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

In their 2010 book, Lorna Weir and Eric Mykhalovskiy conceptualised the role of vigilance in unknown and emerging infectious disease threats. Theirs is a macro-level account which draws on empirical data to describe vigilance as a set of technical and political arrangements that govern collection, analysis, interpretation and communication of data as it pertains to unknown threats. In this paper we expand their work to detail a conceptual analysis of the role of vigilance at the micro-level during periods of high infectious disease threat. Our data are daily press conferences and associated non-discursive tools in New South Wales (NSW), Australia during times of heightened COVID-19 risk. This paper is a conceptual analysis that draws on theories of vigilance and related concepts to show how a key aspect of vigilance is making previously unseen threats visible or present. Communications formulated and encouraged three types of vigilance as a set of governing relations: institutional or authority-based; individual outward-facing; and individual inward-facing. We also describe the relationship between vigilance and related concepts that are used in response to anticipated public threats. Authority based vigilance involved contact tracing and policing of movement and behaviours. In individual outward facing vigilance people were asked to be alert to, analyse, and react to risk in their immediate environment. Inward facing vigilance required people to gather and react to information about their own behaviours and within their own bodies. There was a relationship between different types of vigilance; as risk increased and authority-based vigilance was less successful in containing the spread of infection, individual vigilance had a stronger role to play. This extension of vigilance at the micro-level sees some of the same unintended consequences as Weir and Mykhalovskiy describe at the global level, particularly in how burdens are inequitably distributed and experienced. • Citizens became an arm of vigilance apparatus during COVID-19 pandemic in Australia. • Vigilance was authority-based; individual outward facing; individual inward facing. • Disadvantaged populations carried higher vigilance burden. • Earlier conceptions of vigilance in infectious disease emergencies are extended. [ABSTRACT FROM AUTHOR]

English-language reporting on the continuing difficulties in accessing Evusheld reflects the marginalization of immunocompromised people in discussions about the public policy response to Covid-19. Moreover, the lack of available data on global Evusheld access, particularly in low-income countries, has emerged as a key form of nonknowledge that must be redressed within public health research. Through examining how knowledge about domestic and global barriers to Evusheld access circulates, and does not circulate, within The New York Times , this paper identifies a case study of the social production of ignorance related to a key issue in the Covid-19 pandemic. Drawing on science and technology studies, the history of science and media studies, I situate these trends in the context of longer explanatory histories of nonknowledge. First, through a critical discourse analysis of the New York Times' reporting on Evusheld access in the U.S., I trace the individualizing framework evident in many articles to longstanding trends in reporting on health and illness, and to the structural marginalization of immunocompromised people in U.S. Secondly, I argue that the near-total absence of reporting on Evusheld access in low-income countries is consistent with the longstanding structural neglect of health crises in the global south. • New York Times coverage of preventative treatment Evusheld rarely discusses access barriers. • Access barriers discussed are largely logistical rather than structural. • The perspectives of immunocompromised people are rarely included in Times articles on Evusheld. • Failure to include voices from impacted communities contributes to agnogenesis. • Centering the perspectives of constituencies most impacted by a health crisis will advance health equity. [ABSTRACT FROM AUTHOR]

This study examines whether individualism weakens the effectiveness of the COVID-19 vaccine eligibility expansions in the United States in 2021, and assesses the associated social benefits or costs associated with individualism. We construct a county-level composite individualism index as a proxy of culture and the fraction of vaccine eligible population as a proxy of vaccination campaign (mean: 41.34%). We estimate whether the COVID-19 vaccine eligibility policy is less effective in promoting vaccine coverage, reducing in COVID-19 related hospitalization and death using a linear two-way fixed effect model in a sample of 2866 counties for the period between early December 2020 and July 1, 2021. We also test whether individualism shapes people's attitudes towards vaccine using a linear probability model in a sample of 625,308 individuals aged 18–65 (mean age: 43.3; 49% male; 59.1% non-Hispanic white, 19.1% Hispanic, 12% African American; 5.9% Asian) from the Household Pulse Survey. The effects of expanded vaccine eligibility are diminished in counties with greater individualism, as evidenced by lower effectiveness in increasing vaccination rates and reducing outpatient doctor visits primarily for COVID-related symptoms and COVID deaths. Moreover, our results show that this cultural influence on attitudes towards vaccine is more pronounced among the less educated, but unrelated to race. Assuming an average level of vaccine eligibility policies and an average intensity of individualism across the nation, we calculate that the average social cost associated with an individualistic culture amid the pandemic is approximately $50.044 billion, equivalent to 1.32% of the total U.S. health care spending in 2019. Our paper suggests that strategies to promote public policy compliance should be tailored to accommodate cultural and social contexts. • We examine whether individualism weakens effectiveness of COVID-19 vaccine policies. • The effects of vaccine policy are diminished in counties with greater individualism. • Individuals have less trust in COVID-19 vaccine in a more individualistic culture. • Strategies to promote policy compliance should be tailored to accommodate cultural contexts. [ABSTRACT FROM AUTHOR]

Achieving sufficient COVID-19 vaccination coverage has been hindered in many areas by vaccine hesitancy. Many studies based on large survey samples have characterized vaccine refusal, but there are fewer in-depth qualitative studies that explore hesitant adoption: the middle-ground between vaccine acceptance and refusal, and how individuals may move across this continuum depending on their lived experience. For this paper, we use the narratives of 25 adults living in off-road, predominately Alaska Native communities to describe the complex decision-making processes undertaken by ' hesitant adopters', defined in our study as those who completed their initial COVID-19 series despite reporting hesitancy. Interviewees' stories help illustrate how hesitant adopters' decision-making processes involved making sense of information through interactions with trusted individuals, lived experiences, observations, emotions, and personal motivations. For the majority of these hesitant adopters' (n = 20, 80%) interpersonal interactions were key in helping to make the decision to get vaccinated. Over half of the interviewees (n = 14, 56%) described how conversations with individuals they trusted, including healthcare providers, family, friends, and interactions through their professional network made them feel safe. One third of the hesitant adopters (n = 7, 28%) attributed their decision to get vaccinated based on the influence of Alaska Native Elders including their knowledge, personal experiences, as well as being motivated by the desire to protect them. Independent research was also important to about a quarter of hesitant adopters (n = 6, 24%), and for these interviewees it was the process of gathering information on their own and learning from others, especially healthcare providers who could answer their questions and alleviate their concerns. This paper illustrates the temporality of vaccine decision-making: vaccine acceptance for those who are hesitant may be an ongoing process that is influenced by personal experience, relationships, and context. • Understanding hesitant adoption provides insights into increasing vaccine acceptance • In remote Alaska, Elders may influence the decisions community members make • Images and conversations reinforced narratives of safety and efficacy • Agency in information-seeking increased vaccine confidence [ABSTRACT FROM AUTHOR]

This paper examines the daily practices of caring for COVID-19 patients in Wuhan, China, in early 2020 and the challenges that nurses faced. The paper shows that the affective contagion, especially among patients, introduced unexpected challenges for nurses in caring for COVID-19-infected patients. Nurses had to contend with the challenges of treating both physical and psychological problems in patients simultaneously. As a result, it was necessary for nurses to adapt to the different rhythm of COVID-19 wards to address these challenges and do so through taking on a range of general and specific nursing tasks and playing a diverse range of roles on the wards, from garbage collector to "psychological counselor." Thus, the paper brings attention to the experiences and demands of providing nursing care in an emergency pandemic context, in particular the necessity of responding to both the physical and the psychological needs of patients. These insights could better prepare health services in China and elsewhere in the world for responding effectively to potential future pandemics. • The affective contagion introduced unexpected challenges for nurses in COVID-19 wards. • Nurses adapt to the different working rhythm in COVID-19 wards than in "normal" wards. • A hierarchy of necessity emerged in the context of caring for COVID-19 patients. [ABSTRACT FROM AUTHOR]

In this paper we explore the impact of the emerging COVID-19 pandemic on the governance of healthcare in the Netherlands. In doing so, we re-examine the idea that a crisis necessarily leads to processes of transition and change by focusing on crisis as a specific language of organizing collective action instead. Framing a situation as a crisis of a particular kind allows for specific problem definitions, concurrent solutions and the inclusion and exclusion of stakeholders. Using this perspective, we examine the dynamics and institutional tensions involved in governing healthcare during the pandemic. We make use of multi-sited ethnographic research into the Dutch healthcare crisis organization as it responded to the COVID-19 pandemic, focusing on decision-making at the regional level. We tracked our participants through successive waves of the pandemic between March 2020 and August 2021 and identified three dominant framings of the pandemic-as-crisis: a crisis of scarcity, a crisis of postponed care and a crisis of acute care coordination. In this paper, we discuss the implications of these framings in terms of the institutional tensions that arose in governing healthcare during the pandemic: between centralized, top-down crisis management and local, bottom-up work; between informal and formal work; and between existing institutional logics. • The COVID-19 pandemic is framed as a crisis of different kinds in healthcare. • Framing impacts decision-making and inclusion of stakeholders. • Ethnographic research provides insights into the consequences of these frames. [ABSTRACT FROM AUTHOR]

