COVID-19 Infectious Diseases Research Articles

Impact of Job Insecurity due to COVID-19 on the Psychological Wellbeing and Resiliency of Food Delivery Personnel

This study examines when and why job insecurity due to COVID-19 leads to decreased well-being in hotel (restaurant) delivery personnel. It also examines resiliency as a moderator between job insecurity and employee anxiety. Data was collected in time lags from 253 respondents of food delivery personnel in hotel restaurants. The findings suggest that job insecurity due to COVID-19 decreased an employee’s well-being via financial stress. Moreover, resiliency played a buffering role in mitigating the damaging impact of job insecurity on fanatical stress. Theoretical and practical implications are included in this paper. COVID-19 is considered as most devastating and fatal diseases of this century since it is negatively impacting many industries, including hotels and restaurants. While some researchers have reflected upon the nature of this disease, the arrival of possible vaccine and economic outcomes, the employees’ psychological outcomes are largely ignored areas of research. Hence, this study attempts to fill this gap by adding relevant knowledge to the field. This study contributes to literature in various ways. Firstly, this study proposes and measures employees’ job insecurity due to infectious disease COVID-19 in hotels. Secondly, anxiety is measured as a mechanism to explain the relationship between perceived job insecurity and employees’ psychological well-being.Thirdly, this study proposes and empirically tests the factors which may decrease employees’ well-being during the outbreak of a COVID-19 pandemic. Fourthly, this study examines employees’ personality trait of resiliency as a buffering factor between job insecurity and employee anxiety. Finally, this research validates the conservation of resources theory in terms of external stressor and personal resource in the form of resiliency. Hence this study is a timely response against the current coronavirus pandemic to expand the scope in domain of mental health specifically among hotel employees to provide insights to practitioners. The objective of this paper is to examine the impact of job insecurity on mental health of hotel employees and to recommend a few avenues for practitioners to mitigate its devastating effects.

Immunity to glycan α-Gal and possibilities for the control of COVID-19.

This initiative is based on research that has been funded by the Consejeria de Educacion, Cultura y Deportes, JCCM, Spain, project ´ CCM17-PIC-036 (SBPLY/17/180501/000185)

Interventions with Positive Side-Effects: Covid-19 Non-Pharmaceutical Interventions and Infectious Diseases in Europe

To assess the efficacy of Covid-19 non-pharmaceutical interventions (NPIs) on infectious disease containment in Europe, we first use weekly 2015-20 data on the spread of influenza and respiratory syncytial virus (RSV) to compare the 2019-20 season of these diseases with the previous five. Although the magnitude of results differs between countries, we document much stronger end-of-season declines in infections in the most recent outbreak than in the earlier ones, implying that they may be driven by NPIs implemented in 2020 to combat Covid-19. To test this conjecture, we use detailed country-specific weekly information on Covid-19 NPIs to estimate several panel models that relate NPI implementation to disease incidence across countries. Not only do certain measures significantly reduce the spread of Covid-19, they also curtail the spread of influenza and RSV. Nonetheless, although we identify workplace closures as a particularly effective measure, we find no evidence for the efficacy of other NPIs such as travel restrictions.

Режим надзвичайного стану під час пандемії: механізм правового регулювання як гарантія забезпечення дотримання принципу верховенства права

