Fernando García-Dolores et al.

Increased suicide rates in Mexico City during the COVID-19 pandemic outbreak: An analysis spanning from 2016 to 2021

Cell, May 2023; doi.org/10.1016/j.heliyon.2023.e16420

Abstract

Coronavirus disease 2019 (COVID-19) has impacted mental health worldwide, and suicide can be a serious outcome of this. Thus, suicide characteristics were examined before and during the COVID-19 pandemic in Mexico City.

Methods

This is a retrospective study including all Mexico City residents who had a coroner's record with a cause of death of intentional self-harm (ICD-10) from January 2016 to December 2021.

Results

From 2016 to 2021, 3636 people committed suicide, of which 2869 were males (78.9%) and 767 females (21.1%). From 2016 to 2019 the suicide rate remained constant (∼6 per 100000) and dramatically increased in 2020 (10.45 per 100,000), to return to the levels of the previous year in 2021 (6.95 per 100000). The suicide rate in 2020 specifically increased from January to June (COVID-19 outbreak) in all age groups. Moreover, every year young people (15–24 years) have the maximum suicide rate and depression was the main suicide etiology.

Conclusion

The COVID-19 pandemic outbreak increased the suicide rate, regardless of age, but suicide prevalence was higher in males and young people, regardless of the COVID-19 pandemic. These findings confirm that suicide is a complex and multifactorial problem and will allow the establishment of new guidelines for prevention and care strategies.

Nafiso Ahmed et al.

Mental health in Europe during the COVID-19 pandemic: a systematic review

The Lancet, June 2023; doi.org/10.1016/S2215-0366(23)00113-X

Abstract

The COVID-19 pandemic caused immediate and far-reaching disruption to society, the economy, and health-care services. We synthesised evidence on the effect of the pandemic on mental health and mental health care in high-income European countries. We included 177 longitudinal and repeated cross-sectional studies comparing prevalence or incidence of mental health problems, mental health symptom severity in people with pre-existing mental health conditions, or mental health service use before versus during the pandemic, or between different timepoints of the pandemic. We found that epidemiological studies reported higher prevalence of some mental health problems during the pandemic compared with before it, but that in most cases this increase reduced over time. Conversely, studies of health records showed reduced incidence of new diagnoses at the start of the pandemic, which further declined during 2020. Mental health service use also declined at the onset of the pandemic but increased later in 2020 and through 2021, although rates of use did not return to pre-pandemic levels for some services. We found mixed patterns of effects of the pandemic on mental health and social outcome for adults already living with mental health conditions.

Hocheol Lee et al.

COVID-19 Phobia among Korean, Chinese, and Japanese students: An international comparative study

Cell, April 2023; doi.org/10.1016/j.heliyon.2023.e15275

Abstract       

This study aimed to identify the characteristic differences and potential contributing factors of coronavirus disease 2019 (COVID-19) phobia between undergraduate and graduate students in Korea, Japan, and China. We used the online survey tool, we retained 460 responses from Korea, 248 responses from Japan, and 788 responses from China for analysis. We performed the statistical analysis; ANOVA F-test and Multiple linear regression. We visualized the results of these calculations using GraphPad PRISM 9. The mean COVID-19 phobia score was highest in Japan at 50.5 points. Psychological fear was identically prevalent in Japan and China, at an average of 17.3 points. Psychosomatic fear was highest in Japan at 9.2 points. Further, economic fear was highest in Korea at 13 points, whereas social fear was highest in China at 13.1 points. In Korea, COVID-19 phobia scores were significantly higher among women than in men. In Japan, COVID-19 phobia scores were significantly higher in individuals who complied with social distancing mandates. In China, a lack of previous experience with self-administered testing kits was associated with significantly lower phobia scores. Individuals who were avoiding crowded places had significantly higher scores in 3 countries. This implies that the students knew that it was necessary to comply with COVID-19 preventive behaviors to prevent infections. The findings of this study could be used as a reference when establishing an approach strategy to reduce COVID-19 phobia among Chinese, Japanese, and Korean students.

Qi Li et al.

