Background At a time when a highly contagious pandemic and global political and economic turmoil are intertwined, worldwide cooperation under the leadership of an international organization has become increasingly important. This study aimed to estimate the effect of COVID-19 on public confidence in the World Health Organization (WHO), which will serve as a reference for other international organizations regarding the maintenance of their credibility in crisis management and ability to play a greater role in global health governance. Methods We obtained individual data from the World Values Survey (WVS). A total of 44,775 participants aged 16 and older from 40 countries in six WHO regions were included in this study. The COVID-19 pandemic was used as a natural experiment. We obtained difference-in-differences (DID) estimates of the pandemic’s effects by exploiting temporal variation in the timing of COVID-19 exposure across participants interviewed from 2017 to 2020 together with the geographical variation in COVID-19 severity at the country level. Public confidence in the WHO was self-reported by the respondents. Results Among the participants, 28,087 (62.73%) reported having confidence in the WHO. The DID estimates showed that the COVID-19 pandemic could significantly decrease the likelihood of people reporting confidence in the WHO after controlling for multiple covariates (adjusted OR 0.54, 95% CI: 0.49–0.61), especially during the global outbreak (0.35, 0.24–0.50). The effect was found in both younger individuals (0.58, 0.51–0.66) and older adults (0.49, 0.38–0.63) and in both males (0.47, 0.40–0.55) and females (0.62, 0.53–0.72), with a vulnerability in males (adjusted P for interaction = 0.008). Conclusion Our findings are relevant regarding the impact of COVID-19 on people’s beliefs about social institutions of global standing, highlighting the need for the WHO and other international organizations to shoulder the responsibility of global development for the establishment and maintenance of public credibility in the face of emergencies, as well as the prevention of confidence crises.

BACKGROUND Doctors have become the focus of social attention, and trust in doctors is related to everyone's health. OBJECTIVE This study examined the association between Internet use behaviors, network information literacy, and trust in doctors. And to analyze the age heterogeneity of the relationship mentioned above and test the mediation role of subjective well-being (SWB). METHODS The data of this study are from the 2020 publicly released data of the Chinese Family Panel Studies (CFPS). This study used Multiple linear regression to test the association between Internet use behaviors, network information literacy, and trust in doctors. This study also analyzed the age heterogeneity of the relationship mentioned above and tested the mediation role of subjective well-being in such a path with the Karlson-Holm-Breen (KHB) method. RESULTS The results of the study found that Internet use including using mobile devices decreased trust in doctors among older adults and increased trust among young adults. SWB played a mediating role (contributing 24.12%, p =0.029) in the young adult sample and a suppressing role (contributing -24.48%, p =0.002) in the older adult sample. However, in mobile device users, improving network information literacy would increase trust in doctors for both older and young adults. SWB also played a mediating role in the young and older samples. CONCLUSIONS The findings contributed to the literature pool by revealing the potential difficulties of Internet function in older adults, and the importance of network information literacy. It highlighted the necessity to guide older people to use the Internet correctly in the Internet era and improve their trust in doctors by improving their network information literacy.

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