Life expectancy in the United States is decreasing. Health disparities are widening. Growing evidence for and integration of social and structural determinants into theory and practice has not yet improved outcomes. The COVID-19 pandemic reinforced the fact. In this paper, we argue that the biomedical model and its underlying scientific paradigm of causal determinism, which currently dominate population health, cannot meet population health needs. While criticism of the biomedical model is not new, this paper advances the field by going beyond criticism to recognize the need for a paradigm shift. In the first half of the paper, we present a critical analysis of the biomedical model and the paradigm of causal determinism. In the second half, we outline the agentic paradigm and present a structural model of health based on generalizable, group-level processes. We use the experience of the COVID-19 pandemic to illustrate the practical applications of our model. It will be important for future work to investigate the empirical and pragmatic applications of our structural model of population health. • Population health must move beyond the biomedical model. • This requires going beyond the model to critique the paradigm of causal determinism. • The agentic paradigm is an alternative to causal determinism. • The structural model is an alternative to the biomedical model. • The structural model highlights structural resilience and congruence in the population. [ABSTRACT FROM AUTHOR]

The COVID-19 spread very quickly around the world following its discovery in China, in December 2019. Lockdowns implemented in China and the Global North to control the propagation of the virus and to save human lives have resulted in a global recession. The transmission of the recessionary effects from the Global North to the Global South is reflected in the decline in sub-Saharan Africa's (SSA) GDP and the associated increase in poverty. The purpose of this paper is to illustrate how the recession induced in China and the Global North by COVID-19 lockdowns may have had indirect effects on SSA mortality that are higher than those directly attributed to the pandemic itself. Our methodology relies on a three-step relationship: (i) the impact of lockdowns on the recession in the North, (ii) the impact of the recession in the North on income in SSA countries, and (iii) the impact of a decline in income on mortality in SSA. We show that COVID-19-induced lockdowns in the Global North, through the severe recessions they induced in the Global South, resulted in the transfer of between 538,000 and 679,000 deaths in one year to SSA, including the deaths of 140,000 to 177,000 children aged 0–5 years. This corresponds to a 6–7% increase in the crude death rate and a 5–6% increase in under-5 mortality. These figures are much higher than the number of deaths directly attributable to COVID-19 in SSA. Thus, policymakers must not lose sight of the indirect excess mortality caused by global economic recession triggered by the pandemic. Our results reveal the need to increase the resilience of SSA countries to exogenous shocks, including COVID-19, which, in addition to increasing poverty, may induce excessive mortality due to the high sensitivity of mortality in SSA countries to economic recession. • Theoretical model of COVID-19 deaths transfer from the Global North to the Global South. • Lockdowns in the Global North generated recession in the Global North. • Spillover effects of the recession from the Global North to sub-Saharan Africa (SSA). • Focus on the impact of income declines on mortality in SSA. • The indirect mortality through recessions in SSA would be higher than the direct mortality. [ABSTRACT FROM AUTHOR]

While carers' vulnerability has often been neglected in the literature, the recent COVID-19 pandemic brought this issue to the fore. This article explores why it has been so often ignored and how could it be dealt with differently. It does so in the form of a philosophical and conceptual investigation illustrated by various examples and situations, related primarily, but not exclusively, to the COVID period. Criticising a property-based view, and based on examples of carers' vulnerability during the pandemic, our investigation suggests that carers' vulnerability is relationally constructed and played out on multiple interwoven dimensions that may contradict each other. Our examples also suggest that the relational construction of vulnerabilities is socially and organisationally mediated, calling for the development of social and organisational forms of mediation that may help carers deal with their vulnerabilities. Second, and rather counterintuitively with regard to the COVID-period, we question the negative valence usually associated with vulnerability and analyse how this affects ways of dealing with carers' vulnerabilities and the co-creation of care. Finally, following Gilson (2014), we propose an ambivalent, relational conception of vulnerability, considered as 'openness to affectation by' and offer some theoretical and practical implications. Theoretically, this conception also allows us to consider such openness as an ability that may nurture carers' 'response-ability'. It also allows us to develop specific relational ethics for and in care relationships. Practically, this re-conceptualisation may help carers better embrace and process their vulnerabilities, including responses to negative affectations following exposure to carees. It may also facilitate their 'reception' of carees, and help co-create and adapt responses to carees' calls, thus avoiding paternalistic responses. • COVID-19 brought to the fore carers' vulnerability. • The paper critically discusses conventional understandings of vulnerability. • It develops an ambivalent and relational conception of vulnerability. • It opens new ways of interpreting and dealing with carers' vulnerability. [ABSTRACT FROM AUTHOR]

From the start of the pandemic, questions were raised concerning how the pandemic could change or even transform relationships to our living environments. COVID-19 has had a disproportionate impact on the health and well-being of older people due to the increased risk of severity of the disease with both advancing age and associated co-morbidities. Restrictions on the movement of older people have also been more severe, with many countries imposing restrictions based on chronological age. In Portugal, confinement measures were targeted at older persons in terms of sheltering-at-home orders for those over 70. This paper looks at the impact of these restrictions on the lives of older people and asks what we can learn from the pandemic about the concept of age-friendly cities (WHO, 2007a). We look at the lived experience of older people to understand how their well-being and mobility were impacted during the crisis and its aftermath. The study was undertaken in four urban areas: Aveiro, Coimbra, Lisbon, and Faro. Data was collected using semi-structured interviews analysed using a process of thematic coding based on the eight pillars of the WHO's Age-Friendly City Checklist (WHO, 2007b). The results are discussed using conceptualisations from the new mobilities paradigm: existential mobility, connection and (im)mobility governance, offering new ways of thinking about age-friendliness in and out of crisis. • Measures to contain COVID-19 were aimed at older people. • Interview data was analysed to understand the impact in Portugal. • Participants reported an existential need to move and connect. • These findings are essential to understanding age-friendly places. • A multi-dimensional framework of mobility is a necessary starting point for AFCC. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy is a barrier to Covid-19 vaccine uptake and displays a social gradient, compounding health disparities. While social gradients are a vital concept in health, they flatten distinctions between types of disadvantaged community. This paper focuses on vaccine hesitance in post-industrial and de-industrialising coalfields. The social consequences of the decline of coal mining may present barriers to vaccine uptake. We ran parallel surveys in Wales (N = 4187) and US states overlapping with central Appalachia (N = 4864), to examine whether vaccine attitudes and uptake varied between areas with different coal mining histories. These surveys were accompanied by qualitative interviews of 36 residents of these coalfields to explore vaccination decisions and triangulate with survey data. Factor analysis identified four axes of attitudes in the survey data: vaccine confidence , covid scepticism , v accine individualism , and concerned confusion. These themes were echoed in the interviews. Vaccine confidence was lower; and covid scepticism, vaccine individualism, and concerned confusion higher, in residents of areas of Wales with greater mining extent and where pits closed during certain periods. Residents of former US coal counties had lower vaccine confidence and higher covid scepticism, while those in current coal counties had greater vaccine individualism and concerned confusion. In former US coal counties and Welsh areas where pits closed since 1980, vaccine uptake was lower. Differences could not be explained by respondents' income and education. In the interviews, norms of social solidarity were often invoked by vaccinated respondents, while unvaccinated respondents did not frame decisions in the context of the industrial history of their areas. The legacy of coal-mining's decline presents barriers to public health campaigns. We show evidence of this across two historically significant coalfields. Attention is needed to avert negative public health consequences of global energy transition. • Coalfields a distinct class of, often disadvantaged, community. • Industrial history may undermine trust in public health. • We find evidence of greater vaccine hesitancy on Welsh and Appalachian coalfields. • Coalfields may require specific public health campaigns. [ABSTRACT FROM AUTHOR]