Prevalence and risk factors of post-traumatic stress disorder symptoms among Chinese health care workers following the COVID-19 pandemic

Cell, March 2023; doi.org/10.1016/j.heliyon.2023.e14415

Abstract

In December 2019, coronavirus disease 2019 (COVID-19) appeared in Wuhan (Hubei, China) and subsequently swept the globe. In addition to the risk of infection, there is a strong possibility that post-traumatic stress disorder (PTSD) may be a secondary effect of the pandemic. Health care workers (HCWs) participating in the pandemic are highly exposed to and may bear the brunt out of stressful or traumatic events. In this cross-sectional study, we assessed the morbidity and risk factors of PTSD symptoms among Chinese HCWs. A total of 457 HCWs were recruited from March 15, 2020, to Mach 22, 2020, including HCWs in Wuhan and Hubei Province (excluding Wuhan), the areas first and most seriously impacted by COVID-19. The morbidity of PTSD symptoms was assessed by the Event Scale–Revised (IES-R). The risk factors for PTSD symptoms were explored by means of logistic regression analysis. Over 40% of the respondents experienced PTSD symptoms more than one month after the COVID-19 outbreak, and this proportion increased to 57.7% in Wuhan HCWs, especially females and HCWs on the frontline. Thus, rapid mental health assessment and effective psychological interventions need to be developed for frontline HCWs to prevent long-term PTSD-related disabilities. Moreover, Negative coping style and neuroticism personality may be regarded as high risk factors for PTSD symptoms. Improving individual coping strategies to enhance resilience should be the focus of further preventive intervention strategies.

Arielle A. J. Scoglio et al. 

Intimate Partner Violence, Mental Health Symptoms, and Modifiable Health Factors in Women During the COVID-19 Pandemic in the US

JAMA, March 2023; doi:10.1001/jamanetworkopen.2023.2977

Abstract

Importance  During the COVID-19 pandemic, the prevalence and severity of intimate partner violence (IPV) increased. Associations between IPV and mental health symptoms and modifiable health factors early in the pandemic have yet to be explored.

Objective  To prospectively investigate the association of IPV with greater risk of mental health symptoms and adverse health factors during the COVID-19 pandemic in 3 cohorts of female participants.

Conclusions and Relevance  Results of the study showed that IPV experiences at the start of the pandemic were associated with worse mental health symptoms and modifiable health factors for female participants younger than 60 years. Screening and interventions for IPV and related health factors are needed to prevent severe, long-term health consequences.

El-Sadr W.M. et al.

Facing the New Covid-19 Reality

NEJM, february 2023; DOI: 10.1056/NEJMp2213920

We’ve come a long way. From the early, terrifying days of a rapidly spreading deadly infection to the current circumstances in which — despite a recent steep rise in transmission rates — Covid-19 has, for many people, become no more than an occasional inconvenience, involving a few days of symptoms and a short isolation period. It’s clear that for many, if not most, people, SARS-CoV-2 infection no longer carries the same risks of adverse outcomes as it did in the early months of the pandemic. These shifts have led to a widespread assumption, fueled by political and economic priorities, that the pandemic is behind us — that it’s time to let go of caution and resume prepandemic life.

The reality, however, would starkly contradict such a belief. Covid-19 currently results in about 300 to 500 deaths per day in the United States — equivalent to an annual mortality burden higher than that associated with a bad influenza season. In addition, many people continue to face severe short- or long-term Covid-19 illness, including people who lack access to vaccines or treatment and those with underlying conditions that impair their immune response to vaccines or render them especially vulnerable to Covid-associated complications. The ever-looming threat of the evolution of a new variant, one that can evade our vaccines and antivirals, remains very real. These facts support the assumption that SARS-CoV-2 will continue to play a major role in our lives for the foreseeable future. This new reality compels us to navigate a more complex social, economic, political, and clinical terrain and to take to heart the lessons learned from the Covid-19 response thus far — both the successes and the missteps.

To date, monitoring of the effects of Covid-19 has rested on several epidemiologic and clinical measures, which have shaped the recommended or mandated protective actions. Most commonly, these measures have included estimated rates of Covid-19 cases, hospitalizations, and deaths; monitoring has also been conducted of circulating SARS-CoV-2 variants and their susceptibility to available vaccines and treatments.

