masks/no masks, ibuprofen/no ibuprofen, chloroquin/no chloroquin etc. the illusion of objective reality in the perpection of the world and even in the context of scientific discourse become (...) more and more evident. Do viruses and medical drugs differentiate between the nationalities of their hosting organisms? The systematic suppression of information that contradicts the respective national narrative as defined by institutionalized authorities lead to a situation in which influencial platforms like YouTube silence everybody that challenges these narratives. (shrink)

BackgroundUnder COVID-19 pandemic, many organizations developed guidelines to deal with the ethical aspects of resources allocation. This study describes the results of an argument-based review of ethical guidelines developed at the European level. It aims to increase knowledge and awareness about the moral relevance of the outbreak, especially as regards the balance of equity and dignity in clinical practice and patient’s care. MethodAccording to the argument-based review framework, we started our research from the following two questions: what are the (...) ethical principles adopted by the ethical guidelines produced at the beginning of the COVID-19 outbreak related to resource allocation? And what are the practical consequences in terms of 'priority' of access, access criteria, management of the decision-making process and patient care?ResultsTwenty-two ethical guidelines met our inclusion criteria and the results of our analysis are organized into 4 ethical concepts and related arguments: the equity principle and emerging ethical theories; triage criteria; respecting patient’s dignity, and decision making and quality of care.ConclusionFurther studies can investigate the practical consequences of the application of the guidelines described, in terms of quality of care and health care professionals’ moral distress. (shrink)

It has now been more than a year since the start of the COVID-19 pandemic. Yet, despite the colossal and unprecedented scientific effort that has been put into it, many claims are still opaque, and many issues must be solved. Among these, one deserves the attention of philosophers of science: the scientific controversy about the theories of SARS-CoV-2 transmission. In this short paper, I analyze the debate between the droplet theory and the airborne theory of viral transmission. I argue (...) that the acceptance of the droplet theory has been due to the philosophical commitments of the dominant scientific actors to a specific theory of evidence, which has become dominant in western democracies, and to a specific set of non-epistemic values, rather than to scientific considerations alone. (shrink)

Rapid, large-scale uptake of new vaccines against COVID-19 will be crucial to decrease infections and end the pandemic. In a recent article in this journal, Julian Savulescu argued in favour of monetary incentives to convince more people to be vaccinated once the vaccine becomes available. To evaluate the potential of his suggestion, we conducted an experiment investigating the impact of payments and the communication of individual and prosocial benefits of high vaccination rates on vaccination intentions. Our results revealed that (...) none of these interventions or their combinations increased willingness to be vaccinated shortly after a vaccine becomes available. Consequently, decision makers should be cautious about introducing monetary incentives and instead focus on interventions that increase confidence in vaccine safety first, as this has shown to be an especially important factor regarding the demand for the new COVID-19 vaccines. (shrink)

New concerns have emerged during the COVID-19 pandemic that greatly impact employees and many other aspects in organizations. We have highlighted the major organizational issues during COVID-19 and classified the relevant research findings based on 45 recent articles. Main themes identified include work setting, perceptions of COVID-19, employee wellbeing, organizational strategies, and influences on career behaviors. Employees have faced challenges due to work conditions that have shifted from traditional commuting to telework. Employees have also become aware of (...) the negative current situation, so their overall wellbeing has been threatened. In response, organizations have strived to promote positive psychological capital for employees as they attempt to cope with this crisis. Organizations have tried to maintain and manage both their employees and their business. People tended to adjust their career-related behaviors based on how they perceived their own wellbeing and organizational strategies. (shrink)

Due to the COVID-19 pandemic, most employees face increasing career-related stress, particularly those who work in multinational corporations, because the international travel constraints prevent them from going back to their families. Hence, it is imperative to investigate the critical impact of employees’ occupational burnout on career-related outcomes. In response, this research explores the moderating effect of OB on the relationships between career competencies and career sustainability. To achieve a more comprehensive understanding of relevant issues, we adopted a mixed-method research (...) design that includes both qualitative and quantitative analyses. Findings indicate that all the three dimensions of CCs were positively related to CS; moreover, OB negatively moderated the individual relationships of CC and BC with CS. The main contribution of this study is to enrich the existing career literature by addressing the critical moderating role of OB in the links of CC and BC individually with CS. Practical implications are also discussed in this study. (shrink)