Введення надзвичайних режимів, зокрема режиму надзвичайного стану, завжди супроводжується обмеженням прав і свобод людини. Обсяг і глибина таких обмежень безпосередньо залежать від тяжкості надзвичайних ситуацій техногенного або природного характеру та рішень, що приймаються публічною владою. Невід’ємною умовою введення та адміністрування надзвичайних режимів має бути додержання принципу верховенства права.
 Метою статті є аналіз норм національного законодавства, що регулює правовідносини, які виникають у зв’язку із уведенням надзвичайних адміністративно-правових режимів, зокрема режиму надзвичайного стану під час пандемії, та визначення правового механізму, що є гарантією додержання принципу верховенства права у відносинах між державою та громадянином.
 Наукова новизна дослідження полягає в аналізі національного законодавства на предмет наявності запобіжників, що обмежують дискрецію публічної влади та забезпечують додержання верховенства права у відносинах держави й людини у разі введення режиму надзвичайного стану у зв’язку з пандемією інфекційної хвороби COVID-19.
 Висновки. Аналіз національного законодавства, що регулює правовідносини, які виникають під час та у зв’язку із введенням надзвичайних режимів, зокрема режиму надзвичайного стану, свідчить про наявність у механізмі правового регулювання запобіжників, що певним чином обмежують дискрецію суб’єкта владних повноважень (Президента України), серед яких: 1) установлення конкретного терміну, на який може бути введено та продовжено режим надзвичайного стану; 2) певним чином (хоча й формально) законодавством обмежено повноваження Президента України з визначення переліку і глибини обмежень прав і свобод у зв’язку з уведенням режиму надзвичайного стану; 3) повноваження щодо затвердження рішень Президента України про введення надзвичайних режимів віднесено до повноважень окремої гілки влади (законодавчої влади).
 Зазначене забезпечує здійснення парламентського контролю за доцільністю та обґрунтованістю рішень Президента України щодо введення та продовження дії надзвичайних режимів, в тому числі щодо відповідності переліку, обсягу та глибини обмежень прав і свобод громадян, які планується застосувати, тяжкості надзвичайної ситуації, що є підставою для введення такого режиму.
 Вищевказані запобіжники становлять правовий механізм реалізації принципу верховенства права та, відповідно, є гарантією додержання прав і свобод людини у разі введення режиму надзвичайного стану.

National Sample Vital Registration System: A sustainable platform for COVID-19 and other infectious diseases surveillance in low and middle-income countries.

National Sample Vital Registration System: A sustainable platform for COVID-19 and other infectious diseases surveillance in low and middle-income countries.

COVID-19 Incidence in Europe: Drivers and Government Interventions

"This study aims to identify the determinant country-level factors that impact the trend of registered death cases from the recently emerged infectious disease COVID-19, analyzing data from March 2020 to July 2020, for 40 European countries. We use four categories of indicators covering major areas of influence: health, demographic, economic, and societal/cultural indicators. We reduce the dimensionality of the data to three latent factors by applying a Principal Component Analysis method, and we employ a multiple linear regression model to estimate the effects of these factors on the trend of death rates. The main result of the study is that a decreasing trend of death cases is the effect of a functional and citizen-oriented state, and is not only impacted by characteristics of the medical system or by individual features. Our findings also suggest that the premises for a low mortality rate are built by policies that have effects in the long- and medium-term. These policies refer to economic growth, sustainable development, healthcare, and the creation of a stable political system and an efficient administration."

Synergism of TNF-α and IFN-γ Triggers Inflammatory Cell Death, Tissue Damage, and Mortality in SARS-CoV-2 Infection and Cytokine Shock Syndromes

COVID-19 is characterized by excessive production of pro-inflammatory cytokines and acute lung damage associated with patient mortality. While multiple inflammatory cytokines are produced by innate immune cells during SARS-CoV-2 infection, we found that only the combination of TNF-α and IFN-γ induced inflammatory cell death characterized by inflammatory cell death, PANoptosis. Mechanistically, TNF-α and IFN-γ co-treatment activated the JAK/STAT1/IRF1 axis, inducing nitric oxide production and driving caspase-8/FADD-mediated PANoptosis. TNF-α and IFN-γ caused a lethal cytokine shock in mice that mirrors the tissue damage and inflammation of COVID-19, and inhibiting PANoptosis protected mice from this pathology and death. Furthermore, treating with neutralizing antibodies against TNF-α and IFN-γ protected mice from mortality during SARS-CoV-2 infection, sepsis, hemophagocytic lymphohistiocytosis, and cytokine shock. Collectively, our findings suggest that blocking the cytokine-mediated inflammatory cell death signaling pathway identified here may benefit patients with COVID-19 or other infectious and autoinflammatory diseases by limiting tissue damage/inflammation.

Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review.