Yet in the current situation, some of these traditional measures have limited value. For example, the availability of rapid antigen tests that can be conducted at home — the results of which often aren’t captured by public health surveillance systems — challenges the validity of reported case numbers and transmission rates in some jurisdictions. There is therefore a need for unbiased monitoring of transmission and infection rates by means of regular testing of sentinel populations or randomly selected representative samples of the general population.1,2 Hospitalization and death rates are certainly more reliable measures than case rates, but these measures are limited by the fact that some hospitalized patients with SARS-CoV-2 infection have been admitted for other reasons and only incidentally tested positive. Furthermore, hospitalization and death are distal outcomes, so their rates have limited value for triggering early action to control the spread of infection and averting the consequences of a surge in cases. Other measures have gained prominence and now play a critical role in defining risk for infection or severe disease. Vaccine and booster coverage and availability and utilization of treatment for Covid-19 are critical variables that affect both the risk of severe illness or death from SARS-CoV-2 and health system capacity and access.

We have gained a deeper appreciation of the breadth of the pandemic’s effects, beyond its obvious health effects. These effects have included loss of employment or housing, disruption of educational systems, and increased rates of food insecurity. Many of these negative social and economic effects were unintended results of mitigation measures, including stay-at-home orders, the shutting down of public venues, and transitions to remote learning. Although these measures were appropriate at the time, their effects weren’t evenly distributed, with some communities facing disproportionate hardship, particularly historically marginalized racial and ethnic groups and communities with limited social and economic reserves. It is thus necessary to take into account the ways in which public health recommendations and policies may differentially affect various subgroups of the population. Government and nongovernmental entities need to create clear pathways for vulnerable populations to obtain access to the resources they need, including masks, vaccines, no-cost treatment, direct economic assistance, supplemental food, rent abatement, and Internet access to support virtual learning and remote access to health services.3 Such an approach requires that the federal government continue to invest in the Covid-19 response, since private-sector investment will be insufficient to meet all needs.4

One of the key challenges that the public health community faces as the pandemic evolves is the need to move away from universal recommendations, or population-wide prevention policy, toward a more differentiated or tailored approach — one that takes into account the characteristics of various communities and the pathogen. Relevant characteristics may include those that influence virus transmission or clinical outcomes, such as vaccine and booster coverage and risk factors for severe outcomes, including chronic medical conditions, racism and discrimination based on ethnicity, and lack of adequate health insurance. The implementation of tailored guidance for specific populations, however, is complicated by the legacy of glaring health disparities, the threat of stigmatization, and prevailing mistrust of authorities in some communities. Health-equity and antiracist principles and insights from the fields of health communication and behavioral science must therefore be taken into account from the start in the development and dissemination of recommendations and the implementation of programs and policies.

There is much to lament in the politicization of the Covid-19 pandemic, the spread of disinformation and misinformation, the deep divisions within the U.S. population and, globally, in people’s perceptions of the pandemic and willingness to trust guidance and embrace protective measures. These divisions should inspire a reexamination of the reasons that some public health recommendations fell flat, in addition to an acknowledgment that political expedience played a role in sowing mistrust. As the pandemic evolves, as the measures of its effects become more complex, and as guidance requires greater tailoring to specific populations, effective communication becomes even more important. Providing clear guidance, including explaining the rationale for various recommendations, acknowledging the social and economic trade-offs involved in complying with them, and offering people the resources they will need to effectively manage these trade-offs, would go a long way toward enabling the adoption of those recommendations.

Most important, attention to the engagement of trusted community leaders and spokespeople is required, as is listening authentically to communities from the start. Rather than focusing solely on what is being recommended, it’s equally important for public health leaders to focus on how recommendations are communicated and disseminated. Early engagement of community representatives is critical so that various aspects of anticipated guidance can be discussed in detail, including rationales, trade-offs, and the most appropriate communication channels and formats. Engagement must not only come in the form of an emergency response, but must involve a consistent presence, which can then be leveraged and activated further during times of urgent need.