The COVID-19 pandemic has dramatically changed the patterns of lifestyle and posed psychological stress on pregnant women. However, the association of sleep duration and screen time with anxiety among pregnant women under the backdrop of the COVID-19 pandemic scenario has been poorly addressed. We conducted one large-scale, multicenter cross-sectional study which recruited 1794 pregnant women across middle and west China. Self-reported demographic characteristics, lifestyle, and mental health status were collected from 6th February to 8th May 2020. We investigated (...) the association of sleep duration and screen time with the risk of anxiety by multivariable logistic regression analysis and linear regression analysis after adjusting potential confounders. The dose-response relationship of sleep duration and screen time with anxiety was visualized using a cubic spline plot. Our data revealed that almost 35% of pregnant women suffered from anxiety during the COVID-19 pandemic. Sleep duration was dose-dependently associated with a lower risk of anxiety among pregnant women, while screen time exhibited a conversed effect. Notably, sleep duration synergistically combined with screen time to diminish the risk of anxiety. Taken together, sleep duration and screen time were independently and jointly associated with anxiety. Therefore, promoting a more active lifestyle and maintaining higher sleep quality could improve the mental health of pregnant women, especially under public health emergency. (shrink)

Spain has become one of the European epicenters of coronavirus (COVID-19), a virus that particularly affects the elderly, since this group accounts for the majority of hospitalized cases and has the highest mortality rates. Therefore, the aim of this research is to understand how elderly people represent and emotionally cope with COVID-19 during the days when the pandemic emerged in Spain. Using a qualitative methodology, a free association exercise elicited by the word “COVID-19” was completed by 115 (...) participants (age range: 60–85 years) from the North of Spain. Lexical analysis was used to analyze the content. The results revealed that the government and the mass media are criticized for failing to communicate a clear message, and for giving out information that is both insufficient and contradictory. However, participants are clear that it is essential to follow the guidelines of the scientists and doctors, which are represented as credible sources. However, when the state of alarm and the lockdown of all citizens was declared, most of the participants represented the risk as being associated with the elderly and the pandemic became something that might also affect their families. Due to these circumstances, negative emotions appear such as fear, nervousness, uncertainty, restlessness, and insecurity. Feelings of solitude and loneliness also emerged, and these are represented as being linked to death. These results indicate the need for governments to manage the current situation with the elderly by placing greater emphasis on social and inclusive policies to help alleviate the possible effects of the pandemic and the lockdown. (shrink)

In their discussion paper of November 2020, Cooket alpresent a draft protocol for navigating circumstances in which emergency services are overwhelmed. Their paper suggests that COVID-related triage decisions should be based on clinical assessment, patient and family consultation, and a range of ethical considerations. In this response, we note that the protocol exhibits an ambiguity that is likely to result in irresolvable dilemmas when put into practice. This ambiguity is exemplified in the paper’s prime ethical imperative (to ‘save more (...) lives and more years of life’), which takes the form of an undefined conjunction whose practical implications are left unspecified. We see this ambiguity in the prime imperative as one manifestation of a broader set of tensions in the protocol. We show that the discipline of human rights provides an essential supplement to the ethical framework on which Cook and colleagues rely, providing a framework for understanding and working through triage dilemmas involving age, discrimination and equality. (shrink)

Malaysia had its first four patients with COVID-19 on 25 January 2020. In the same week, the World Health Organization declared it as a public health emergency of international concern. The pandemic has since challenged the ethics and practice of medicine. There is palpable tension from the conflict of interest between public health initiatives and individual’s rights. Ensuring equitable care and distribution of health resources for patients with and without COVID-19 is a recurring ethical challenge for clinicians. Palliative (...) care aims to mitigate suffering caused by a life-limiting illness, and this crisis has led to the awareness and urgency to ensure it reaches all who needs it. We share here the palliative care perspectives and ethical challenges during the COVID-19 pandemic in Malaysia. (shrink)

Stereotypes about exotic peoples and animals of the Orient shaped popular origin stories about COVID-19 in media reports. Outbreak narratives centred on the seafood market in Wuhan began to fall apart as new evidence was published by medical doctors, virologists, and epidemiologists. No viruses in bats or pangolins have been found that are direct ancestors of SARS-CoV2, the virus responsible for COVID-19 symptoms. Viruses are also being transformed as they interact with the human institutions, infrastructures and behaviours that (...) facilitate their spread. Epidemiological growth curves are shaped by national and foreign capital, cosmopolitanism, aspirations for independence and ongoing interdependence, the discourse of power and the discourse of resistance, as well as coexistence and violence. In reckoning with SARS-CoV2, we need to anticipate disruptive surprise of viral emergence rather recursively search for origins. Departing from Foucault’s foundational insights, this article gestures towards genealogies of possible viral futures. (shrink)

