Lockdowns, or modern quarantines, involve the use of novel restrictive non-pharmaceutical interventions (NPIs) to suppress the transmission of COVID-19. In this paper, I aim to critically analyze the emerging history and philosophy of lockdowns, with an emphasis on the communication of health evidence and risk for informing policy decisions. I draw a distinction between evidence-based and modeling-based decision-making. I argue that using the normative framework of evidence-based medicine would have recommended against the use of lockdowns. I first review the World (...) Health Organization’s evidence-based pandemic preparedness plans for respiratory viruses. I then provide a very brief history of COVID-19 modeling, which was cited as justification for the use of lockdowns in the U.K., the U.S., and much of the world. I focus on the so-called Imperial College model designed by Neil Ferguson et al. as well as the so-called Oxford model designed by José Lourenço et al. I analyze the evidence-based pandemic response known as ‘mitigation’, and I compare it with Ferguson et al.’s experimental strategy known as ‘suppression’. I summarize the strengths and weaknesses of these strategies based on their diametric aims and each model’s parametric assumptions. Based on my critical analysis of the suppression strategy, I attempt to expose what has been called the ‘logic of lockdowns’, which Sunetra Gupta of the Oxford model group has suggested is flawed. Finally, I consider Trisha Greenhalgh’s objection to evidence-based policy based on the precautionary principle, and I attempt to offer a response. I conclude with a brief narrative review of the emerging randomized evidence on restrictive NPIs, which seems to support my claim that mitigation was the strategy that would have been recommended by evidence-based medicine. If this is true, then COVID-19 modeling may serve as an important reminder of the enduring lesson of evidence-based medicine: that one should always ‘Trust the Evidence!’ for better health policy. (shrink)

The pandemic of COVID-19 prompted several paradigm shifts throughout society, including in education. This study aimed to examine the relationships of students' engagement in online synchronous collaborative learning activities (OSCLA) with their self-efficacy (LSE), peer social support (LPSS), state of well-being (SWB), and level of academic performance (LAP). A total of 176 Filipino Grade 12 SHS students, 18 years old and older, from a private educational institution were purposively selected for this study. Data were generated using an online survey. Results (...) show that collaborative learning activities are frequently conducted (median = 4) in their synchronous online classes. It also revealed that their LSE is high (median = 4), their LPSS is high (median = 4), their LE is moderate (median = 3), their SWB is high (median = 4), and their LAP is high (median = 94.85). The results showed a statistically significant correlation of their LSE (r = 0.69, p 0.001) and LPSS with their OSCLA LE (r = 0.438, p 0.001). A statistically significant positive moderate correlation between LE and SWB (r = 0.536, p 0.001) was also found, however, no correlation was found between their OSCLA LE and LAP (r = 0.065, p = 0.393). Thus, the use of a well-designed OSCLA is strongly recommended as it positively impacts students' SWB but should be regularly reviewed for its effectiveness in sustaining improvement in the LAP of the students. (shrink)

An estimated 700,000 people in the United States have "long COVID," that is, symptoms of COVID-19 persisting beyond three weeks. COVID-19 and its long-term sequelae are strongly influenced by social determinants such as poverty and by structural inequalities such as racism and discrimination. Primary care providers are in a unique position to provide and coordinate care for vulnerable patients with long COVID. Policy measures should include strengthening primary care, optimizing data quality, and addressing the multiple nested domains of inequity.