The current moment in the Covid-19 pandemic is a pivotal one. There is an urgent need to confront a future in which SARS-CoV-2 will remain with us, threatening the health and well-being of millions of people throughout the world. At the same time, it’s important to acknowledge that objectively we are in a better place with regard to the virus than we’ve ever been and that in fact many people believe the pandemic is behind us. This reality compels us to avoid using alarmist language and to offer valid and feasible solutions to bring people along to a new, nonemergency phase of the pandemic. How we craft our policies, programs, and associated messaging in this context and who delivers the messages is as important as ever.

Hamshire et al.

Multivariate profile and acute-phase correlates of cognitive deficits in a COVID-19 hospitalised cohort

EClinicalMedicine, May2022; doi: 10.1016/j.eclinm.2022.101417

Abstract

Background: Preliminary evidence has highlighted a possible association between severe COVID-19 and persistent cognitive deficits. Further research is required to confirm this association, determine whether cognitive deficits relate to clinical features from the acute phase or to mental health status at the point of assessment, and quantify rate of recovery.

Methods: 46 individuals who received critical care for COVID-19 at Addenbrooke's hospital between 10th March 2020 and 31st July 2020 (16 mechanically ventilated) underwent detailed computerised cognitive assessment alongside scales measuring anxiety, depression and post-traumatic stress disorder under supervised conditions at a mean follow up of 6.0 (± 2.1) months following acute illness. Patient and matched control (N = 460) performances were transformed into standard deviation from expected scores, accounting for age and demographic factors using N = 66,008 normative datasets. Global accuracy and response time composites were calculated (G_SScore& G_RT). Linear modelling predicted composite score deficits from acute severity, mental-health status at assessment, and time from hospital admission. The pattern of deficits across tasks was qualitatively compared with normal age-related decline, and early-stage dementia.

Findings: COVID-19 survivors were less accurate (G_SScore=-0.53SDs) and slower (G_RT=+0.89SDs) in their responses than expected compared to their matched controls. Acute illness, but not chronic mental health, significantly predicted cognitive deviation from expected scores (G_SScore (p=​​0.0037) and G_RT (p = 0.0366)). The most prominent task associations with COVID-19 were for higher cognition and processing speed, which was qualitatively distinct from the profiles of normal ageing and dementia and similar in magnitude to the effects of ageing between 50 and 70 years of age. A trend towards reduced deficits with time from illness (r∼=0.15) did not reach statistical significance.

Interpretation: Cognitive deficits after severe COVID-19 relate most strongly to acute illness severity, persist long into the chronic phase, and recover slowly if at all, with a characteristic profile highlighting higher cognitive functions and processing speed.

D. Fanelli et al.

Do individual and institutional predictors of misconduct vary by country? Results of a matched-control analysis of problematic image duplications

PlosOne, March 2022; doi.org/10.1371/journal.pone.0255334

Abstract

Pressures to publish, perverse incentives, financial interest and gender are amongst the most commonly discussed risk factors for scientific misconduct. However, evidence of their association with actual data fabrication and falsification is inconclusive. A recent case-controlled analysis of articles containing problematic image duplications suggested that country of affiliation of first and last authors is a significant predictor of scientific misconduct. The same analysis found null or negative associations with individual proxies of publication rate, impact and gender. The latter findings, in line with previous evidence, failed to support common hypotheses about the prevalence and causes of misconduct, but country-level effects may have confounded these results. Here we extend and complete previous results by comparing, via matched-controls analysis, articles from authors in the same country. We found that evidence for individual-level risk factors may be significant in some countries, and null or opposite in others. In particular, in countries where publications are rewarded with cash incentives, and especially China, the risk of problematic image duplication was higher for more productive, more frequently cited, earlier-career researchers working in lower-ranking institutions, in accordance with a “misaligned incentives” explanation for scientific misconduct. However, a null or opposite pattern was observed in all other countries, and especially the USA, UK and Canada, countries where concerns for misaligned incentives are commonly expressed. In line with previous results, we failed to observe a statistically significant association with industry funding and with gender. This is the first direct evidence of a link between publication performance and risk of misconduct and between university ranking and risk of misconduct. Commonly hypothesised individual risk factors for scientific misconduct, including career status and productivity, might be relevant in countries where cash-reward policies generate perverse incentives. In most scientifically active countries, however, where other incentives systems are in place, these patterns are not observed, and other risk factors might be more relevant. Policies to prevent and correct scientific misconduct may need to be tailored to a countries’ or institutions’ specific context.