Objectives: To examine associations of changing employment conditions, specifically switching to working from home or job loss, with mental health, using data collected during the COVID-19 pandemic.Methods: Data from 2,301 US adults in employment prior to COVID-19 were collected April 3rd−7th, 2020. Participants reported whether their employment remained unchanged, they were WFH when they had not been before, or they had lost their job due to the pandemic. Outcomes were symptoms of depression, anxiety, stress, loneliness, and positive mental (...) health assessed using validated questionnaires. Linear regression quantified associations of employment changes with mental health outcomes, controlling for age, sex, race, BMI, smoking status, screen time, physical activity, marital status, chronic conditions, and current COVID-19 containment strategies being followed.Results: Compared to participants whose employment remained unchanged, those who switched to WFH did not differ in any measures of mental health. Participants who had lost their job reported higher symptoms of depression, anxiety, and stress, and lower PMH. Loneliness did not differ between groups.Conclusion: This study demonstrates that concerns around potential adverse mental health effects, particularly increases in loneliness, should not preclude WFH in the general population, while considering each individual's personal circumstances, and the acute adverse association of job loss with mental health. Tailored and sensitive interventions may be required to prevent deteriorations in mental health associated with job loss during periods of societal stress. (shrink)

PurposeThe COVID-19 lockdown interrupted normal daily activities, which may have led to an increase in sedentary behavior. The aim of this study was to investigate the effect of the COVID-19 pandemic on the level of physical activity among Swiss office workers.MethodsOffice workers from two Swiss organizations, aged 18–65 years, were included. Baseline data from January 2020 before the COVID-19 pandemic became effective in Switzerland were compared with follow-up data during the lockdown phase in April 2020. Levels of (...) physical activity were assessed using the International Physical Activity Questionnaire. Paired sample t-tests or Wilcoxon signed-rank test were performed for statistical analysis.ResultsData from 76 participants were analyzed. Fifty-four participants were female. The mean age was 42.7 years at baseline. About 75% of the participants met the recommendations on minimal physical activity, both before the COVID-19 pandemic and during the lockdown. Weak statistical evidence for a decline in total physical activity in metabolic equivalent of task minutes per week was found, with no evidence for a decrease in the three types of activity: walking, moderate-intensity activity and vigorous-intensity activity. Across the three categories “high,” “moderate,” and “low” physical activity, 17% of the participants became less active during the lockdown while 29% became more active.ConclusionThe COVID-19 pandemic did not result in a reduction in total physical activity levels among a sample of Swiss office workers during the first weeks of lockdown. Improved work-life balance and working times may have contributed to this finding.Clinical Trial Registrationwww.ClinicalTrials.gov, NCT04169646. Registered 15 November 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04169646. (shrink)

The COVID-19 pandemic has exposed the many challenges and difficulties of healthcare systems caring for older frail people. This public health crisis has indeed jeopardised the concept of the welfare state, in particular the right of older people to uncompromised healthcare. Together with the clinical challenges facing the geriatric patient and the organisational difficulties of the healthcare systems, sociocultural factors may have also played a substantial role in the strategies that countries have applied in coping with the pandemic. In (...) this opinion article, we report attitudes towards the older populations of two countries, Italy and Israel, during the COVID-19 pandemic as viewed through the looking-glass of the media. (shrink)

COVID-19 caused levels of household food insecurity to spike, but the precarity of so many people in wealthy countries is an outgrowth of decades of eroding public provisions and labour protections that once protected people from hunger, setting the stage for the virus’ unevenly-distributed harms. The prominence of corporate-sponsored foodbanking as a containment response to pandemic-aggravated food insecurity follows decades of replacing rights with charity. We review structural drivers of charity’s growth to prominence as a hunger solution in North (...) America, and of its spread to countries including the UK. By highlighting pre-pandemic pressures shaping foodbanking, including charities’ efforts to retool themselves as health providers, we ask whether anti-hunger efforts during the pandemic serve to contain ongoing socioeconomic crises and the unjust living conditions they cause, or contest them through transformative pathways to a just food system. We suggest that pandemic-driven philanthropic and state funding flows have bolstered foodbanking and the food system logics that support it. By contextualising the complex and variegated politics of foodbanking in broader movements, from community food security to food sovereignty, we reframe simplistic narratives of charity and highlight the need for justice-oriented structural changes in wealth redistribution and food system organisation if we are to prevent the kinds of emergency-within-emergency that we witnessed as COVID-19 revealed the proximity of many to hunger. (shrink)