COVID-19 vaccine hesitancy has previously been modelled using data on intentions – expressed prior to vaccine availability. Once vaccines became widely available, it became possible to model hesitancy using actual vaccination uptake data. This paper estimates the determinants of the joint distribution of COVID-19 vaccination intentions (declared before the release of any vaccine) and actual vaccination take-up (when it was widely available across the age distribution). We use high quality longitudinal data (UK Household Longitudinal Study) collected during the pandemic in the UK, merged to a wide variety of individual characteristics collected prior to the COVID-19 pandemic. Our estimation draws on pre-Covid values of variables for a sample that includes 10,073 observations from the September 2021 wave. The contribution of this paper is to model hesitancy and uptake jointly. The work shows that people who might be regarded as marginalised in society (measured, before the pandemic began) are less likely to say that they intend to be vaccinated and they go on to also be more likely to actually remain unvaccinated. It also shows that there is a large positive correlation between the unobservable determinants of intention and of uptake. This high positive correlation has an important implication - that information campaigns can be reasonably well profiled to target specific groups on the basis of intention data alone. We also show that changing one's mind is not correlated with observable data. This is consistent with two explanations. Firstly, the new information available on the arrival of vaccines, that they are safe and effective, may be more optimistic than was originally assumed. Secondly, individuals may have been more pessimistic about the effects associated with infection before vaccines became available. • We use high quality longitudinal data collected during the pandemic in the UK. • The contribution of this paper is to model vaccine hesitancy and uptake jointly. • People who are marginalised in society are more likely to be hesitant and not vaccinated. [ABSTRACT FROM AUTHOR]

The Delta-Omicron wave of the COVID-19 pandemic (Wave 4) in the United States occurred in Fall of 2021 through Spring of 2022. Although vaccinations were widely available, this was the deadliest period to date in the U.S., and the toll was especially high in rural areas, exacerbating an existing rural mortality penalty. This paper uses county-level multilevel regression models and publicly available data for 47 U.S. states and the District of Columbia. We describe differences in COVID-19 case and mortality rates across the rural-urban continuum during Wave 4 of the COVID-19 pandemic. Using a progressive modeling approach, we evaluate the relative contribution of a range of explanatory factors for the rural disadvantage we observe, including: pre-pandemic population health composition, vaccination rates, political partisanship, socioeconomic composition, access to broadband internet rate, and primary care physicians per capita. Results show that rural counties had higher observed burdens of cases and deaths in Wave 4 compared to more urban counties. The most remote rural counties had Wave 4 COVID-19 mortality rates 52% higher than the most urban counties. Older age composition, worse pre-pandemic population health, lower vaccination rates, higher share of votes cast for Donald Trump in the 2020 Presidential election, and lower socioeconomic composition completely explained the rural disadvantage in reported COVID-19 case rates in Wave 4, and accounting for these factors reversed the observed rural disadvantage in COVID-19 mortality. In models of mortality rate, Trump vote share had the largest effect size, followed by the percentage of the population age 50 or older, the poverty rate, the pre-pandemic mortality rate, the share of residents with a 4-year college degree, and the vaccination rate. These findings add to a growing literature describing the disproportionate toll of the COVID-19 pandemic on rural America, highlighting the combined effect of multiple sources of rural disadvantage. • Rural counties had higher case and death rates in the Delta-Omicron wave. • Rural counties had up to 51% more deaths per capita than the most urban counties. • Age, health, and SES composition partially explained the rural disadvantage. • Vaccination and Trump vote share were separate factors in the rural disadvantage. • Multiple sources of disadvantage combined in rural areas to produce poor outcomes. [ABSTRACT FROM AUTHOR]

In this paper, we explore the material and symbolic effects of "deservingness projects" (Kline, 2019) for Latinx immigrants as they have played out over the COVID-19 pandemic. On a material level, exclusionary policies have exacerbated Latinx immigrants' disenfranchisement and contributed to disproportionate sickness and economic strife during the pandemic. On a symbolic level, they have contributed to subjective experiences of fear, distress, and desperation, and have eroded many immigrants' trust in institutions and support systems. Crucially, though, the pandemic's injustices have also crystallized a sense of outrage and indignation among some Latinx immigrants, provoking assertions of self-worth and sociopolitical projects of belonging and mutual care. Our findings thus challenge the notion that subjective self-understandings as 'undeserving' are fundamental to the undocumented experience and show that the pandemic's fallout has strengthened some immigrants' ability and willingness to "make claims for inclusion" (Abrego, 2011) and sociopolitical change. • Exclusionary policies have harmed Latinx immigrants during the pandemic. • Materially, they have contributed to disproportionate sickness and economic strife. • Symbolically, they have led to fear, distress, and eroded trust in institutions. • But pandemic injustices have also prompted righteous indignation and claims-making. • A sense of 'undeservingness' is not fundamental to the undocumented experience. [ABSTRACT FROM AUTHOR]

Public experiences of COVID-19 pandemic lockdown differed dramatically between countries and socio-economic groups. Low-income countries raise unique empirical and ethical concerns about (1) the balance between benefits and social harms and (2) how explanatory disease models and everyday life realities influenced the experience and interpretation of lockdown itself. In this paper, we present qualitative data on community perceptions and experiences of the pandemic from a remote area of Haiti, with a focus on the 2020 lockdown. We conducted in-depth interviews with 30 community leaders in Grand'Anse Department, southwest Haiti, at two time periods: May 2020 and October–December 2021. We divide our results into five sections. First, our analysis showed that lockdown was widely considered ineffective at controlling COVID-19. Despite the lack of testing, community leaders believed most of the local population had caught COVID-19 in the first half of 2020, with limited reported mortality. Public concern about the pandemic largely ended at this time, overtaken by other socio-economic and political crises. Second, we found that popular explanations for the low fatality rate were related to various coping strategies: the strength of people's immune systems, use of natural prophylactic folk teas, beliefs about the virus, spiritual protections and the tropical weather. Third, we found that lockdown was widely seen to have not been appropriate for the Haitian context due to various challenges with compliance in the face of socio-economic vulnerability. Fourth, we found strong negative feelings about the social consequences of lockdown measures, which lasted from March–August 2020, including adverse effects on: food security, household income, education, health, and psychosocial well-being. Finally, these perceptions and experiences reinforced popular ideas that lockdown had been imposed by elites for financial and/or political gain, something that was also reflected in the discourse about the low vaccine acceptance rate. Our study showed that pandemic respiratory virus response in Haiti should better balance restrictive non-pharmaceutical interventions (NPIs) with existing socio-economic vulnerability. Local socio-behavioral dynamics and risk perceptions decrease the overall effectiveness of NPIs in fragile states and alternatives to lockdown, such as shielding the most vulnerable, are likely to be a more appropriate strategy. • A qualitative study with community leaders in rural Haiti (2020–21). • Explored perspectives & experiences of COVID-19 and lockdown. • Lockdowns in Haiti were seen as ineffective and not appropriate. • They were also socially harmful and contributed to growing public distrust. • Alternatives, such as shielding the vulnerable, likely more appropriate. [ABSTRACT FROM AUTHOR]

Access to medicines has become a major concern for countries worldwide during the COVID-19 pandemic, as pharmaceutical production and trade have been disrupted in the course of the crisis. Antibiotics are one group of medicines where worries about access have been raised. Access to the right antibiotic at the right time is important not only for curing infections of individual patients, but also for curbing antibiotic resistance globally. Reliable pharmaceutical supply is key to ensuring access to medicines. The global supply of generic medicines has over the last decades been transformed by the rise of India's pharmaceutical industry. In this paper, I trace the changing role of this industry for the global export of antibiotics, by mapping and describing changes in Indian antibiotic exports and discussing these in light of historical processes and events. The paper offers a novel approach to analyse global antibiotic trajectories by using international trade data from publicly available resources combined with a secondary literature review. I show that India's pharmaceutical industry today holds a key role as one of the world's biggest exporters of antibiotic medicines, but with an increasing dependency on China as a supplier of antibiotic ingredients. This produces both opportunities and concerns for access to antibiotics globally. • Offers a novel approach to trace antibiotic and pharmaceutical geographies. • Uses international trade data to map India's role for global antibiotics supply. • Describes that India has become one of the world's biggest exporters of antibiotics. • Shows that India is highly dependent on China for import of antibiotic ingredients. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has disproportionately impacted ethnic minorities in the global north, evidenced by higher rates of transmission, morbidity, and mortality relative to population sizes. Orthodox Jewish neighbourhoods in London had extremely high SARS-CoV-2 seroprevalence rates, reflecting patterns in Israel and the US. The aim of this paper is to examine how responsibilities over health protection are conveyed, and to what extent responsibility is sought by, and shared between, state services, and 'community' stakeholders or representative groups, and families in public health emergencies. The study investigates how public health and statutory services stakeholders, Orthodox Jewish communal custodians and households sought to enact health protection in London during the first year of the pandemic (March 2020–March 2021). Twenty-eight semi-structured interviews were conducted across these cohorts. Findings demonstrate that institutional relations – both their formation and at times fragmentation – were directly shaped by issues surrounding COVID-19 control measures. Exchanges around protective interventions (whether control measures, contact tracing technologies, or vaccines) reveal diverse and diverging attributions of responsibility and authority. The paper develops a framework of public health relations to understand negotiations between statutory services and minority groups over responsiveness and accountability in health protection. Disaggregating public health relations can help social scientists to critique who and what characterises institutional relationships with minority groups, and what ideas of responsibility and responsiveness are projected by differently-positioned stakeholders in health protection. • COVID-19 produced diverse responses and relations around health protection in London. •Pandemic preparedness can be enhanced by mapping possible partners in localities. •Establishing public health partnerships requires adequate resources. •Public health services cannot defer responsibility entirely to local partners. •Households are key constituents of public health relations. [ABSTRACT FROM AUTHOR]

