As the coronavirus disease 2019 (COVID-19) spread globally, emerging variants such as B.1.1.529 quickly became dominant worldwide. Sustained community transmission favors the proliferation of mutated sub-lineages with pandemic potential, due to cross-national mobility flows, which are responsible for consecutive cases surge worldwide. We show that, in the early stages of an emerging variant, integrating data from national genomic surveillance and global human mobility with large-scale epidemic modeling allows to quantify its pandemic potential, providing quantifiable indicators for pro-active policy interventions. We validate our framework on worldwide spreading variants and gain insights about the pandemic potential of BA.5 and BA.2.75 sub-lineages. Country-level epidemic intelligence is not enough to contrast the pandemic of respiratory pathogens such as SARS-CoV-2 and a scalable integrated approach, i.e. pandemic intelligence, is required to enhance global preparedness.

The dynamics of a spreading disease and individual behavioral changes are entangled processes that have to be addressed together in order to effectively manage an outbreak. Here, we relate individual risk perception to the adoption of a specific set of control measures, as obtained from an extensive large-scale survey performed via Facebook—involving more than 500,000 respondents from 64 countries—showing that there is a “one-to-one” relationship between perceived epidemic risk and compliance with a set of mitigation rules. We then develop a mathematical model for the spreading of a disease—sharing epidemiological features with COVID-19—that explicitly takes into account non-compliant individual behaviors and evaluates the impact of a population fraction of infectious risk-deniers on the epidemic dynamics. Our modeling study grounds on a wide set of structures, including both synthetic and more than 180 real-world contact patterns, to evaluate, in realistic scenarios, how network features typical of human interaction patterns impact the spread of a disease. In both synthetic and real contact patterns we find that epidemic spreading is hindered for decreasing population fractions of risk-denier individuals. From empirical contact patterns we demonstrate that connectivity heterogeneity and group structure significantly affect the peak of hospitalized population: higher modularity and heterogeneity of social contacts are linked to lower peaks at a fixed fraction of risk-denier individuals while, at the same time, such features increase the relative impact on hospitalizations with respect to the case where everyone correctly perceive the risks.

An infodemic—an outpouring of information, including misleading and also fake news—is accompanying the current pandemic caused by SARS-CoV-2. In the absence of valid therapeutic approaches, behavioral responses may seriously affect the social dynamics of contagion, so the infodemic may cause confusion and disorientation in the public, leading to possible individually and socially harmful choices. This new phenomenon requires specific modeling efforts to better understand the complex intertwining of the epidemic and infodemic components of a pandemic crisis, with a view to building an integrative public health approach. We propose three models, from epidemiology to game theory, as potential candidates for the onset of the infodemics and statistically assess their accuracy in reproducing real infodemic waves observed in a data set of 390 million tweets collected worldwide. Our results show that evolutionary game-theory models are the most suitable ones to reproduce the observed infodemic modulations around the onset of the local epidemic wave. Furthermore, we find that the number of confirmed COVID-19 reported cases in each country and worldwide are driving the modeling dynamics with opposite effects.

The infection caused by SARS-CoV-2, responsible for the COVID-19 pandemic, is characterized by an infectious period with either asymptomatic or pre-symptomatic phases, leading to a rapid surge of mild and severe cases putting national health systems under serious stress. To avoid their collapse, and in the absence of pharmacological treatments, during the early pandemic phase countries worldwide were forced to adopt strategies, from elimination to mitigation, based on non-pharmacological interventions which, in turn, overloaded social, educational and economic systems. To date, the heterogeneity and incompleteness of data sources does not allow to quantify the multifaceted impact of the pandemic at country level and, consequently, to compare the effectiveness of country responses. Here, we tackle this challenge from a complex systems perspective, proposing a model to evaluate the impact of systemic failures in response to the pandemic shock. We use health, behavioral and economic indicators for 44 countries to build a shock index quantifying responses in terms of robustness and resilience, highlighting the crucial advantage of proactive policy and decision making styles over reactive ones.

Online platforms play a relevant role in creation and diffusion of false or misleading news. Concerningly, the COVID-19 pandemic is shaping a communication network - barely considered in the literature - which reflects the emergence of collective attention towards a topic that rapidly gained universal interest. Here, we characterize the dynamics of this network on Twitter, analyzing how unreliable content distributes among its users. We find that a minority of accounts is responsible for the majority of the misinformation circulating online, and identify two categories of users: a few active ones, playing the role of "creators", and a majority playing the role of "consumers". The relative proportion of these groups (≈14% creators - 86% consumers) appears stable over time: Consumers are mostly exposed to the opinions of a vocal minority of creators, that could be mistakenly understood as of representative of the majority of users. The corresponding pressure from a perceived majority is identified as a potential driver of the ongoing COVID-19 infodemic.