The SARS-CoV-2 (COVID-19) pandemic continues to expose underlying inequities in healthcare for black, indigenous and Latinx communities in the USA. The gaps in equitable care for communities of colour transcend the diagnosis, treatment and vaccinations related to COVID-19. We are experiencing a continued gap across racial and socioeconomic lines for those who suffer prolonged effects of COVID-19, also known as ‘Long COVID-19’. What we know about the treatment for Long COVID-19 so far is that it (...) is complex, requires a multidisciplinary approach and there is still much research needed to fully understand the effects. In this paper, we discuss pragmatic considerations for including affected communities, relevant stakeholders, and leaders from communities of colour in the planning and implementation of Long COVID-19 research. (shrink)

The COVID-19 pandemic has posed many challenges, especially for families. Both the public and the scientific community are currently discussing the extent to which school closings have worsened existing social differences, especially with regard to children’s academic and socio-emotional development. At the same time, parents have had to manage childcare and home schooling alongside their jobs and personal burdens posed by the pandemic. Parents’ possibilities for meeting these cognitive and emotional challenges might also depend on the different conditions in (...) families. For this reason, the present paper investigates the structural and process characteristics of the family as well as children’s and parents’ psychological characteristics that predict how parents assess their ability to support their child’s learning during homeschooling as well as parents’ perceived emotional stress caused by school closure. The study analyses data of the Newborn Cohort Study of the German National Educational Panel Study. The two dependent variables were measured during the COVID-19 pandemic after the first school closure in Germany, at a time when the children of this cohort were attending second grade. Besides a number of control variables, families’ structural characteristics [socioeconomic status, education], process characteristics, parents’ psychological characteristics, and the child’s psychological characteristics from earlier waves were included as predictors. The results of structural equation models show that perceived stress was associated with structural factors and the preceding psychological stress of parents. Parents with higher preceding stress reported higher perceived stress. Interestingly, higher-educated parents also reported more stress than lower educated parents during the pandemic. The effect was the other way around for SES – parents with lower SES reported more stress than parents with higher SES. The self-reported abilities to support the learning of the child seemed to be mainly predicted by the parent’s education as well as preceding psychological stress. To sum up, the results identify important aspects that determine how parents handle the challenges of the school closures. Especially, socially disadvantaged families carry their burden into the pandemic. (shrink)

The COVID-19 pandemic has been the most mediatised health crisis in human history, involving a rapid circulation of knowledge in global networks and a continuous flow of spectacular images and narratives that have rendered the pandemic graspable in cultural, political, and moral terms. This article proposes that the intertwined nature of two opposite trends of knowledge production – scientific reasoning and affective storytelling – can be analytically approached through the concept of ‘outformation’ that provides explanatory power and conceptual clarity (...) to make sense of the disorderly flows of knowledge in the pandemic-era. Using frame analysis, the article examines how one key term of the pandemic era, herd immunity, is taken from its scientific context and mobilised across different epistemic arenas from journalistic media to parliamentary debates as a vehicle for mistrust towards political and expert authorities in Finland that is a country characterised by high levels of trust towards authorities. The Finnish case is not only a national case about the framing of a specific term in times of epistemic instability but also provides a valuable lens to knowledge production during the pandemic era. (shrink)

The COVID-19 pandemic gave rise to social and economic problems and pose a threat to most of enterprise. Faced with crisis and challenge, effective leaders and devoted employees are important factors for enterprises to overcome difficulties. We propose a moderated mediation model wherein narcissistic leader predicts subordinate’s followership through leader self-interest behavior perceived by subordinates, with organizational identification of leader acting as the contextual condition. Two-wave data collected from 303 employees in the manufacturing and technology industry in China supported (...) our hypothesized model. We found that narcissistic leader has negative impact on subordinates’ followership due to their perception of leader’s self-interest behavior. Further, organizational identification of leader plays a moderate role in the relationship between narcissistic leader and subordinates’ followership. Theoretical and practical implications are discussed. We also offer several promising directions for future research. (shrink)

