Tag Archives: pandemic

Forecasting the Trajectory of an Epidemic

Mark Levene is Professor of Computer Science in Birkbeck’s Department of Computer Science and Information Systems. He shares insights from research into modelling the waves of an epidemic.

Epidemics such as COVID-19 come in “waves”, although the precise definition of a wave in this context is somewhat elusive.  A standard way to model the epidemic is as a time series that records, say the number of daily hospitalisation or deaths, and these can be plotted to view the progress of the epidemic.

Waves in the time series span from one valley to another with a peak in between them. The shape of an individual wave can be modelled as a statistical distribution and several waves can be sequentially combined. More often than not waves are not symmetric, that is, the rate at which, say hospitalisations, increase is not the same rate at which they decrease once the peak of the wave has been reached. This non-symmetrical nature of a wave is called its skewness.

To take into account the skewness of epidemic waves we introduce the skew logistic distribution, which is a novel yet simple extension of the symmetric logistic distribution widely used in the modelling of epidemic data.

To validate our model, we provide a full analysis of the first four waves of COVID-19 deaths in the UK from the 30 January 2020 to 30 July 2021.

Our results show a good fit to the proposed skew logistic distribution, and thus could potentially augment existing more established models that are being used to forecast the trajectory of an epidemic.

Our findings have been published in MDPI Entropy.

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More Vulnerable but Happier? A study of older residents in the first lockdown

The national lockdowns in 2020 affected people in different ways, depending on age, social habits and living situation. In this blog, Dr David Tross, an Associate Lecturer in the Department of Geography discusses the findings of a study of how the first lockdown affected their wellbeing.

The hands of a person joined together

Asked to record her feelings about lockdown during the first wave of the COVID -19 pandemic, Alice*, a 71-year-old divorcee living in Cheshire, describes it as ‘the longest and best holiday I have ever had’ while Catherine, a 60-year-old married retiree living in Essex, states: ‘if it wasn’t for this virus, I would consider this my ideal life-style’.

These are a few snippets from 24 written accounts of the first lockdown by older individuals, volunteers responding to a Summer 2020 of the Mass Observation Project, a longstanding social research initiative that generates written commentaries about a range of contemporary social issues from residents across the UK (my older sample are part of a broader age-based panel). While Catherine and Alice were unusual in being quite so enthusiastic about the experience of lockdown, the older age group is of particular interest sociologically because of a paradoxical theme emerging about the impact of the pandemic: despite being more vulnerable to dying or being hospitalised by COVID-19, older people’s wellbeing seemed less affected than that of other age groups. While overall levels of subjective wellbeing in the UK declined (unsurprisingly but still noticeably- given that this was the first national drop in the 10 years of measurement), older people’s self-reported levels of loneliness, anxiety and depression rose at a much lower rate than other age groups. The main losers? Young people, whose self-reported anxiety and depression tripled.

One explanation is about relative change to lifestyle. For my older cohort, it was the lack of fundamental change to their normal routine that characterised the majority of responses. As one put it, ‘’my life just seems to have trundled on regardless’ and her explanation, being retired and ‘not being directly or indirectly affected by the pandemic’ also illustrates a wider point. Provided you or others you knew hadn’t suffered from the virus, three key disruptions in the lives of many UK households: work routine, threats to income and home-schooling children, were not generally a factor for this group. Indeed, when prompted to describe changes in her routine, Catherine writes that ‘for the first time in our lives we now take a multi-vitamin every day’. With all due deference to the restorative powers of Vitamin D, this is not quite the seismic change the pandemic wrought upon many.

Another explanation is about relative expectations. Take loneliness. Despite having larger social networks and more frequent communication with friends and family, younger people self-reported as the loneliest age group in lockdown, surely underlining the discrepancy between the expectations of this age group and the reality (to take one example, students confined to their university halls). However, experiencing less disruption wasn’t always a lockdown advantage. In June 2020, an ONS survey indicated that almost half of UK working-age adults were reporting benefits of lockdown- not commuting, a slower pace of life, spending more time with family- precisely because of the forced but not necessarily unwelcome upheaval in their lives. Although many older respondents did write about enjoying popular activities of lockdown highlighted by the survey- gardening, walking, spending more time in nature, taking up creative hobbies- this was often only a slightly extended version of their pre-pandemic routines.