Pertwee E at al.

An epidemic of uncertainty: rumors, conspiracy theories and vaccine hesitancy

Nature Medicine, https://www.nature.com/articles/s41591-022-01728-z

CONTENUTO E COMMENTO : Una delle più grandi sfide di sanità pubblica dall’inizio della pandemia è stato arginare la cosiddetta « infodemia », ovvero l’epidemia di disinformazione relativa alla COVID-19 e, soprattutto, alla relativa campagna vaccinale. In questo perspective article, gli autori suppongono che il fenomeno dell’esitazione vaccinale non affondi le sue radici nella bassa qualità del sistema informativo sui vaccini in sé, quanto nella perdita di fiducia nei confronti dell’autorità sanitaria, in un sentimento di esclusione dalla vita politica e, infine, in un inasprimento dell’ansia sociale riguardante la velocità dello sviluppo tecnologico.

In sostanza, gli autori sottolineano come, per combattere efficacemente l’esitazione vaccinale, le campagne di salute pubblica debbano, più che espandere e rafforzare il sistema informatio, lavorare sul riconsolidamento di un sentimento di fiducia nei confronti delle istituzioni.

 Sander van der Linden 

Misinformation: susceptibility, spread, and interventions to immunize the public

Nature Medicine (2022), https://www.nature.com/articles/s41591-022-01713-6

CONTENUTO E COMMENTO: Interessante review che sintetizza le conoscenze attuali in psicologia nel contest della vaccine hesitancy. Sulla scia della dichiarata “infodemic” del WHO nel 2020, vengono tracciati molti parallelismi tra epidemiologia e vaccinazione. Concettualmente possiamo infatti dividere la ricerca attuale in tre grandi dimensioni teoretiche, qui sintetizzate per brevita’ in concetti :

• Suscettibilita’:
• “Affermazioni ripetute hanno piu’ probabilita’ di essere giudicate come vere che nuove affermazioni”: meccanismo noto come processing fluency. I dati dimostrano come la precedente esposizione a fake news aumenti l’accurateza percepita, come le verita’ illusorie possano essere attribuite sia ad affermazioni plausibili che non e che queste verita’ non siano mediate da stili di ragionamento come analitico vs intuitivo.
• Gli individui piu’ anziani sono piu’ suscettibili (potenzialmente dovuto a fattori come una piu’ grande illiteracy digitale o declino cognitivo).
• Persone con orientamenti politici piu’ estremi e polarizzati a destra sono piu’ suscpettibili a misinformazione anche quando questa non e’ politica.
• Skills e stili di pensiero analitici hanno correlazione negativa con la suscettibilita’ alla misinformazione.
• Inattention account (classical reasoning): teoria per cui le persone sono impegnate nel condividere informazioni accurate, ma il contesto dei social media le distrae da questo intento.