Distinct sources of stress have emerged during the COVID-19 pandemic. Particularly, fear is expected to generate significant psychological burden on individuals and influence on either unsafe behavior that may hinder recovery efforts or virus-mitigating behaviors. However, little is known about the properties of measures to capture them in research and clinical settings. To resolve this gap, we evaluated the psychometric properties of a novel measure of fear of illness and viruses and tested its predictive value for future development of (...) distress. We extracted a random sample of 450 Chilean adult participants from a large cross-sectional survey panel and invited to participate in this intensive longitudinal study for 35 days. Of these, 163 ended up enrolling in the study after the demanding nature of the measurement schedule was clearly explained to them. For this final sample, we calculated different Confirmatory Factor Analyses (CFA) to evaluate the preliminary proposed structure for the instrument. Complementarily, we conducted a content analysis of the items to qualitatively extract its latent structure, which was also subject to empirical test via CFA. Results indicated that the original structure did not fit the data well; however, the new proposed structure based on the content analysis did. Overall, the modified instrument showed good reliability through all subscales both by its internal consistency with Cronbach’s alphas ranging from 0.814 to 0.913, and with test–retest correlations ranging from 0.715 to 0.804. Regarding its convergent validity, individuals who scored higher in fears tended to also score higher in depressive and posttraumatic stress symptoms at baseline. Furthermore, higher fears at baseline predicted a higher score in posttraumatic stress symptomatology 7 days later. These results provide evidence for the validity, reliability, and predictive performance of the scale. As the scale is free and multidimensional potentially not circumscribed to COVID-19, it might work as a step toward understanding the psychological impact of current and future pandemics, or further life-threatening health situations of similar characteristics. Limitations, practical implications, and future directions for research are discussed. (shrink)

The novelty of the coronavirus disease 2019 (COVID-19) pandemic is that it is occurring in a globalized society enhanced by digital capabilities. Our aim was to analyze the psychological and emotional states of participants in different pandemic-related contexts, with a focus on their digital and physical distancing behaviors. The online survey was applied during the ascending phase of the pandemic in March 2020 in two neighboring EU countries: Italy and Croatia. The study subjects involved four groups, two directly affected (...) by epidemiological measures and two serving as controls—(1) participants from Italy who were in lockdown (Italy group), (2) participants from Croatia who were not in lockdown but who were in direct contact with an infected person and underwent epidemiological measures (CRO-contact group), (3) participants from Croatia who were in an analogous situation but not near the same infected person (CRO-no contact group), and (4) participants from Croatia who were not aware of any infected person (CRO-unrelated group). The survey consisted of validated scales of psychological and emotional states, and custom-made questionnaires on the digital (online) and physical (off-line) behavior of the participants. The Italy group in lockdown had higher self-perceived scores for depression, stress, post-traumatic intrusion, and avoidance, as well as the highest digital activity and physical distancing than the not-in-lockdown Croatian groups. The insight into the extent of online activities and off-line isolation allowed for the introduction of Digital Activity and Physical Distancing Scores. Self-perceived post-traumatic avoidance was higher in both the Italy and CRO-contact groups than the control CRO-no contact and CRO-unrelated groups, and higher avoidance correlated with higher Digital Activity and Physical Distancing Scores. Being in direct contact with the infected person, the CRO-contact group had no other alterations than unexpectedly lower post-traumatic hyperarousal when compared with the Italy group. The Italy group in lockdown demonstrated higher self-perceived psychological toll together with higher digital activity and physical distancing than Croatian groups not in lockdown, even when compared with the affected CRO-contact group. The study outcomes suggest that the general emergency measures influenced citizens in lockdown more than exposure to the virus through direct contact with an infected person. (shrink)

Physical exercise is seen as the main ally for health promotion, preventing and protecting the organism from several diseases. According to WHO, there is a tendency of constant growth in the elderly population in the coming years. The regular practice of exercises by the elderly becomes relevant to minimize the deleterious effects of the aging process and to increase the fitness index. Recently, the world population started a confrontation against Corona Virus Disease (COVID-19), which is the most significant public (...) health challenge globally. Although social isolation is a reasonable measure in an attempt to stop contamination by COVID-19, this measure has limited the ability of individuals to exercise outdoors or in gyms and health clubs, which increased the risk of developing chronic illnesses related to a sedentary lifestyle. The critical point is that the recent recommendations on exercise prescription to combat the potentially harmful effects of COVID-19 failure to adequately address resistance exercise interventions as home-based exercise strategy. Thus, in this paper, we discussed the physical exercise as medicine if the training status is enough to protect the elderly against COVID-19 infection, about the role of physical activity on immunosuppression. Possible risks for COVID-19 infection, and the old training methods, such as no-load resistance training as possible resistance exercise strategies and high-intensity interval training, as new proposals of home-based exercise interventions, could perform during the current COVID-19 pandemic. (shrink)