The boosterish narrative of lockdown was brilliantly satirised by the Financial Times opinion writer Janan Ganesh as ‘Oh! What a lovely curfew’. Decrying the tendency to ‘frame the lockdown as a disguised gift to the species’ as ‘tasteless’, he highlights that what ‘started out as twee high jinks about banana bread’ only reflects the deeper truth that there were winners and losers of lockdown, and socio-economic circumstances were one important dividing line.

Because, as the MO writers were penning their responses, it was already clear that one nation under lockdown had revealed two nations experiencing very different realities. One, living in affluent areas, in decent-size homes with access to gardens, furloughed from jobs or working from home and saving money; another, living in crowded accommodation in less affluent areas, disproportionately non-white, more likely to self-report as depressed and anxious, and, if still employed, having to take their chances with the virus in public-facing roles.

My writers belong mostly to the first tribe. They have gardens, own their homes and generally live in more rural and affluent areas of the UK. This may help to explain their relative lack of proximity to COVID deaths and hospitalisations. If they are lucky, then many acknowledged this. Take three indicative comments: ‘I felt so sorry for families in high-rise flats‘; ‘we have been very busy in our garden, it must be terrible to be in lockdown with nowhere to get out’; lockdown ‘is mostly easy, being retired, well off and a white woman’. These are the voices of privileges being checked.

While statistics tend to flatten the difference within social groups, qualitative research highlights the diversity of experience. Lockdown was a miserable experience for older writers whose culturally and socially gregarious lives were dramatically curtailed (limited space precludes exploring other negative factors, including those with health conditions whose treatment was disrupted). While Alice declared ‘it wouldn’t bother me if I never went to cinemas, restaurants and celebratory events again’, for others for whom these social and cultural engagements really matter, any benefits conferred by lockdown could not compensate for their lack. As one male retiree wrote, ‘I saved money but lost my social contacts’.

One significant loss was volunteering. The older writers broadly align with the demographics of what researchers have termed the ‘civic core’, the segment of the population who do the most volunteering and civic participation (including voting). This core is generally older, female, rural and live in less deprived areas. Over half of the cohort volunteered regularly pre-pandemic (compared to 25% of the UK adult population as a whole), and for some, the combination of service closures and personal vulnerability meant that they could no longer do so. ‘My friend and I who have worked together in Citizens Advice (CAB) and have done for many years, were over 70 and at risk and asked not to come’ writes one 80-year-old; ‘I have volunteered at CAB first as an adviser and latterly doing admin for over 45 years so this was a huge loss’. Another who organised events for other older residents in the village hall has moved some of these online but laments that this is ‘just not the same. I miss my social connections’.

The loss of volunteering opportunities also provides a more nuanced understanding of the unprecedented community response in the first wave of the pandemic. In what has been described as the largest peacetime civilian mobilisation in UK history, an estimated three million people in April and May of 2020 formed the vanguard of neighbourhood covid support groups delivering key medical services, food provision and support to vulnerable people across the UK. The Local Trust calls this as ‘an extraordinary response to the crisis, and evidence of a surge in community spirit’. And yet the spontaneous emergence of informal and locally focused covid mutual support groups ran alongside a sharp drop in formal volunteering, as charities and voluntary associations closed services and furloughed staff, or where older volunteers were too vulnerable to participate. This doesn’t mean that older people weren’t part of the bottom-up community response; some in the cohort took active roles. But it did mean that many older citizens who formed the bedrock of UK Civil Society were now, at the apotheosis of voluntary contribution, left without a contribution to make.

*names have been invented






The Experiences of Junior Doctors Working During the COVID-19 Pandemic

In light of the rapid rise in Omicron cases in the UK, Dr Kevin Teoh, Senior Lecturer in Organizational Psychology, shares the latest findings from a study exploring junior doctors’ mental health.

Dr Kevin Teoh smiling, standing against a wall.

A big factor behind the increasing COVID-19 restrictions being (re)-implemented following the emergence of the Omicron variant is the pressure that our healthcare system is under. It is easy to see the healthcare system as this big organisation and not fully realise that its most important makeup is its people – who have their own thoughts, feeling and emotions.