The objective of our systematic review is to identify prognostic factors that may be used in decision-making related to the care of patients infected with COVID-19. We conducted highly sensitive searches in PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL) and Embase. The searches covered the period from the inception date of each database until April 28, 2020. No study design, publication status or language restriction were applied. We included studies that assessed patients with confirmed or suspected SARS-CoV-2 infectious disease and examined one or more prognostic factors for mortality or disease severity. Reviewers working in pairs independently screened studies for eligibility, extracted data and assessed the risk of bias. We performed meta-analyses and used GRADE to assess the certainty of the evidence for each prognostic factor and outcome. We included 207 studies and found high or moderate certainty that the following 49 variables provide valuable prognostic information on mortality and/or severe disease in patients with COVID-19 infectious disease: Demographic factors (age, male sex, smoking), patient history factors (comorbidities, cerebrovascular disease, chronic obstructive pulmonary disease, chronic kidney disease, cardiovascular disease, cardiac arrhythmia, arterial hypertension, diabetes, dementia, cancer and dyslipidemia), physical examination factors (respiratory failure, low blood pressure, hypoxemia, tachycardia, dyspnea, anorexia, tachypnea, haemoptysis, abdominal pain, fatigue, fever and myalgia or arthralgia), laboratory factors (high blood procalcitonin, myocardial injury markers, high blood White Blood Cell count (WBC), high blood lactate, low blood platelet count, plasma creatinine increase, high blood D-dimer, high blood lactate dehydrogenase (LDH), high blood C-reactive protein (CRP), decrease in lymphocyte count, high blood aspartate aminotransferase (AST), decrease in blood albumin, high blood interleukin-6 (IL-6), high blood neutrophil count, high blood B-type natriuretic peptide (BNP), high blood urea nitrogen (BUN), high blood creatine kinase (CK), high blood bilirubin and high erythrocyte sedimentation rate (ESR)), radiological factors (consolidative infiltrate and pleural effusion) and high SOFA score (sequential organ failure assessment score). Identified prognostic factors can help clinicians and policy makers in tailoring management strategies for patients with COVID-19 infectious disease while researchers can utilise our findings to develop multivariable prognostic models that could eventually facilitate decision-making and improve patient important outcomes. Prospero registration number: CRD42020178802. Protocol available at: https://www.medrxiv.org/content/10.1101/2020.04.08.20056598v1.

COVID-19 classification by CCSHNet with deep fusion using transfer learning and discriminant correlation analysis

Aim: COVID-19 is a disease caused by a new strain of coronavirus. Up to 18th October 2020, worldwide there have been 39.6 million confirmed cases resulting in more than 1.1 million deaths. To improve diagnosis, we aimed to design and develop a novel advanced AI system for COVID-19 classification based on chest CT (CCT) images. Methods: Our dataset from local hospitals consisted of 284 COVID-19 images, 281 community-acquired pneumonia images, 293 secondary pulmonary tuberculosis images; and 306 healthy control images. We first used pretrained models (PTMs) to learn features, and proposed a novel (L, 2) transfer feature learning algorithm to extract features, with a hyperparameter of number of layers to be removed (NLR, symbolized as L). Second, we proposed a selection algorithm of pretrained network for fusion to determine the best two models characterized by PTM and NLR. Third, deep CCT fusion by discriminant correlation analysis was proposed to help fuse the two features from the two models. Micro-averaged (MA) F1 score was used as the measuring indicator. The final determined model was named CCSHNet. Results: On the test set, CCSHNet achieved sensitivities of four classes of 95.61%, 96.25%, 98.30%, and 97.86%, respectively. The precision values of four classes were 97.32%, 96.42%, 96.99%, and 97.38%, respectively. The F1 scores of four classes were 96.46%, 96.33%, 97.64%, and 97.62%, respectively. The MA F1 score was 97.04%. In addition, CCSHNet outperformed 12 state-of-the-art COVID-19 detection methods. Conclusions: CCSHNet is effective in detecting COVID-19 and other lung infectious diseases using first-line clinical imaging and can therefore assist radiologists in making accurate diagnoses based on CCTs.

Electrocardiographic Findings and Clinical Outcome in Patients with COVID-19 or Other Acute Infectious Respiratory Diseases.