In this conceptual paper, we argue that at times of crisis, what is sometimes called "evidence-based" or "science-driven" policymaking—establishing scientific truths and then implementing them—must be tempered by a more agile, deliberative and inclusive approach which acknowledges and embraces uncertainty. We offer pragmatism as one potential option, using examples from the UK to illustrate how such an approach might have changed particular crisis decisions and led to better outcomes. We propose that to better prepare for the next public health crisis, five pragmatism-informed shifts are needed in the science-policy relationship: from scientism to science-informed narrative rationality that emerges from practice; from knowledge-then-action to acting judiciously under uncertainty; from hierarchies of evidence to pluralist inquiry; from polarized camps to frame-reflective dialogue; and from an "inside-track" science-policy dialogue to greater participatory democracy. We suggest an agenda for a pragmatist-informed program of applied research on crisis public health policymaking. • Conceptual paper arguing for pragmatism in crisis public health policymaking. • Particularly in crises, certainty is elusive; there is no single scientific truth. • Deliberate on real-world problems from multiple epistemological and moral angles. • Surface and explore how different actors frame and assign meaning to an issue. • Link ideas to emergent action with (rather than on) partner communities. [ABSTRACT FROM AUTHOR]

Marked ethnic inequalities in COVID-19 infection and its consequences have been documented. The aim of this paper is to identify the range and nature of evidence on potential pathways which lead to ethnic inequalities in COVID-19 related health outcomes in the United Kingdom (UK). We searched six bibliographic and five grey literature databases from 1st December 2019 to 23rd February 2022 for research on pathways to ethnic inequalities in COVID-19 health outcomes in the UK. Meta-data were extracted and coded, using a framework informed by a logic model. Open Science Framework Registration: DOI 10.17605/OSF.IO/HZRB7. The search returned 10,728 records after excluding duplicates, with 123 included (83% peer-reviewed). Mortality was the most common outcome investigated (N = 79), followed by infection (N = 52). The majority of studies were quantitative (N = 93, 75%), with four qualitative studies (3%), seven academic narrative reviews (6%), nine third sector reports (7%) and five government reports (4%), and four systematic reviews or meta-analyses (3%). There were 78 studies which examined comorbidities as a pathway to mortality, infection, and severe disease. Socioeconomic inequalities (N = 67) were also commonly investigated, with considerable research into neighbourhood infrastructure (N = 38) and occupational risk (N = 28). Few studies examined barriers to healthcare (N = 6) and consequences of infection control measures (N = 10). Only 11% of eligible studies theorised racism to be a driver of inequalities and 10% (typically government/third sector reports and qualitative studies) explored this as a pathway. This systematic map identified knowledge clusters that may be amenable to subsequent systematic reviews, and critical gaps in the evidence-base requiring additional primary research. Most studies do not incorporate or conceptualise racism as the fundamental cause of ethnic inequalities and therefore the contribution to literature and policy is limited. • 123 UK studies examined pathways to ethnic inequalities in COVID-19 outcomes. • Socioeconomic inequalities and comorbidities were commonly explored as pathways. • 30% of studies aggregated ethnic groups into one broad category (e.g., non-White). • Only 11% studies considered racism as a driver of ethnic inequalities. • We provide recommendations for future research into ethnic inequalities in health. [ABSTRACT FROM AUTHOR]

Following the successful development of vaccines for COVID-19, attention turned to the problem of vaccine access. However, in contexts where vaccines are available, hesitancy remains a major problem. Informed theoretically by the scholarship on vaccine anxiety, this paper uses a qualitative research approach that included 144 semi-structured interviews to investigate how social and political dynamics shaped people's perspectives in particular environments in Ghana, Cameroon, and Malawi about COVID-19's viral spread and COVID-19 vaccines. Vaccines and the viral spread of COVID-19 are related to political tensions and class-related fractures in particular contexts, and how the public interprets COVID-19's viral spread and engages with vaccination is based on people's social and political environment and their experience. Subjectivities are also rooted in coloniality. Vaccine confidence goes beyond clinical and regulatory authority approvals, and encompasses forces that are economic, social, and political in nature. Thus, an exclusive focus on technical prescriptions for enhancing vaccine uptake will not achieve significant positive results. • Vaccines are related to political tensions and class-related fractures in particular settings. • Political context shapes how people view mandatory vaccination. • The body is a mirror of socio-political context. • Worries about getting COVID-19 vaccines cut across professional and income-related categories. • Distrust in vaccines has national and international dimensions. [ABSTRACT FROM AUTHOR]

Health education campaigns often aim to create awareness by increasing objective knowledge about pathogens, such as COVID-19. However, the present paper proposes that confidence in one's knowledge more than knowledge is a significant factor that leads to a laxer attitude toward COVID-19 and hence lower support for protective measures and reduced intention to comply with preemptive behaviors. We tested two hypotheses in three studies conducted between 2020 and 2022. In Study 1, we assessed participants' level of knowledge and confidence, as well as attitudes toward COVID-19. In Study 2, we tested the relation between fear of COVID-19 and protective behaviors. In Study 3, we used an experimental approach to show the causal effect of overconfidence on fear of COVID-19. In addition to manipulating overconfidence and measuring fear of COVID-19, we also measured prophylactic behaviors. In Study 1, more overconfident participants had a laxer attitude toward COVID-19. While knowledge had an increasing effect on worry, confidence in said knowledge significantly decreased worry about COVID-19. In Study 2, participants who were more worried about COVID-19 were more likely to engage in protective behaviors (e.g., wearing masks). In Study 3, we show that when overconfidence was experimentally diminished, fear of COVID-19 increased. The results support our claim that the effect of overconfidence on attitudes toward COVID-19 is causal in nature. Moreover, the results show that people with higher fear of COVID-19 are more likely to wear masks, use hand sanitizers, avoid crowded places or social gatherings, and get vaccinated. Managing adherence to public health measures is critical when it comes to highly infectious diseases. Our findings suggest that efficient information campaigns to increase adherence to public health measures should focus on calibrating people's confidence in their knowledge about COVID-19 to prevent the spread of the virus. • While knowledge increases fear of COVID-19, confidence has the opposite effect. • Fear of COVID-19 increases the adherence to public safety measures. • Health education campaigns should aim to calibrate confidence to increase adherence. [ABSTRACT FROM AUTHOR]

In many parts of the world nursing home residents have experienced a disproportionate risk of exposure to COVID-19 and have died at much higher rates than other groups. There is a critical need to identify the factors driving COVID-19 risk in nursing homes to better understand and address the conditions contributing to their vulnerability during public health crises. This study investigates the characteristics associated with COVID-19 cases and deaths among residents in U.S. nursing homes from 2020 to 2021, with a focus on geospatial and racial inequalities. Using data from the Centers for Medicare and Medicaid Services and LTCFocus, this paper uses zero-inflated negative binomial regression models, Kruskal-Wallis tests, and Local Moran's I to generate statistical and geospatial results. Our analysis reveals that majority Hispanic facilities have alarmingly high COVID-19 cases and deaths, suggesting that these facilities have the greatest need for policy improvements in staffing and financing to reduce racial inequalities in nursing home care. At the same time we also detect COVID-19 hot spots in rural areas with predominately White residents, indicating a need to rethink public messaging strategies in these areas. The top states with COVID-19 hot spots are Kentucky, Pennsylvania, Illinois, and Oklahoma. This research provides new insights into the socio-spatial contexts and inequities that contribute to the vulnerability of nursing home residents during a pandemic. • Geographic and racial inequalities are important indicators of covid-19 risk. • Covid-19 cases & deaths are high among facilities with majority Hispanic residents. • Facilities with majority Hispanic residents have high covid-19 vaccination rates. • Most covid-19 hot spots of cases & deaths are in predominantly White, rural areas. • The top states with covid-19 hot spots of cases & deaths are KY, PA, IL, and OK. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has introduced dramatic adversities for public health around the world, especially in low and middle-income countries. While research has shown the pandemic to have direct effects on a variety of major economic and health crises, its impact on health-related behaviors is not clear. In this paper, I examine how exposure to the pandemic affects alcohol use and smoking in Peru, which experienced one of the highest COVID-related death rates albeit implementing one of the strictest lockdown policies in the world. I find that post pandemic consumption of alcohol and smoking in the last 30 days decreases by 41.3% and 44.1% respectively when compared to pre-pandemic rates. I also conclude that the intensity of engaging in these behaviors change such that the frequency of consuming alcohol in the last 30 days, binge drinking and the probability of smoking daily falls. While drinking behavior returns to pre-pandemic levels, the negative effect on smoking weakens but remains for almost two years preceding the pandemic. • Estimates changes in alcohol consumption and smoking due to the pandemic in Peru. • Alcohol use and smoking decreases at both the extensive and intensive margins. • The largest fall in drinking and smoking was immediately after the lockdown. • Alcohol consumption returns to the pre-pandemic level by the end of 2021. • The reduction in smoking weakens but perdures by the end of 2021. [ABSTRACT FROM AUTHOR]