In this study, we sought to better understand what that experience was like for individual doctors working during this pandemic. Over the past three years I have been working on a project led by Dr Ruth Riley at the University of Birmingham on working cultures, mental health and suicide among junior doctors in the National Health Service. When the COVID-19 pandemic started, we were able to capture the experience and impact of our participants working on the front lines, and in this study we focus on interviews with fifteen junior doctors drawn from a larger online survey of 456 junior doctors.

Challenges of working during the pandemic

Here we saw participants share at a personal level strong feelings of helplessness and powerlessness – especially in relation to the exposure to death and suffering. One participant shared that: “’I’d seen a whole ward just emptied out and then refilled overnight, after people had just died. It was horrendous”. There was also significant concern not only about being infected, but about potentially infecting loved ones outside of the workplace.

Unsurprisingly, the pandemic created substantial upheaval for junior doctors’ workplaces. Patients loads increased substantially while there was a distinct lack of support reported by others. The already under-staffed system was stretched even further as colleagues were infected, had to isolate or simply needed a break having exceeded their working hours.

On top of that, our junior doctors reported a new pressure in having to take on all the new information about this new virus on top of their existing heavy workloads, as this participant shared: “We were getting 20 emails a day, and every single one would have a red flag saying ‘vital, important, must read’, and you’d worry you’d missed something […] there’s so much information, it was constant, and you couldn’t switch off”.

There were changes to work practices, such as increased phone and online consultations, which not only necessitated learning new systems but also was not always conducive to the task at hand or supporting patient needs. It was also an additional source of complaint and abuse from patients who were frustrated with these new forms of consultations. Restrictions on group sizes, socialising and training also accentuated feelings that their training, support and learning needs were not being met.

Strategies of coping with the pandemic

Recognising the challenges from the pandemic, it was therefore concerning that many participants shared the inadequacy of personal coping strategies. Although these may have been useful before the pandemic, it was often felt that it was not enough during the pandemic.

Participants here shared how crying was one way of dealing with emotions. Others tried to be stoic – over time they were worn though and resigned that things were not going to get any better. This led to one participant sharing that “we’ve sort of entered a collective sort of depressive state of acceptance”.

More proactive examples had junior doctors trying to exert more control over their situation, seeking out new roles and tasks, such as getting more involved with supporting relatives which helped them feel as though were actually accomplishing something – “It wasn’t that sort of like, ‘I put lines in people and hopefully’, and then just watching them die”. Others shared about how they had to actively seek out psychological support to help them cope and prevent them from spiralling further.

Positive impact on working practices

Not all was doom, with participants also sharing positive examples of change. Crucially, some changes to work practices – such as longer rotations and working in consistent teams – led to feelings of better stability and more support. There were also examples of how less bureaucracy and more control allowed junior doctors to focus on more efficient and better ways of working with each other and for their patients.

Organisations too had to rapidly learn how to support their workers, with more access to psychological help and resources, or the provision of basic facilities being reinstated – including refreshments and rest areas. These were important given that “there were huge queues at the supermarket, and we were working 12-hour shifts, and it was unpredictable whether you could get food”.

What does this mean?

This study was an eye-opening experience into the challenges faced by junior doctors on working on the front-line at the start of the pandemic. As we enter its second year, serious questions need to be raised about how we support and retain not only junior doctors, but all workers in the healthcare system who likely have similar experiences. At the very least, a greater sense of appreciation and empathy for the work that they are doing is needed.

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Are COVID-19 conspiracies a threat to public health?

A collaboration between Dr Marie Juanchich, Dr Miroslav Sirota, and PhD researcher Daniel Jolles from the University of Essex and Dr Lilith A. Whiley from Birkbeck, University of London explores conspiracy theorists’ responses to public health recommendations.

Picture of a crowd with anti-vaxx posters.

Pandemics are a fertile backdrop for conspiracy theories.

As COVID-19 spread in early 2020 and uncertainty around the origins and transmission of the virus grew, conspiracy theories filled in the gaps. Social media was rife with claims that COVID-19 was an artificially created bioweapon, a plot by pharmaceutical companies to profit from vaccines – even that it was being spread across the 5G network!

At the height of the pandemic’s first wave, conspiracy-related content received greater engagement than content from sources such as the World Health Organisation and our National Health Services – a very worrisome fact.

What are the implications of this for public health?

Together with colleagues from the University of Essex Department of Psychology, I sought to understand whether this ‘infodemic’ of conspiracy theory content posed a threat to public health initiatives such as mask wearing, social distancing and take-up of the COVID-19 vaccination.