Vs

• Motivated reasoning account: teoria per cui le persone sono motivate politicamente nel ragionamento, per cui si inizia il processo di ragionamento con uno scopo prefissato e quindi gli individui interpretano nuove (dis)informazioni per raggiungere lo scopo. Una variante di questa teoria “motivated numeracy account” suggerisce che il Sistema di ragionamento analitico e riflessivo non aiuta necessariamente le persone in ragionamenti piu’ accurati, ma e’ spesso al servizio del pensiero basato sull’identita’. I dati a conforto di questa tesi illustrano come anche coloro con grandi doti di pensiero analitico diventino meno accurate e si polarizzino quando riflettono su temi a sfondo politico (es. Valutare una terapia cutanea vs politiche del controllo delle armi).
• LIMITI: replication crisis in psicologia, partisan bias come effetto di espozione selettiva invece che motivated reasoning, non necessariamente polarizzazione significa non volonta’ di aggiornare le proprie convinzioni sulle nuove evidenze.
• COVID: problema di salute pubblica politicizzato molto rapidamente.
• Diffusione:
• Modello suscettibile-infetto-guarito per quantificare la diffusione della misinformazione. R0 rappresenta gli individui che cominceranno a postare fake news dopo contatto con qualcuno gia’ infetto. Il potenziale per un’infodemia e’ maggiore per R0 >1. Tutti i social network hanno potenziale per scatenare una diffusione infodemica, ma alcuni ne sono maggiormente responsabili: ad esempio su Twitter una fake news ha il 70% di probabilita’ in piu’ di essere condivisa che una notizia vera e quest’ultima ha bisogno di 6 volte piu’ di tempo per raggiungere 1500 persone che una storia falsa. Un piccolo numero di account sono responsabili della maggioranza del contenuto condiviso e consumato (Supercondivisori e superconsumatori).
• Esposizione non significa infezione. Le stime di esposizione basate sui dati dei social media non corrispondono con le esperienze riportate dalle persone, il che getta ombra sull’accuratezza delle stime di esposizione, basata solitamente su scarsi dati pubblici e che dipende molto dalle assunzioni del modello. Spesso poi le persone condividono contenuto anche sulla base di cio’ che ritengono “interessante SE vero”.
• LIMITI: studi dimostrano che e’ difficile persuadere utilizzando i tradizionali metodi pubblicitari, studi che testano esposizioni single invece che la persuasione intesa come funzione di esposizioni ripetute a misinformazione. Sforzi di microtargeting hanno aumentato l’abilita’ dei produttori di misinformazione di identificare e colpire individui piu’ suscettibili alla persuasion.
• Immunizzazione:
• Approcci terapeutici: fact-checking e debunking: le migliori pratiche attualmente disponibili possono essere riassunte in questa imagine:

L’efficacia e’ strettamente dipendente dalla qualita’ del debunk, dal passare del tempo e dalle ideologie e credo precedenti. E‘ quindi importante trasmettere il messaggio con la verita’, far riferimento al consenso scientifico ed autorita’ del settore, assicurarsi che la correzione sia facilmente accessibili e non piu’ complessa che la misinformazione iniziale e con una spiegazione causale alternativa coerente.

• LIMITI: natura post-hoc, rischio di backfiring (worldview e familiarity)
• Approcci profilattici:
• prebunking: remind alle persone di “pensare prima di postare”.
• teoria dell’inoculazione: avvisare prima su queste tematiche ed esporre gli individui a dosi molto attenuate di misinformazione accoppiate con forti correzioni perche’ sviluppino resistenza cognitive contro misinformazioni future. I due meccanismi attraverso cui opera: minaccia motivazionale (desiderio di difendersi dalla manipolazione), prebunking (esposizione a un esempio attenuato di attacco). Il principale scopo di questa tattica e’ di immunizzare le persone contro le strategie di misinformazione piu’ comuni (impersonamento di falsi esperti, appelli alla paura, teorie della cospirazione).
• Attenzione agli aspetti attivi vs passivi: sono stati sviluppati giochi per favorire questo passaggio di informazioni.
• Tempo: come nell’immunita’ in senso biologico, l’immunita’ psicologica diminuisce nel tempo e puo’ essere mantenuta con dei booster.

LIMITI: sarebbe necessario capire a che tipi di tattiche le misinformazioni future faranno appello.

Pertwee E. et Al.

An epidemic of uncertainty: rumors, conspiracy theories and vaccine hesitancy

Nature medicine, March 2022; https://www.nature.com/articles/s41591-022-01728-z

CONTENUTO E COMMENTO: COMMENTO: Articolo perspective che affronta l’attuale infodemia sul COVID nel contest della vaccine hesitancy.

• Paesaggio della misinformazione vaccinale

Prima dell’epidemia, la maggior parte delle piattaforme di social media non avevano nessuna politica contro la misinformazione vaccinale. Molti passi sono stati compiuti da allora: ad esempio, riduzione del ranking di gruppi e pagine promotori di disinformazione sui vaccini da parte di Fb, la riduzione degli introiti pubblicitari per i canali antivaccinisti su Youtube, signpost per fonti di informazioni credibili, label su informazioni potenzialmente errate o rimozione di contenuto ad alto rischio di causare danno nel mondo reale. Tutto cio’ ha pero’ portato a grandi domande su come monopoli tecnologici private abbiano la competenza istituzionale o la legittimita’ democratica di arbitrare su verita’ scientifiche o conseguenze nel mondo reale di atti di libera espressione.