Extant research on COVID-19 suggests that many socio-economic determinants, by affecting personal behavior, have influenced the evolution of the pandemic. In this paper we study the role played in this regard by average levels of self-esteem in the public. There are reasons to believe that both low and very levels of self-esteem may have an effect on the spread of COVID-19, for opposite reasons. On the one hand, people with low self-esteem may not worry enough to behave in the way recommended (and prescribed, through non-pharmaceutical interventions) by the authorities; people with very high self-esteem, on the other hand, may be over-confident and fail to follow the prescriptions, believing that they do not need them. In this study we test this hypothesis by means of a quantitative cross-country analysis, using a hybrid model and the Rosenberg self-esteem scale. Our results suggest the existence of a U-shaped relationship between the trend of COVID-19 and average levels of self-esteem in a country. • Self-esteem played a positive role in containing COVID-19 pandemic contagion when is at a low level. • There is empirical evidence of a transformation of this relationship with higher levels of self-esteem. • The relationship is therefore U-shaped. • This finding confirms previous results regarding the negative effects of high levels of self-esteem on social outcomes. [ABSTRACT FROM AUTHOR]

There is a growing concern that inequalities are hindering health outcomes. This paper's primary objective is to investigate the role of relative deprivation and inequality in explaining the daily spread of the Covid-19 pandemic. For this purpose, we use secondary cross-sectional data across 119 (developed and developing) countries from January 2020 – to April 2021. For the empirical analysis, we use a recent dynamic panel data modelling approach that allows us to identify the role of time-invariant variables such as degree of globalisation, political freedom and income inequality on the dynamics of the pandemic and fatality rates across countries. We find that new cases per million and fatality rates are highly persistent processes. After controlling for time-varying mobility statistics from the Google mobility database and region-specific dummy variables, the two significant factors that explain the severity of Covid-19 spread in a country are per-capita Gross Domestic Product (GDP) and Yitzhaki's relative income deprivation index. Lagged value of new cases per million significantly explains cross-country variations in the daily case fatality rates. A higher proportion of the older population and pollution increased fatality rates while better medical infrastructure reduced it. • Higher inequality led to a faster spread of Covid-19 cases. • Per-capita GDP has a positive and significant effect on Covid-19 cases. • Google mobility data is a good predictor of Covid-19 cases. • Faster spread of Covid-19 cases is associated with higher case fatality rates. • Pollution increased Covid-19 fatality rates. [ABSTRACT FROM AUTHOR]

In this study, we expand on the newly devised sociological concept of pandemic practices that emerged during the COVID-19 outbreak by applying it to the HIV/AIDS pandemic. The analytical heuristic of pandemic practices distinguishes between four kinds of practices: (i) primary practices that encompass the public's direct response to the pandemic, (ii) responsive practices that encompass altered routines and social interactions, (iii) adaptive practices that encompass more elusive organisational and legal legacies and (iv) meta-practices that produce particular narratives about the pandemic dynamics that might lead to lasting socio-cultural behavioural changes. In this paper we probe further into the notion of meta-practices. The results show that the prolonged nature of the HIV/AIDS pandemic combined with the widespread stigmatisation of vulnerable groups has led to distinct social practices that fragment along socio-economic lines both internally in countries but also between high-income and low-income countries. As the COVID-19 pandemic becomes increasingly endemic, lessons learned from HIV/AIDS expose the dangers of similar fragmentations where parts of the population return to normal but where many others continue to suffer not only from adverse health outcomes but also social exclusion and stigmatisation. Thus, we argue that attention to pandemic practices, and how they produce and reinforce underlying socio-economic vulnerabilities would strengthen long-term pandemic responses. • We theorize HIV/AIDS as totalising (like COVID-19) but as more unevenly experienced as such. • This paper expands on the newly devised sociological concept of 'pandemic practices'. • Our expansion centre on the precedents pandemics set and their competition for salience. [ABSTRACT FROM AUTHOR]

COVID-19 vaccine hesitancy poses a global health threat by potentially delaying the attainment of herd immunity to attenuate infection and transmission. Most governments across the world are engrossed with formulating strategies to surmount conservative group behavior such as vaccine hesitancy typical under risky and uncertain situations such as in the case of COVID-19. This paper examines herding behavior in vaccine hesitancy with a special focus on the moderating role of household access to health information from village health workers under different risk perceptions. We use the 2021 Zimbabwe Vulnerability Assessment Committee cross-section household national survey consisting of 13, 583 valid observations. Our major findings indicate that herding behavior plays a role in rural households' hesitancy to COVID-19 vaccine inoculation. Furthermore, whilst access to health information from village health workers reduces herding behavior in vaccine hesitancy, it does so more when the household perceives itself to be at high risk of contracting COVID-19. Analysing herding behavior in vaccine hesitancy can help policymakers develop more targeted vaccination strategies, such as promoting access to health information through channels like village health workers, especially for households at high risk of contracting COVID-19. • People follow the herd in vaccine hesitancy when the vaccine is fairly unknown. • Health information from village health workers reduces vaccine hesitancy. • Perceived high risk of infection increases acceptance of expert vaccination advice. [ABSTRACT FROM AUTHOR]

While the overall impact of the COVID-19 pandemic on U.S. population health has been devastating, it has not affected everyone equally. The risks of hospitalization and death from the disease are relatively low for the population as a whole, but much higher for specific subpopulations defined by age, health status, and race or ethnicity. The extent to which Americans perceive these disparities is an open question, with potentially important political implications. Recognition of unequal impacts may prime concerns about justice and fairness, making Americans more concerned and willing to support government intervention. On the other hand, belief that the pandemic primarily threatens "other people" or out-groups may reduce, rather than increase, a person's concern. Partisanship and media consumption habits are also likely to play a role in these perceptions, as they do in most issues related to COVID-19. In this paper, we use original survey data from the Cooperative Election Study (N = 1000) to explore Americans' perceptions of which groups are most harmed by the pandemic, the demographic and political determinants of these perceptions, and the relationship of these perceptions with their opinions about COVID-related mitigation policy. We find that, on average, people perceived accurately that certain groups (e.g., Black Americans, older people) were more affected, but these group perceptions varied by demographic and political characteristics of respondents. We find, in contrast with recent experimental evidence, that the perception that populations of color were harmed was associated with more support for pandemic mitigation strategies. More research should investigate the relationships among pandemic politics and the racial dynamics of the target populations most affected. • In fall 2020, survey participants recognized groups harmed by COVID based on age. • They had lower recognition of racial groups harmed, lowest for Native Americans. • Perceptions of groups harmed varies by information exposure and politics. • Perceiving group disparities was associated with more support for pandemic policy. • The racial dynamics surrounding the politics of COVID-19 requires more attention. [ABSTRACT FROM AUTHOR]

Power and politics are both critical concepts to engage with in health systems and policy research, as they impact actions, processes, and outcomes at all levels in health systems. Building on the conceptualization of health systems as social systems, we investigate how power and politics manifested in the Finnish health system during COVID-19, posing the following research question: in what ways did health system leaders and experts experience issues of power and politics during COVID-19, and how did power and politics impact health system governance? We completed online interviews with health system leaders and experts (n = 53) at the local, regional, and national level in Finland from March 2021 to February 2022. The analysis followed an iterative thematic analysis process in which the data guided the codebook. The results demonstrate that power and politics affected health system governance in Finland during COVID-19 in a multitude of ways. These can be summarized through the themes of credit and blame, frame contestation, and transparency and trust. Overall, political leaders at the national level were heavily involved in the governance of COVID-19 in Finland, which was perceived as having both negative and positive impacts. The politicization of the pandemic took health officials and civil servants by surprise, and events during the first year of COVID-19 in Finland reflect recurring vertical and horizontal power dynamics between local, regional, and national actors. The paper contributes to the growing call for power-focused health systems and policy research. The results suggest that analyses of pandemic governance and lessons learned are likely to leave out critical factors if left absent of an explicit analysis of power and politics, and that such analyses are needed to ensure accountability in health systems. • Power and politics affect outcomes and processes at all levels of the health system. • Power and politics can be empirically studied through a focus on health system governance. • We studied how power and politics affected the governance of COVID-19 in the Finnish health system. • Interviews (n = 53) with health system leaders revealed several themes of power and politics. • Themes included credit and blame, frame contestation, and transparency and trust. [ABSTRACT FROM AUTHOR]