Background. Cardiac involvement in coronavirus SARS-CoV-2 infection (COVID-19) has been reported in a sizeable proportion of patients and associated with a negative outcome; furthermore, a pre-existing heart disease is associated with increased mortality in these patients. In this prospective single-center case-control study we investigated whether COVID-19 patients present different rates and clinical implications of an abnormal electrocardiogram (ECG) compared to patients with an acute infectious respiratory disease (AIRD) caused by other pathogens. Methods. We studied 556 consecutive patients admitted to the emergency department of our hospital with symptoms of AIRD; 324 were diagnosed to have COVID-19 and 232 other causes of AIRD (no-COVID-19 group). Standard 12-lead ECG performed on admission was assessed for various kinds of abnormalities, including ST segment/T wave changes, atrial fibrillation, ventricular arrhythmias, and intraventricular conduction disorders. Results. ECG abnormalities were found in 120 (37.0%) and 101 (43.5%) COVID-19 and no-COVID-19 groups, respectively (p = 0.13). No differences in ECG abnormalities were found between the 2 groups after adjustment for clinical and laboratory variables. During a follow-up of 45 ± 16 days, 51 deaths (15.7%) occurred in the COVID-19 and 30 (12.9%) in the no-COVID-19 groups (p = 0.39). ST segment depression ≥ 0.5 mm (p = 0.016), QRS duration (p = 0.016) and presence of any ECG abnormality (p = 0.027) were independently associated with mortality at multivariable Cox regression analysis. Conclusion. Among patients hospitalized because of AIRD, we found no significant differences in abnormal ECG findings between COVID-19 vs. no-COVID-19 patients. The ECG on admission was helpful to identify patients with increased risk of death in both groups of patients.

A Study on Foods That Boost The Immune System During The Covid-19 Pandemic

The coronavirus (COVID-19) has spread rapidly across the world and been declared a pandemic by the World Health Organization. One of the ways to combat COVID-19 and other infectious diseases is to boost the immune system. It is, therefore, of utmost importance to eat well and consume foods that boost the immune system. This study investigated the effect of Nigella sativa (black seed) oil, silverberry, date, grape, Asphodelus aestivus, Rheum ribes, and carob on the immune system. There is no cure yet for Covid-19. However, scientists and healthcare professionals recommend that people eat foods that are rich in vitamins and minerals to bolster their immune system to fight COVID-19 because immunodeficiency is the Achilles' heel of Covid-19 pandemic

Initial whole-genome sequencing and analysis of the host genetic contribution to COVID-19 severity and susceptibility

The COVID-19 pandemic has accounted for millions of infections and hundreds of thousand deaths worldwide in a short-time period. The patients demonstrate a great diversity in clinical and laboratory manifestations and disease severity. Nonetheless, little is known about the host genetic contribution to the observed interindividual phenotypic variability. Here, we report the first host genetic study in the Chinese population by deeply sequencing and analyzing 332 COVID-19 patients categorized by varying levels of severity from the Shenzhen Third People’s Hospital. Upon a total of 22.2 million genetic variants, we conducted both single-variant and gene-based association tests among five severity groups including asymptomatic, mild, moderate, severe, and critical ill patients after the correction of potential confounding factors. Pedigree analysis suggested a potential monogenic effect of loss of function variants in GOLGA3 and DPP7 for critically ill and asymptomatic disease demonstration. Genome-wide association study suggests the most significant gene locus associated with severity were located in TMEM189–UBE2V1 that involved in the IL-1 signaling pathway. The p.Val197Met missense variant that affects the stability of the TMPRSS2 protein displays a decreasing allele frequency among the severe patients compared to the mild and the general population. We identified that the HLA-A*11:01, B*51:01, and C*14:02 alleles significantly predispose the worst outcome of the patients. This initial genomic study of Chinese patients provides genetic insights into the phenotypic difference among the COVID-19 patient groups and highlighted genes and variants that may help guide targeted efforts in containing the outbreak. Limitations and advantages of the study were also reviewed to guide future international efforts on elucidating the genetic architecture of host–pathogen interaction for COVID-19 and other infectious and complex diseases.

1+1 > 2: Integration of the Host-directed Traditional Chinese Medicine and the Virus-targeted Modern Medicine in Control of COVID-19

The COVID-19 pandemic has caused millions of infections and hundreds of thousands deaths in the world. The pandemic is still ongoing and no specific antivirals have been found to control COVID-19. The integration of Traditional Chinese Medicine with supportive measures of Modern Medicine has reportedly played an important role in the control of COVID-19 in China. This review summarizes the evidence of TCM in the treatment of COVID-19 and discusses the plausible mechanism of TCM in control of COVID-19 and other viral infectious diseases.