• Ruolo dell’insicurezza sociale

Le teorie del complotto sul covid e la vaccinazione vanno lette invece come espressione di paure ed anise popolari. La vaccine hesitancy va affrontata come problema di fiducia e non solo come un problema informative. Le teorie cospirazioniste sono tentativi di imporre coerenza narrativa a situazioni terrorizzanti, come rivoluzioni, guerre, ecc. Queste nascono dal desiderio di donare del senso al proprio ambiente sociale in contesti di insicurezza, riassumendo eventi complessi in storie semplificati, ideali per la trasmissione culturale. I contesti di insicurezza di questi due anni hanno pertanto esacerbato anche preoccupazioni gia’ presenti, come ad esempio quelle relative alla salute e le nuove tecnologie. Su questa linea, studi dimostrano che I 1/5 degli americani crede che i vaccini COIVD siano usati dal governo per diffondere microchip: questo mostra la diffusione delle preoccupazioni su sorveglianza digitale e la commodificazione dei dati personali.

• Importanza della fiducia

Un ecosistema informativo disfunzionale potrebbe aver accelerato la diffusione di miti e teorie del complotto sul covid, ma non li ha direttamente causati. Focalizzarsi sull’ecosistema oscura il piu’ ampio contest storico, istituzionale e sociocolturale. In molti paesi, e’ stata cruciale la mancanza di fiducia nelle istituzioni chiave coinvolte in produzione, fornitura, distribuzione dei vaccini. La fiducia diventa importante ogni qual volta sia implicato un implicito squilibrio di potere tra le parti e gli individui che hanno fiducia sono in una condizione vulnerabile. Questo diventa ancora piu’ importante in contesti di alta insicurezza sociale dove spesso gli individui devono prendere decisioni su informazioni incomplete.

La fiducia nel contesto vaccinale va considerate in toto, tenendo in conto il prodotto, il produttore e il policy maker. Le teorie del complotto contribuiscono al clima di insicurezza anche se le persone non ci credono: e’ dimostrato che anche se gli individui non credono nel contenuto anti vaccinista, l’esposizione a questo tipo di narrative instilla il dubbio sulla sicurezza ed efficacia dei vaccini o sui motivi di coloro coinvolti in produzione e amministrazione.  La fiducia e’ inoltre legata alle esperienze passate, per cui i gruppi marginalizzati come minoranze etniche o religiose sono meno fiduciose nei vaccini in generali e meno propense a farsi vaccinare.

• Volatilita’ del sentimento

L’epidemiologia emotive e’ un termine che spiega come le decisioni sulla salute non sono determinate solo dal pensiero razionale, ma dipendono anche dai sentimenti. La paura e l’ansia ha effetti negativi sui comportamenti preventivi, come l’isolamento, e aumentano la stigmatizzazione di chi e’ malato mentre emozioni positive, come la speranza di tornare alla normalita’, motivano le persone a seguire le misure di salute pubblica. Le esperienze passate collettive puo’ guidare i gruppi a internalizzare emozioni condivise che possono influenzare  l’accettazione o il rifiuto di interventi di salute pubblica

La vaccine hesitancy va quindi riconosciuto come un processo di decision-making invece che un set di credo, attitudini e comportamenti prefissati. Essere indecisi in contesti di incertezza non e’ come essere antivaccinazione: I soggetti esitanti sono piu’ spesso consumatori di contenuto antivaccinale, ma non sono spesso ideologicamente opposti alla vaccinazioni. La comunicazione nei vaccini deve partire da posizioni di empatia e mirare a ricostruire la fiducia, attraverso messaggeri adeguati e relazioni stabilite. I politici e le autorita‘ di salute pubblica devono accuratamente soppesare I rischi di misure che possano essere potenzialmente interpretate come coercitive o stigmatizzanti, come ad esempio i passaporti vaccinali. Nonostante l’enfasi sulla fiducia, e’ comunque importante adottare misure che aggrediscano la misinformazione, specialmente ocn misure proattive che mirino a costruire la resilienza delle idee dannose prima che le persone siano esposte a queste.