The SARS-CoV2 pandemic led to drastic social restrictions globally. Early data suggest that women in science have been more adversely affected by these lockdowns than men, with relatively fewer scientific articles authored by women. However, these observations test broad populations with many potential causes of disparity. Australia presents a natural experimental condition where several states of similar demographics and disease impact had differing approaches in their social isolation strategies. The state of Victoria experienced 280 days of lockdowns from 2020 to 2021, whereas the comparable state of New South Wales experienced 107 days, most of these in 2021, and other states even fewer restrictions. To assess how the gender balance changed in Australian biomedical publishing with the lockdowns, we created a custom workflow to analyse PubMed data from more than 120,000 published articles submitted in 2019–2021 from Australian authors. Broadly, Australian women have been incredibly resilient to the challenges faced by the lockdowns. There was an increase in the number of published articles submitted in 2020 that was equally due to women as men, including from Victoria. On the other hand, articles specifically addressing COVID-19 were significantly less likely to be authored by women than those on other topics, a finding not likely due to particular gender imbalance in virology or viral epidemiology, since publications on HIV followed similar patterns to previous years. By 2021, this imbalance had reversed, with more COVID-19-related papers authored by women than men. These data suggest women from Victoria were less able to rapidly transition to new research early in the pandemic but had accommodated to the new conditions by 2021. This work indicates we need strategies to support women in science as the pandemic continues and to continue to monitor the situation for its impact on vulnerable groups. • We analyzed PubMed data from >120,000 articles from Australian authors. • COVID-19 pandemic lockdown severity had no gender-specific effect. • Women authored fewer COVID-19 articles than expected in 2020. • Women's publishing of COVID-19 work normalized in 2021. • Women were less able to rapidly transition to new research in the COVID pandemic. [ABSTRACT FROM AUTHOR]

The information set from which individuals make their decision on vaccination includes signals from trusted agents, such as governments, community leaders and the media. By implementing restrictions, or by relaxing them, governments can provide a signal about the underlying risk of the pandemic and indirectly affect vaccination take-up. Rather than focusing on measures specifically designed to increase vaccine acceptance, this paper studies how governments' non-pharmaceutical policy responses to the pandemic can modify the degree of preventive health behavior, including vaccination. To do so, we use repeated waves of a global survey on COVID-19 Beliefs, Behaviors and Norms covering 18 countries from October 2020 to March 2021. Controlling for the usual determinants, we explore how individuals' willingness to get vaccinated is affected by changes in government restriction measures (as measured by the Oxford Stringency Index). This relationship is mediated by individual characteristics, social norms (social pressure to conform with what most people do), and trust in government institutions. Our results point to a complex picture as the implementation of restrictions is associated with increased acceptance in some contexts and decreased acceptance in others. The stringency of government restrictions has significant positive correlations with vaccine acceptance in contexts of weak social norms of vaccine acceptance and lower trust in government. In countries or communities with tighter social norms and high trust in health authorities, vaccine acceptance is high but less sensitive to changes in policies. These results suggest that the effect of government policy stringency is stronger among individuals who report lower trust and weaker social norms of vaccine acceptance. • Reports results from the analysis of an online survey on health behaviors during the COVID-19 • Provides evidence on the relationship between vaccine acceptance and lockdown policies • Finds stricter non-pharmaceutical interventions are associated with higher vaccine acceptance • Shows that this association is stronger for individuals with lower trust in health authorities [ABSTRACT FROM AUTHOR]

Since the first wave of COVID-19 in March 2020 the number of people living with post-COVID syndrome has risen rapidly at global pace, however, questions still remain as to whether there is a hidden cohort of sufferers not accessing mainstream clinics. This group are likely to be constituted by already marginalised people at the sharp end of existing health inequalities and not accessing formal clinics. The challenge of supporting such patients includes the question of how best to organise and facilitate different forms of support. As such, we aim to examine whether peer support is a potential option for hidden or hardly reached populations of long COVID sufferers with a specific focus on the UK, though not exclusively. Through a systematic hermeneutic literature review of peer support in other conditions (57 papers), we evaluate the global potential of peer support for the ongoing needs of people living with long COVID. Through our analysis, we highlight three key peer support perspectives in healthcare reflecting particular theoretical perspectives, goals, and understandings of what is 'good health', we call these: biomedical (disease control/management) , relational (intersubjective mutual support) and socio-political (advocacy, campaigning & social context). Additionally, we identify three broad models for delivering peer support: service-led , community-based and social media. Attention to power relations, social and cultural capital, and a co-design approach are key when developing peer support services for disadvantaged and underserved groups. Models from other long-term conditions suggest that peer support for long COVID can and should go beyond biomedical goals and harness the power of relational support and collective advocacy. This may be particularly important when seeking to reduce health inequalities and improve access for a potentially hidden cohort of sufferers. • Co-produced peer support can help people living with Long COVID. • Increasing the use of effective peer support may reduce health inequalities. • Inclusive peer support can benefit 'hardly reached' Long Covid cohorts. • Linking biomedical, relational and socio-political styles are most effective. [ABSTRACT FROM AUTHOR]

A major challenge in managing disasters during a pandemic is assessing the inequalities in society and protecting vulnerable people. The objective of this paper is to geographically understand the discrimination and inequality against minorities by COVID-19. This study designed a locational discrimination index (LDI) to measure COVID-19 discrimination against minorities at county-level in the US. LDI is the difference between the death proportion of a minority and the proportion of a minority's population. If LDI >0 is significant, COVID-19 discrimination is identified against a minority in a county. I further developed a locational minority inequality index (LMII), and LMII of a minority is directly quantified by comparing its LDI with the LDI of the majority population (i.e., the White population in the US). If LMII>0 is significant, a significant health inequality is confirmed against a minority in a county. In the US, I found 157 counties with significant discrimination against Black people, and 103 counties with significant inequality against Black people; 58 counties with significant discrimination against the American Indian population, but 38 counties with significant inequality against the American Indian population; 17 counties with significant discrimination against Native Hawaiians, but only 8 counties with significant inequality; for Hispanic people, 47 counties had significant discrimination, and 64 counties had significant inequality; for Asians, 7 counties had significant discrimination, but 28 had significant inequality. LDI, LMII, and the thematic mapping provide novel insight into COVID-19 discrimination and inequalities. To the best of our knowledge, this is the first time anyone has quantitatively and statistically defined and mapped COVID-19 discrimination and inequality against minorities at a county-level across the US. Based on this, governments and communities could make efficient decisions and take effective action to addressthe significant discrimination and inequality against Black, American Indian, Native Hawaiian, Hispanic, and Asian people, which can be applied to other pandemics or public health disasters in the USA or other countries. • The significant discrimination and inequality of COVID-19 are tested and mapped. • Locational discrimination index to quantify minority's vulnerability is developed. • Locational minority inequality index is developed to further compare inequality in vulnerability. • COVID-19 caused significant spatial inequality between minorities and the white population in the USA. [ABSTRACT FROM AUTHOR]

In a context of mistrust in public health institutions and practices, anti-COVID/vaccination protests and the storming of Congress have illustrated that conspiracy theories are real and immanent threat to health and wellbeing, democracy, and public understanding of science. One manifestation of this is the suggested correlation of COVID-19 with 5G mobile technology. Throughout 2020, this alleged correlation was promoted and distributed widely on social media, often in the form of maps overlaying the distribution of COVID-19 cases with the instillation of 5G towers. These conspiracy theories are not fringe phenomena, and they form part of a growing repertoire for conspiracist activist groups with capacities for organised violence. In this paper, we outline how spatial data have been co-opted, and spatial correlations asserted by conspiracy theorists. We consider the basis of their claims of causal association with reference to three key areas of geographical explanation: (1) how social properties are constituted and how they exert complex causal forces, (2) the pitfalls of correlation with spatial and ecological data, and (3) the challenges of specifying and interpreting causal effects with spatial data. For each, we consider the unique theoretical and technical challenges involved in specifying meaningful correlation, and how their discarding facilitates conspiracist attribution. In doing so, we offer a basis both to interrogate conspiracists' uses and interpretation of data from elementary principles and offer some cautionary notes on the potential for their future misuse in an age of data democratization. Finally, this paper contributes to work on the basis of conspiracy theories in general, by asserting how – absent an appreciation of these key methodological principles – spatial health data may be especially prone to co-option by conspiracist groups. • Mis-use of spatial data is a key part of conspiracy thinking around health issues. • This makes mis-specified correlations, such as 5G and COVID-19, more likely to occur. • Understanding of spatial data is necessary to challenge conspiracist conclusions. [ABSTRACT FROM AUTHOR]