Viral kinetics of SARS-CoV-2 over the preclinical, clinical, and postclinical period

BackgroundIt is necessary to know the viral kinetics and conduct epidemiological investigations of confirmers to prevent the spread of the new infectious disease COVID-19 to the community. To date, no study has been published on viral kinetics during the preclinical and clinical periods of SARS-CoV-2. MethodsA confirmed case was defined as a patient with positive results by real-time reverse transcription polymerase chain reaction (RT-PCR) assay for SARS-CoV-2. Both specimen types were collected over the whole clinical course in all patients. Asymptomatic patients who had been screened for COVID-19 due to a strong epidemiological link were also enrolled. The study population included 54 hospitalized patients with confirmed COVID-19. ResultsCOVID-19 shows a very high viral load on the day of symptom development, which then decreases overall. Rapid viral proliferation was observed 0–5 days before symptoms developed. Cycle threshold (Ct) value was the lowest in the clinical course from 5 days before symptoms to 10 days after symptoms occurred (Ct < 30). The rRT-PCR results were negative approximately 3 weeks after the onset of symptoms. However, there was a continuous pattern that was negative and positive for up to 6 weeks and more. ConclusionConsidering the characteristic that COVID-19 has a high viral load before symptoms appear, it is necessary to consider to expand the scope of epidemiological investigations. As there is a very low possibility of transmission after 10 days of symptom occurrence, it may be considered to release isolation after 10 days of symptom occurrence in limited resource situations. This study allows for the planning of epidemiological investigations, patient's ward supply, and follow-up of patients through sequential changes in viral loads over the entire clinical course. In addition, it is possible to estimate the clinical time at which the patient is present.

Computational strategies to combat COVID-19: useful tools to accelerate SARS-CoV-2 and coronavirus research.

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is a novel virus of the family Coronaviridae. The virus causes the infectious disease COVID-19. The biology of coronaviruses has been studied for many years. However, bioinformatics tools designed explicitly for SARS-CoV-2 have only recently been developed as a rapid reaction to the need for fast detection, understanding and treatment of COVID-19. To control the ongoing COVID-19 pandemic, it is of utmost importance to get insight into the evolution and pathogenesis of the virus. In this review, we cover bioinformatics workflows and tools for the routine detection of SARS-CoV-2 infection, the reliable analysis of sequencing data, the tracking of the COVID-19 pandemic and evaluation of containment measures, the study of coronavirus evolution, the discovery of potential drug targets and development of therapeutic strategies. For each tool, we briefly describe its use case and how it advances research specifically for SARS-CoV-2. All tools are free to use and available online, either through web applications or public code repositories. Contact:evbc@unj-jena.de

COVID-19 Salgını ve Bulaşıcı Hastalıkların Yarattığı Küresel Krizlerle Mücadelede Uluslararası Hukuk

The COVID-19 pandemic, which emerged in late 2019, continues to unsettle the entire world. Along with the losses of many lives, the pandemic caused maybe one of the most devastating damage in the last century on many fields such as healthcare, economy, trade, and tourism. The rapid contagion of the pandemic has brought into question the roles of the international institutions, primarily the World Health Organization (WHO), which are expected to build a ground for the global cooperation and coordination. The purpose of this article is to provide an assessment of the institutional mechanisms and instruments in international law for combatting the global crises caused by the COVID-19 pandemic and infectious diseases. In the first chapter, WHO’s structure and regulations are explained, and particularly the International Health Regulations (2005) are examined in detail. In the second chapter, the functionality of the WHO system during the COVID-19 pandemic is evaluated, and some solutions for the current deficiencies of the system are proposed. In the final chapter, the direct relation between the global crises caused by the COVID-19 pandemic and infectious diseases and the roles played by global governance systems in the fields of international human rights law, international trade law, and international collective security system are examined. In conclusion of this article, the significance of international law for effectively solving global problems such as pandemics is emphasized.

Physical Activity, Immune Function and Risk of Community Acquired Infectious Disease in the General Population: Systematic Review and Meta-Analysis