What is a conspiracy theorist?

A conspiracy theorist is someone who believes in powerful, malevolent individuals, and has low trust in government and science.

Individuals with a ‘conspiracy mindset’ have in common some general beliefs that predispose them to believe in conspiracy theories. These include:

  • Governments are evil
  • Small, secret and powerful organisations control the world order
  • These organisations cover-up the existence of extra-terrestrial life, threaten people’s health and freedom and control the flow of information

At the heart of these beliefs is the notion that ill-intentioned groups are acting behind the scenes, so trust is a key factor in conspiracy beliefs.

Some cognitive attributes might also make people more vulnerable to conspiracy beliefs. People who engage in analytical thinking, which involves a more in-depth evaluation of the information, are less likely to fall prey to misinformation.

Did conspiracy theorists follow public health initiatives in the COVID-19 pandemic?

Prior research suggests that conspiracy beliefs could prevent people from complying with public health guidance during a pandemic. For example, Oliver and Wood (2014) discovered that people who believe in HIV conspiracy theories are less likely to attend regular medical check-ups.

Previous studies also suggest that there is a negative relationship between conspiratorial beliefs and support for government COVID-19 health guidelines. However, the evidence does not provide a consistent picture. In a study by Briddlestone et al. (2020), for example, conspiracy beliefs were negatively related to social distancing, but not to hand hygiene.

We carried out three complementary studies to further understanding on the relationship between conspiracy beliefs and health protective behaviours during the COVID-19 pandemic. In some of the previous work that has been in this area, researchers investigated conspiracy theories where the virus was presented as a hoax or where its severity was exaggerated – in those cases, we could expect negative relationships with any type of health care protective behaviours. In our studies, we focused only on conspiracy theories that recognised the virus and accepted that it was ‘real’. In a series of surveys conducted at the height of the UK’s first wave, we examined to what extent participants agreed with COVID-19 conspiracy theories and how this compared to their mindset, trust in government, social characteristics, and health protective behaviours.

Key findings were:

  • A conspiracy mindset was associated with believing in COVID-19 conspiracy theories.
  • Individuals with low trust in authority and intuitive (rather than analytical) thinking styles held stronger conspiracy beliefs.
  • Individuals who were more educated or who held a conservative ideology also had stronger conspiracy beliefs.
  • People from ethnic minority groups and those who were employed as frontline workers were more likely to have conspiracy beliefs.
  • Conspiracy theory believers reported following health guidelines, such as hand washing and social distancing, as much as others, but were less likely to agree to get tested or vaccinated against the virus and more likely to share misinformation online.

The fact that conspiracy theorists comply with public health guidelines around COVID-19 but are unwilling to be tested or vaccinated for the virus, appears contradictory.

What is interesting, however, is that all the behaviours that conspiracy believers performed as much or more than other people provide autonomy and control, for example hand washing or wearing a mask. Getting tested or vaccinated, on the other hand, requires trust in others. Our results confirmed that conspiracy theory believers were reluctant to undertake actions in which they had lower levels of personal control, viewing these actions as more risky and less beneficial.

What are the implications of these findings when tackling the COVID-19 pandemic?

While conspiracy believers are frequently presented as risk takers who refuse to follow official health recommendations, our findings show that this is not the case. Conspiracy believers adhere as much, or even more, to the protective behaviours that give them a sense of personal control.

However, hesitancy around getting tested and vaccinated against COVID-19 due to a lack of trust is a cause for concern. The increased prevalence of conspiracy theories in frontline workers and individuals from ethnic minorities may explain the greater hesitancy to be vaccinated against COVID-19 observed in both of those groups.

We suggest the following recommendations that could support the uptake of public health initiatives:

  • Design communications around testing and vaccination for COVID-19 in a way that is also inclusive of conspiracy believers, for example, clearly communicating the risks and
  • Health messages to be delivered by trusted sources.
  • Promote health advice that is supportive of individual autonomy, for example, when inviting healthcare professionals for a flu vaccine.
  • Ensure transparency from pharmaceutical companies in their data sharing to increase trust.
  • Include prompts for fostering analytical thinking in COVID-19 communications to prevent the spread of false information.

Blog post written by Isobel Edwards and Dr Lilith A. Whiley.

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