Motivated by current debates over the relationship between epidemic and trust, this paper estimates the short-term effects of the Covid-19 pandemic on general trust, political trust, and trust in physicians in China. Using an individual-level national longitude dataset, results from the Difference-in-Difference estimation show that greater exposure to Covid-19 risks significantly decreased general and political trust among the Chinese population, except for the younger generation (age 8–22). Higher exposure to Covid-19 in malleable ages of trust formation (age 8–22) may worsen individuals' general trust but improve their trust in local officials and physicians. Results from heterogeneity tests reveal that Covid-19 exacerbated general trust among the vulnerable groups, whereas their political trust was stable. • Short- and middle-term social implications of Covid-19 are estimated. • General and political trust is decreased except for the younger generation. • Trust in officials and physicians among the cohort aged 8–22 increases. • Heterogeneous effects can be observed and are exacerbated among vulnerable groups. [ABSTRACT FROM AUTHOR]

Pandemic preparedness and COVID-19 response indicators focus on public health outcomes (such as infections, case fatalities, and vaccination rates), health system capacity, and/or the effects of the pandemic on the economy, yet this avoids more political questions regarding how responses were mobilized. Pandemic preparedness country rankings have been called into question due to their inability to predict COVID-19 response and outcomes, and COVID-19 response indicators have ignored one of the most well documented secondary effects of the pandemic – its disproportionate effects on women. This paper analyzes pandemic preparedness and response indicators from a feminist perspective to understand how indicators might consider the secondary effects of the pandemic on women and other equity deserving groups. Following a discussion of the tensions that exist between feminist methodologies and the reliance on indicators by policymakers in preparing and responding to health emergencies, we assess the strengths and weakness of current pandemic preparedness and COVID-19 response indicators. The risk with existing pandemic preparedness and response indicators is that they give only limited attention to secondary effects of pandemics and inequities in terms of who is disproportionately affected. There is an urgent need to reconceptualize what 'successful' pandemic preparedness and response entails, moving beyond epidemiological and economic measurements. We suggest how efforts to design COVID response indicators on gender inclusion could inform pandemic preparedness and associated indicators. • A feminist perspective on debates about the use of indicators in global health. • Pandemic preparedness and response indicators consideration of gender is limited. • COVID-19 has led to the development of innovative gender-based approaches. • These can be built upon through greater integration of feminist approaches. [ABSTRACT FROM AUTHOR]

This study examines whether people smoked more under the Coronavirus Disease 2019 (COVID-19) closure policies which trapped them at home with their families. In such circumstances, the pleasure from smoking could be more tempting than usual, but at the same time smokers' families are more likely to be victims of passive smoking. This study uses temporal and regional variations in policy strengths with data from the Oxford COVID-19 Government Response Tracker project (OxCGRT) to examine the impact of COVID-19 closure policies on smoking behaviors. With longitudinal data from the China Family Panel Studies (CFPS) in 2018 and 2020, we find diminished smoking behaviors among Chinese male adults when the government implemented strict public health policies for the COVID-19 pandemic. People with more conscientiousness personality traits or stronger pro-family attitudes tend to smoke less as policy stringency increases. • This paper examines whether people smoke more under COVID-19 closure policies. • Policy stringency is the average OxCGRT score in the past 30 days before survey. • We find people smoke less when the index of policy stringency becomes higher. • Conscientious personality traits and pro-family attitudes are proxies of altruism. • The discouraging effects are stronger among people with higher family altruism. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic has affected countries and regions to varying degrees. In this paper, I examine the socioeconomic determinants of Covid-19 mortality and study whether vaccinations have affected the relationship between those determinants and Covid-19 mortality rates across local areas in England. I use monthly data for 6791 Middle Layer Super Output Areas for the period from March 2020 to April 2021 and estimate a spatial correlations model with local authority and time fixed effects. To study whether vaccinations have affected the relationship between socioeconomic determinants and Covid-19 mortality, I extend the model to include interactions between socioeconomic variables and the lagged cumulative vaccination rate. I find that Covid-19 mortality is higher in areas that have an older population, a larger share of Asian population, higher population density, lower income, poorer pre-existing health and a larger share of employment in health and social care occupations. Vaccinations have weakened the links between mortality and these socioeconomic characteristics. These findings highlight the importance of making vaccines widely available and encouraging take-up, to reduce inequality in Covid-19 mortality across socioeconomic groups. • Covid-19 mortality is higher in areas of England with an older population. • Mortality is higher in areas with a larger share of Asian population. • Mortality is higher in areas with higher population density and lower income. • Mortality is higher in areas with poorer health and more health workers. • Vaccines weaken the links between mortality and socioeconomic characteristics. [ABSTRACT FROM AUTHOR]

Research in several countries shows higher Covid-19 vaccination willingness and uptake among physicians than nurses. Our paper aims to characterize and explain this difference. In early 2021, we surveyed 1047 U.S. primary care professionals who served adolescents, ages 11–17. The national sample included physicians (71%) as well as nurses and advanced practice providers. The survey assessed the three domains of the Increasing Vaccination Model: thinking and feeling , social processes , and direct behavior change. Covid-19 vaccine uptake was higher among physicians than among nurses and advanced practice providers (91% vs. 76%, p <.05). Overall, in the thinking and feeling domain, higher confidence in Covid-19 vaccination, higher perceived susceptibility to the disease, and stronger anticipated regret were associated with higher vaccine uptake (all p <.05). In the social processes domain, perceiving more positive social norms for Covid-19 vaccination, receiving recommendations to get the vaccine, and wanting to help others were associated with higher vaccine uptake (all p <.05). In the direct behavior change domain, receiving an invitation to get the vaccine and better access to vaccination were associated with higher uptake (both p <.05). Of these variables, most of the thinking and feeling and social processes variables mediated the association of training with vaccine uptake. Physicians had higher Covid-19 vaccine uptake than nurses and advanced practice providers, corresponding with their more supportive vaccine beliefs and social experiences. Efforts to reach the remaining unvaccinated cohort can build on these findings. • Covid-19 vaccine uptake among advanced practice providers and nurses was lower than in physicians. • Vaccine confidence and social norms explained the difference in Covid-19 vaccine uptake. • Recommendations from employers and providers suppressed some differences in vaccination. • Behavioral nudges – invitation and incentives – were associated with more vaccine uptake. • Offers directions and contexts for future vaccination interventions and programs in the U.S. [ABSTRACT FROM AUTHOR]

In this paper, we trace how mathematical models are made 'evidence enough' and 'useful for policy'. Working with the interview accounts of mathematical modellers and other scientists engaged in the UK Covid-19 response, we focus on two weeks in March 2020 prior to the announcement of an unprecedented national lockdown. A key thread in our analysis is how pandemics are made 'big'. We follow the work of one particular device, that of modelled 'doubling-time'. By following how modelled doubling-time entangles in its assemblage of evidence-making, we draw attention to multiple actors, including beyond models and metrics, which affect how evidence is performed in relation to the scale of epidemic and its policy response. We draw attention to: policy; Government scientific advice infrastructure; time; uncertainty; and leaps of faith. The 'bigness' of the pandemic, and its evidencing, is situated in social and affective practices, in which uncertainty and dis-ease are inseparable from calculus. This materialises modelling in policy as an 'uncomfortable science'. We argue that situational fit in-the-moment is at least as important as empirical fit when attending to what models perform in policy. • Pandemics are performed as crises of uncertain yet catastrophic potential. • Mathematical models are forms of scalar narrative affording epidemics their scale. • Models and projections are made useful as evidence in their situated policy events. • Calculations are given agency as affects in the evidencing of pandemics. • Modelling pandemics is a site of 'uncomfortable science' and 'dis-ease'. [ABSTRACT FROM AUTHOR]

Covid-19 vaccination was associated with a general feeling of hesitancy, and its arrival increased fear and economic anxiety. This paper investigates the impacts of Covid-19 vaccination on fear and economic anxiety using a worldwide sample of 194 countries observed from December 1st, 2020 to March 4th, 2021. The difference-in-differences investigation approach shows that with the vaccine's arrival, the Google search trends measuring fear and anxiety are increasing. The arrival of the vaccine has created a general feeling of fear, and people have a lack of confidence in the vaccine's efficiency to overcome the Covid-19 crisis. Specifically, anxiety increased when the delta variant was discovered in India. Governments' interventions must ensure that the Covid-19 vaccine does not have adverse side effects that can harm public health. We suggested that policy makers should focus on increasing the number of older adults willing to receive the vaccine. It can be effective in explaining the benefits of the vaccine, and denying false information about the vaccine and its serious side effects. • Covid-19 vaccination was associated with a general feeling of hesitancy. • We show that with the vaccine's arrival, the Google search trends measuring fear and anxiety are increasing. • Anxiety increased when the delta variant was discovered in India. • Policy makers should focus on increasing the number of older adults willing to receive the vaccine. [ABSTRACT FROM AUTHOR]