Background: Regular physical activity is prime modality for the prevention of numerous non-communicable diseases and has also been advocated for resilience against COVID-19 and other infectious diseases. However, there is currently no systematic and quantitative evidence synthesis of the association between habitual physical activity and the strength of human immune system. Methods: We conducted systemic review and meta-analysis according to PRISMA guidelines and following a pre-registered protocol (PROSPERO CRD42020178825 ). We searched seven databases (MEDLINE, Embase, Cochrane CENTRAL, Web of Science, CINAHL, PsycINFO, and SportDiscus) up to April 2020 for randomised control trials and prospective observational studies were included if they compared groups of adults with different levels of physical activity and reported immune system cell count, concentration of antibody, risk of clinically diagnosed infections, risk of hospitalisation and mortality due to infectious disease. Studies involving elite athletes were excluded. The quality of the selected studies was critically examined following the Cochrane guidelines using ROB2 and ROBINS_E. Data were pooled using a random-effects model. Findings: A total of 16833 abstract were screened to identify 55 studies including seven prospective studies and 48 randomised control trials. The meta-analysis showed that higher level of habitual physical activity is associated with a 31% risk reduction (HR= 0.69 CI [0.61 – 0.78]) of community acquired infectious disease and 37% risk reduction (HR= 0.64 CI [0.59 – 0.70]) of infectious disease mortality. Randomised control trials showed that physical activity interventions resulted in increased immunosurveillance cell counts (CD4+, 32 cells/µL, 95% CI 7 to 56 cells/µL), increased immunoglobulin IgA concentration (standardised mean difference 0.311, 95% CI 0.131 to 0.484) and decreased neutrophil counts (704 cells/µL, 95% CI 68 to 1340) compared to inactive controls. Physical activity increased antibody concentration after vaccination compared to vaccination without adjunct physical activity (standardised mean difference 0.210, 95% CI 0.015 to 0.406). Results differed between healthy adults, obese adults, clinical population and older adults. There appear to be no moderating effects of physical activity volume, intensity or type.Interpretation: The practice of any type of regular, moderate to vigorous physical activity appears to be associated with enhanced immunosurveillance and mucosal immune responses. This is likely to explain the significant risk reduction of community acquired infectious diseases and infectious disease mortality, as well as an increase in the potency of vaccination.Funding Statement: None.Declaration of Interests: None.

Outbreak, Prevalence and Mortality of Severe Acute Respiratory Syndrome (SARS-CoV-2) Infections in Kerala- A Perspective Study

Severe acute respiratory syndrome (SARS-CoV-2) is the causative agent of infectious disease COVID-19. In India, since the first case reported in Kerala, on January 30, 2020, the outbreak has gradually spread nationwide. The epidemic effect of COVID-19 infection was carried out from January 30 to April 28, 2020 (90 days) across the state. Among the districts studied, Kasaragod and Kannur district exhibit the highest COVID-19 cases, whereas Alapuzha and Wyanad districts have the least number of positive cases. The new positive COVID-19 cases were reported exponentially after 45 days to 75 days. There was a decline in the number across the state. As of April 28, 2020, the number of positive cases was 485, recovered cases were 356, active cases were 123, and the fatal cases were 3. Among gender, male individuals are more susceptible to COVID-19 infection than female individuals. The number of newly diagnosed patients has been declining, and the epidemic is gradually being controlled.

Estimating the severity of COVID-19: Evidence from the Italian epicenter.

We provide results on the level of COVID-19 excess mortality in the Italian region of Lombardy and in the province of Bergamo using official and original data sources. Since February 2020 Lombardy and in particular the province of Bergamo have been severely hit by the novel COVID-19 infectious disease. Combining official statistics, retrospective data and original data (i.e., obituaries and death notices) we provide a tentative estimate of the number of deaths either directly or indirectly, associated with COVID-19 as well as the total number of persons infected. Our findings suggest that the reported number of deaths attributable to COVID-19 identified by public authorities accounts only for one half of the observed excess mortality between March 2020 and previous years.

Low voice pitch in orally delivered recommendations can increase compliance with hand sanitizer use among young adults

Oral communications delivered in a low voice pitch are more persuasive and perceived as more pleasant and truthful than are communications delivered in a high pitch. The research reported in this article explored whether young adults’ compliance with an orally delivered recommendation to use hand sanitizer, an action thought to limit the spread of COVID-19 and other infectious diseases, would increase when the message was delivered in a low versus a high voice pitch. In an experiment involving 478 university students in Australia, a public health announcement delivered in a low voice pitch, compared with one delivered in a high voice pitch, increased participants’ sense of power, which increased their perceived behavioral control over their physical health and, in turn, increased their likelihood of using hand sanitizer. Because voice pitch is an aspect of health communications that can be modified easily at a low cost, the findings suggest a simple approach that public health and policy officials can adopt to improve hand hygiene in a population of people who spend a lot of time in close proximity and who should therefore practice hand hygiene routinely to protect themselves and others from infection.