PurposeThe COVID-19 pandemic caused a massive healthcare crisis. To investigate what makes healthcare system resilient and physicians better at coping during a crisis situation, our study investigated the role risk exposure, such as working at COVID-19 entry points, sleep, and perceived work safety played in reducing negative psychological functioning at work, as well as their effects on adverse and potentially fatal incidences of compromised safety and medical errors.MethodsOur study included a representative sample of 1,189 physicians, from all 12 (...) Slovenian regions and all medical occupations, as registered by the Medical Chamber of Slovenia. For the purposes of this study, a Questionnaire of Sleep and Psychological Functioning at Work was developed in the form of an online retrospective self-report. Additionally, our study included items assessing physicians perceived work safety and frequency of negative outcomes during the first month of the Covid-19 epidemic.ResultsPhysicians working at COVID-19 entry points were more likely to experience night awakening, slept less than 5 h per night, experience nightmares, and had lower levels of psychological functioning in comparison to other physicians. Both hypothesized models showed adequate fit. A higher score on the sleep scale has been shown to predict lower levels of negative psychological functioning at work and, indirectly, reduced incidences of compromised safety and medical errors. Contrary to our expectations, no significant direct effect of sleep on compromised safety and medical errors was found. When perceived work safety was added into the model, the model showed improved fit, with perceived work safety predicting better sleep, less negative psychological functioning at work, and less compromised safety.ConclusionSleep and safety both play an important role in reducing negative psychological functioning at work and, by doing so, decreasing the negative and potentially fatal incidents during the pandemic, such as compromised safety and medical errors. Further, research is needed to see how medical guidelines can be updated to ensure physicians sleep and that their safety is protected. (shrink)

COVID-19 outbroke in Wuhan, China, in December 2019 and promptly became a pandemic worldwide, endangering health and life but also causing mild-to-severe psychological distress to lots of people, including healthcare workers. Several studies have already showed a high prevalence of depression, anxiety, and post-traumatic symptoms in HCWs but less is known about the efficacy of psychological interventions for relieving their mental distress. The aims of this study were: to evaluate the psychological adjustment of Italian HCWs during the COVID-19 (...) pandemic; to investigate the efficacy of an expressive writing intervention, based on Pennebaker’s paradigmatic protocol, on their psychological adjustment; to analyze if outcomes of EW vary in function of individual differences. Fifty-five HCWs were randomly assigned to one of two writing conditions: EW or neutral writing. Psychological adjustment was assessed before and after three writing sessions. Participants who received the EW intervention showed higher improvements in ptsd, depression, and global psychopathology symptoms. Improvements in EW group varied in function of age, gender, marital status, and baseline values: young, men, married participants and those who had higher baseline scores showed a higher reduction of psychological distress symptoms while women, single and those who had lower baseline value showed increased social support, and resilience. In conclusion, the EW intervention had positive effects which varied in function of individual differences on HCWs’ psychological health. (shrink)

The COVID-19 pandemic forced German universities to adjust their established operations quickly during the first nationwide lockdown in spring 2020. Lecturers and students were confronted with a sudden transition to remote teaching and learning. The present study examined students’ preparedness for and perspective on this new situation. In March and April 2020, we surveyed n = 584 students about the status quo of their perceived digital literacy and corresponding formal learning opportunities they had experienced in the past. Additionally, the (...) students reported the direction of changes in key study characteristics they expected from this new situation. Moreover, they reported the extent to which they believe they will be able to master this new study situation successfully. Two categories of independent variables were considered: context-related variables and person-related variables. Our results show that students did not have many learning opportunities to promote their digital literacy, suggesting that they were not appropriately prepared for this new situation. Results for digital literacy vary by competence area. However, there is a positive correlation between past formal learning opportunities and corresponding digital competences. Master students reported more learning opportunities and higher digital literacy only in one competence area compared to bachelor students. Regarding the expected change of key study characteristics, some characteristics were expected to worsen and fewer to improve. A multiple regression analysis explained 54% of the estimated probability of successful remote learning. Students’ age, state anxiety, positive state affect, general self-efficacy, the availability of an own workplace, past learning opportunities in digital content creation, and the estimated preparedness of lecturers for remote teaching were significant explaining factors. Our results provide valuable insights into the perspective of students on studying during the COVID-19 pandemic and beyond. We discuss important factors that should be addressed by educational measures in the future. (shrink)