ABSTRACT In response to the COVID-19 pandemic, public health communication campaigns have been targeted at reducing viral transmission, specifically among populations most vulnerable to infection and death from the virus (e.g. older adults). However, other individuals who have not been defined as vulnerable populations may also suffer from a decrease in health because of the measures aimed at reducing viral transmission, such as social distancing. To illuminate this issue, we investigate the role of social and media resources in complementing limited offline communication and supporting mental and physical health during this pandemic. We then suggest an alternative audience segmentation strategy based on social and media resources for public health interventions. Based on online survey data from 723 adults in South Korea, the regression analysis results indicated that individuals with lower levels of social resources suffered more during the pandemic. The cluster analysis results revealed that, contrary to the traditional definition of vulnerable populations, a cluster of younger people were unhealthier than a cluster of older people because of a lack of social resources. Clusters with different levels of ICT skills and uses for health-related activities also experienced the pandemic differently. These findings imply public health interventions should focus on social resources beyond the demographic factors to determine target audiences, and that they should take advantage of the target audiences’ media resources to encourage them to forge intimate connections with others and to engage in health-related activities.

Since the emergence of the first cases of SARS-CoV-2 infection in late 2019 and the declaration of a global pandemic in March 2020, the public health and economic impacts of the COVID-19 pandemic have been substantial. The impact of the pandemic is being felt around the world, and in its early stages, only a few countries were successful in limiting community transmission by early and proactive public health measures aimed at preventing importation and seeding of infection in their jurisdictions. As we collectively learned about this new pathogen and its transmission routes and patterns, most countries relied on public health measures based on previous experience of epidemics of respiratory pathogens with human-to-human transmission to mitigate the effects of COVID-19 infection. These measures included isolation and quarantine, stay-at-home orders, closure of nonessential businesses and schools, physical distancing, limiting social interactions, and enhanced respiratory hygiene, collectively known as nonpharmaceutical interventions (NPIs). These interventions were later supplemented by the recommendation and/or mandate that the public wear nonmedical masks with the aim of reducing transmission at the population level.1 As unintended consequences and the economic toll of public health restrictions continue to mount, a strategy to end this pandemic logically involves deploying effective and safe vaccines. There are several vaccines, mostly based on messenger RNA and nonreplicating viral vector technologies, now approved for use by regulatory authorities around the world. Because the rollout of vaccination campaigns around the world still depends on vaccine supply and available public health infrastructure, it is only natural to ask when we can roll back public health NPIs. Elsewhere in JAMA Network Open, Patel et al2 describe an agent-based mathematical modeling approach to simulate several scenarios of different vaccine effectiveness and vaccine coverage associated with maintaining or discontinuing NPIs within a large representative sample of a synthetic population (agents) of more than 1 million people in North Carolina. The population was further stratified by ethnicity/race and urban/suburban/rural settings based on census data. The model was parameterized to characterize the underlying transmission dynamics of SARS-CoV-2 infection and calibrated and validated against public health surveillance data in North Carolina. Vaccination was implemented in the model during 6 months by transitioning individuals into a recovered/immune state. The NPIs represented in the model included quarantine, school closures, social distancing, and mask wearing, which were modeled by implementing the reduction in transmission rates associated with these interventions over time. By generating the model’s projections of the number of infections, hospitalizations, and deaths during an 18-month period and comparing these outcomes for several scenarios, the authors found some interesting results. First, it is apparent that lifting NPIs while rolling out vaccinations was associated with a significant increase in the number of infections, hospitalizations, and deaths across the range of vaccine effectiveness and vaccine coverage assumptions. Second, achieving a higher vaccine coverage leads to a greater reduction in the number of infections, even with the relatively lower vaccine effectiveness in the absence of NPIs with a combination of 75% coverage and 50% efficacy, resulting in a greater risk reduction compared with 25% coverage and 90% efficacy. Third, the cumulative incidence of infections, hospitalizations, and deaths varied by ethnicity/race and place of residence across different scenarios, with African American persons and residents of rural areas faring the worst.2 + Related article

Vaccines, antivirals, and monoclonal antibodies (mAbs) represent three cornerstone strategies in modern infectious disease control. However, the development and deployment of these interventions for the same pathogens have raised questions about potential redundancy and resource prioritization. From a public health perspective, they all play distinct, complementary roles: vaccines serve as the first line of defense, preventing infection, reducing transmission, and mitigating disease severity at the population level. Antivirals are deployed after infection to inhibit viral replication, shorten illness duration, reduce complications, and protect high-risk individuals. Monoclonal antibodies offer both prophylactic and therapeutic benefits, particularly for vulnerable populations with inadequate vaccine responses or during outbreak scenarios requiring rapid protection. The concept of self-limiting infections further elucidates why some vaccines, antivirals and mAbs are not universally pursued for all viruses. Rather than being counterproductive, strategic investment in these therapeutic measures constitutes a layered, resilient approach to pandemic preparedness and endemic disease management. This Perspective argues that the evolving milieu of viral threats; including issues of vaccine escape, waning immunity, and variable host response necessitates an integrated strategy leveraging the strengths of both prophylactic and therapeutic measures. In this fight against infectious diseases, strategic synergy, not competition, must guide future public health policies.