Worldwide, the socioeconomic impacts of COVID-19 disproportionally affect vulnerable groups in society. This paper assesses responses to, and impacts of, the pandemic among mobile migrant populations who work in Artisanal and Small-scale Gold Mining (ASGM) in Suriname and French Guiana. These populations are characterized by poverty, informal or illegal status, and limited access to health care and information. Field research in Suriname (November 2020–January 2021) and French Guiana (January, May, June 2021) included qualitative interviews, informal conversations and observations, and a quantitative survey with 361 men and women in ASGM communities. Contrary to reports from the ASGM sector elsewhere, interviewed inhabitants of ASGM areas in Suriname and French Guiana showed little concern about COVID-19. Respondents reported feeling safer in the forest where they work than in the urban areas or in their home country. Trust in home remedies and over-the-counter pharmaceuticals further reduced anxiety about the pandemic. Three-quarters of survey respondents reported that the COVID-19 pandemic had not affected their work or income at all. The researchers conclude that in these remote Amazon communities, responses to COVID-19 mirror attitudes and behavior vis-à-vis malaria and other health risks: self-medicate, ignore, and pray. Living on the margins of society mitigates the socioeconomic impacts of COVID-19, as containment measures are not applied to these socially invisible populations. Whereas the urban poor are severely hit by the pandemic, this hidden population benefits from high gold prices, an outdoors lifestyle, and traditional resourcefulness in dealing with a life full of risks. • Regular exposure to risk drives health risk behavior. • Self-medication against COVID-19 popular among Amazonian mobile migrant populations. • COVID-19 containment measures scarcely affect socially invisible rural populations. • In ASGM communities, approach to COVID-19 parallels approach to malaria. • Small-scale gold mining provides resilience during global health and economic crisis. [ABSTRACT FROM AUTHOR]

This paper explores news media discourse about COVID-19 during the spring of 2020 in Sweden, aiming to provide an understanding of how moralising discourse is employed in narratives about public health risks and responses. We investigate print news media content about the corona virus and COVID-19 during the early stages of the outbreak, guided analytically by framework focusing on the relationship between moral panics and moral regulation. We direct attention, first, to how both moral majorities and villains, i.e., 'folk devils', and heroes are constructed in the news. Secondly, we look at how visions for interventions are produced discursively in relation to such constructions. Our findings suggest that moralising discourse largely target risk behaviours and health care claims of middle-class groups. We also find that news media discourse about the pandemic in Sweden is marked by attacks on government interventions that are distinctly different from observations in other contexts. In conclusion, we discuss these observations in relation the political and discursive context, and the potential impact of moralising discourse on the legitimacy of public health interventions and the welfare state. Finally, we also discuss how our findings can inform theoretical discussions about political populism, moralising discourse and public health. • Moralising discourse marked Swedish news media narratives about COVID-19. • Calls for interventions by 'moral entrepreneurs' targeted risks among 'folk devils'. • It was different in character to discourse emerging in other contexts. • It was also characterised by traits associated with medical populism. [ABSTRACT FROM AUTHOR]

This paper presents the first longitudinal study of sex disparities in COVID-19 cases and mortalities across U.S. states, derived from the unique 13-month dataset of the U.S. Gender/Sex COVID-19 Data Tracker. To analyze sex disparities, weekly case and mortality rates by sex and mortality rate ratios were computed for each U.S. state, and a multilevel crossed-effects conditional logistic binomial regression model was fitted to estimate the variation of the sex disparity in mortality over time and across states. Results demonstrate considerable variation in the sex disparity in COVID-19 cases and mortalities over time and between states. These data suggest that the sex disparity, when present, is modest, and likely varies in relation to context-sensitive variables, which may include health behaviors, preexisting health status, occupation, race/ethnicity, and other markers of social experience. • First report of findings from unique longitudinal dataset of sex-disaggregated COVID-19 data in U.S. states. • Sex disparities in COVID-19 are highly heterogeneous in magnitude and direction and vary across states and over time. • Gender-related and other social and contextual factors likely shape COVID-19 sex disparities. • Single-factor approaches are ill-positioned to explain patterns in sex disparities in COVID-19 outcomes. [ABSTRACT FROM AUTHOR]

The economic impact of COVID-19 has exacerbated inequalities in society, but disability has been neglected. This paper contributes to this knowledge gap by providing a comprehensive analysis of the differential labour market impact of COVID-19 by disability in the UK. Using data from the Labour Force Survey before and during the pandemic it estimates disability gaps in pre-pandemic risk factors, as well as changes in labour market inequality nearly one year on. Disabled workers are found to face higher COVID-19-related economic and health risks, including being more likely to work in 'shutdown' industries, and in occupations with greater proximity to others and exposure to disease. However, established measures of inequality, including the disability employment and pay gap suggest limited impact of COVID-19 in 2020. Nevertheless, the increase in the probability of being temporarily away from work, even among otherwise comparable workers, is 40% higher for disabled workers and consistent with disproportionate use of the government's job retention scheme. While the reasons for this are likely to be complex, there is a risk that it will contribute to future disability-related labour market inequality. • We explore disability-related labour market inequality in the UK during COVID-19. • We estimate COVID-19 work-related risk factors and changes in outcomes. • Disabled workers face greater COVID-19 economic and health risks pre-pandemic. • Disability gaps in employment and pay exhibit minimal change one year post-pandemic. • Disabled workers have a markedly larger rise in being temporarily away from work. [ABSTRACT FROM AUTHOR]

According to the global Multidimensional Poverty Index (MPI), an internationally comparable measure, poverty in developing countries has fallen substantially over the last 15 years. The COVID-19 pandemic and associated economic contraction are negatively impacting multiple dimensions of poverty and jeopardising this progress. This paper uses recent assessments of food insecurity and school closures made by UN agencies to inform microsimulations of potential short-term impacts of the pandemic under alternative scenarios. These simulations use the nationally representative datasets underlying the 2020 update of the global MPI. Because these datasets were collected in various years before the pandemic, we develop models to translate the simulated impacts to 2020. Our approach accounts for the country-specific joint distribution of deprivations in the simulations, recent poverty reduction trends, and resulting differences in the responsiveness of the global MPI to the scenarios. Aggregating results across 70 countries that account for 89% of the global poor according to the 2020 global MPI, we find that the potential setback to multidimensional poverty reduction is between 3.6 and 9.9 years under the alternative scenarios. We argue that the extent to which such disruptions result in persistent increases of poverty and deprivations may be attenuated by appropriate policy responses. • We evaluate the potential impact of COVID-19 and policy responses on global poverty. • We use 70 microdata sets underlying the global multidimensional poverty index. • Our simulations are informed by assessments of UN agencies (WFP and UNESCO). • Our results suggest a potential global setback to poverty reduction of around 9 years. • Appropriate policy measures may prevent deprivations from becoming persistent. [ABSTRACT FROM AUTHOR]

In this paper we analyze the changes in accessibility to emergency and community food services before and during the COVID-19 pandemic in the City of Hamilton, Ontario. Many of these food services are the last line of support for households facing food insecurity; as such, their relevance cannot be ignored in the midst of the economic upheaval caused by the pandemic. Our analysis is based on the application of balanced floating catchment areas and concentrates on households with lower incomes (

This paper aims to understand the relationship between area level deprivation and monthly COVID-19 cases in England in response to government policy throughout 2020. The response variable is monthly reported COVID-19 cases at the Middle Super Output Area (MSOA) level by Public Health England, with Index of Multiple Deprivation (IMD), ethnicity (percentage of the population across 5 ethnicity categories) and the percentage of the population older than 70 years old and time as predictors. A GEE population-averaged panel-data model was employed to model trends in monthly COVID-19 cases with the population of each MSOA included as the exposure variable. Area level deprivation is significantly associated with COVID-19 cases from March 2020; however, this relationship is reversed in December 2020. Follow up analysis found that this reversal was maintained when controlling for the novel COVID-19 variant outbreak in the South East of England. This analysis indicates that changes in the role of deprivation and monthly reported COVID-19 over time cases may be linked to two government policies: (1) the premature easing of national restrictions in July 2020 when cases were still high in the most deprived areas in England and (2) the introduction of a regional tiered system in October predominantly in the North of England. The analysis adds to the evidence showing that deprivation is a key driver of COVID-19 outcomes and highlights the unintended negative impact of government policy. • Area level deprivation is significantly associated with monthly COVID-19 cases. • Initially, areas with higher levels of deprivation had higher reported cases. • Government policy played a role in reversing this relationship. [ABSTRACT FROM AUTHOR]