The public health research agenda for infodemic management has five workstreams: (1) measuring and continuously monitoring the impact of infodemics during health emergencies; (2) detecting signals and understanding the spread and risk of infodemics; (3) responding and deploying interventions that mitigate and protect against infodemics and their harmful effects; (4) evaluating infodemic interventions and strengthening the resilience of individuals and communities to infodemics; and (5) promoting the development, adaptation, and application of interventions and toolkits for infodemic management. Each workstream identifies research questions and highlights 49 high priority research questions.

As COVID-19 spreads worldwide, an infodemic – i.e., an over-abundance of information, reliable or not – spreads across the physical and the digital worlds, triggering behavioral responses which cause public health concern. We study 200 million interactions captured from Twitter during the early stage of the pandemic, from January to April 2020, to understand its socio-informational structure on a global scale. The COVID-19 global communication network is characterized by knowledge groups, hierarchically organized in sub-groups with well-defined geo-political and ideological characteristics. Communication is mostly segregated within groups and driven by a small number of subjects: 0.1% of users account for up to 45% and 10% of activities and news shared, respectively, centralizing the information flow. Contradicting the idea that digital social media favor active participation and co-creation of online content, our results imply that public health policy strategies to counter the effects of the infodemic must not only focus on information content, but also on the social articulation of its diffusion mechanisms, as a given community tends to be relatively impermeable to news generated by non-aligned sources.

With hindsight, the main weakness behind the ineffective response to the coronavirus disease 2019 (COVID-19) pandemic in some countries has been the failure to understand, and take account of, the multilayered systemic interdependencies that spread the effects of the pandemic across social, technological, economic and health-care dimensions. For example, to respond to the COVID-19 pandemic, all people were required to rapidly adjust to social distancing and travel restrictions. Such a complex behavioural response entails adaptation to achieve a full recovery from the systemic shock. To capitalize on the positive effects of disruption to the status quo, much more complex socioeconomic modelling needs to be considered when designing and evaluating possible public health interventions that have major behavioural implications. We provide a simple example of how this reasoning may highlight generally unacknowledged connections and interdependencies and guide the construction of scenarios that can inform policy decisions to enhance the resilience of society and tackle existing societal challenges.

During COVID-19, governments and the public are fighting not only a pandemic but also a co-evolving infodemic—the rapid and far-reaching spread of information of questionable quality. We analysed more than 100 million Twitter messages posted worldwide during the early stages of epidemic spread across countries (from 22 January to 10 March 2020) and classified the reliability of the news being circulated. We developed an Infodemic Risk Index to capture the magnitude of exposure to unreliable news across countries. We found that measurable waves of potentially unreliable information preceded the rise of COVID-19 infections, exposing entire countries to falsehoods that pose a serious threat to public health. As infections started to rise, reliable information quickly became more dominant, and Twitter content shifted towards more credible informational sources. Infodemic early-warning signals provide important cues for misinformation mitigation by means of adequate communication strategies.

The analysis team distilled the suggestions into a set of 50 proposed actions for a framework for managing infodemics in health emergencies. The consultation revealed six policy implications to consider. First, interventions and messages must be based on science and evidence, and must reach citizens and enable them to make informed decisions on how to protect themselves and their communities in a health emergency. Second, knowledge should be translated into actionable behavior-change messages, presented in ways that are understood by and accessible to all individuals in all parts of all societies. Third, governments should reach out to key communities to ensure their concerns and information needs are understood, tailoring advice and messages to address the audiences they represent. Fourth, to strengthen the analysis and amplification of information impact, strategic partnerships should be formed across all sectors, including but not limited to the social media and technology sectors, academia, and civil society. Fifth, health authorities should ensure that these actions are informed by reliable information that helps them understand the circulating narratives and changes in the flow of information, questions, and misinformation in communities. Sixth, following experiences to date in responding to the COVID-19 infodemic and the lessons from other disease outbreaks, infodemic management approaches should be further developed to support preparedness and response, and to inform risk mitigation, and be enhanced through data science and sociobehavioral and other research.