Economic and social impacts of COVID-19 and public health measures: results from an anonymous online survey in Thailand, Malaysia, the United Kingdom, Italy and Slovenia

AbstractIn the absence of a vaccine and widely available treatments for COVID-19, governments have relied primarily on non-pharmaceutical interventions to curb the pandemic. To aid understanding of the impact of these public health measures on different social groups we conducted a mixed-methods study in five countries (‘SEBCOV - Social, ethical and behavioural aspects of COVID-19’). Here we report the results of the SEBCOV anonymous online survey of adults.Overall, 5,058 respondents from Thailand, Malaysia, the United Kingdom, Italy and Slovenia completed the self-administered survey between May and June 2020. Post-stratification weighting was applied, and associations between categorical variables assessed.Among the five countries, Thai respondents appeared to have been most, and Slovenian respondents least, affected economically. Overall, lower education levels, larger households, having children under 18 in the household, being 65 years or older and having flexible/no income were associated with worse economic impact. Regarding social impact, respondents expressed most concern about their social life, physical health, and mental health and wellbeing.There were large differences between countries in terms of voluntary behavioural change, and in compliance and agreement with COVID-19 restrictions. Overall, self-reported compliance was higher among respondents reporting a high understanding of COVID-19. UK respondents felt able to cope the longest and Thai respondents the shortest with only going out for essential needs or work, with 60% and 26% respectively able to cope with 29 days or longer. Many respondents reported seeing news that seemed fake to them, the proportion varying between countries, and with education level and self-reported levels of understanding of COVID-19.Our data showed that COVID-19 public health measures have uneven economic and social impacts on people from different countries and social groups. Understanding the factors associated with these impacts can help to inform future public health interventions and mitigate their negative consequences on people’s lives.SummaryWhat is already known?COVID-19 public health measures and lockdowns most negatively affect those who are socio-economically disadvantaged.Misinformation about COVID-19 is widespread.What are the new findings?In the countries in which we conducted our survey, lower education levels, larger households, having children under 18 in the household, being 65 years or older and having flexible/no income were associated with worse economic impact.There were large differences between countries in terms of voluntary change of behaviour, as well as compliance and agreement with COVID-19 related public health measures.Younger age and lower education levels appear to be associated with lower self-perceived levels of understanding of COVID-19.A significant proportion of the population received conflicting information and news that seemed fake to them, in particular about coronavirus being an engineered modified virus.What do the new findings imply?Our findings imply that there are significant differences in how people from different social groups and different countries experienced COVID-19 and related public health measures, and any support initiatives should take this into account.Our findings confirm that communication around COVID-19 could be improved, and help identify specific areas to target (e.g. origin of virus) and specific groups of people who may benefit most from improved communication (e.g. younger people, those with lower levels education).

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Influence of the COVID-19 epidemic on prevention and vaccination behaviors among Chinese children and adolescents: results from an online survey (Preprint)

10.2196/preprints.26372 ◽

2020 ◽

Author(s):

Zhiyuan Hou ◽

Suhang Song ◽

Fanxing Du ◽

Lu Shi ◽

Donglan Zhang ◽

...

Keyword(s):

Public Health ◽

Influenza Vaccine ◽

Children And Adolescents ◽

Online Survey ◽

Prevention Measures ◽

Cross Sectional ◽

Education Levels ◽

Lower Education ◽

Quota Sampling ◽

Chinese Children And Adolescents

BACKGROUND The COVID-19 epidemic and containment strategies may affect personal behaviors. OBJECTIVE To assess the change in children and adolescents’ prevention and vaccination behaviors amid China’s COVID-19 epidemic. METHODS We conducted a cross-sectional online survey in mid-March 2020 using proportional quota sampling in Wuhan (the epicenter) and Shanghai (a non-epicenter). Data were collected from 1,655 parents with children aged 3-17 years. Children and adolescents’ prevention and vaccination behaviors before and during the epidemic were assessed. RESULTS Parent-reported prevention behaviors increased among the children and adolescents, with 82.2% always wearing masks when going out and having increased the frequency and duration of handwashing and only 46.9% of children and adolescents going out during the COVID-19 epidemic. Meanwhile, 56.1% of the families took unproven measures against COVID-19. Parent-reported vaccination behaviors showed mixed results, with 74.8% delaying scheduled vaccines and 80.9% planning to have their children get the influenza vaccine after the epidemic. By socioeconomic status, those children and adolescents from larger families and whose parents having lower education levels were less likely to improve prevention behaviors but more likely to take unproven measures. Girls were less likely to always wear a mask when going out and wash hands than boys. CONCLUSIONS Prevention behaviors and attitudes toward influenza vaccine have been improved during the COVID-19 epidemic. Public health prevention measures should be continuously promoted, particularly among girls and the lower educated and larger families. Meanwhile, misinformation about COVID-19 remains a serious challenge and needs to be addressed by public health stakeholders.

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The impact of COVID-19 on the care of people living with noncommunicable diseases in low- and middle-income countries: an online survey of physicians and pharmacists in nine countries

Primary Health Care Research & Development ◽

10.1017/s146342362100030x ◽

2021 ◽

Vol 22 ◽

Author(s):

Chris Bullen ◽

Jessica McCormack ◽

Amanda Calder ◽

Varsha Parag ◽

Kannan Subramaniam ◽

...

Keyword(s):

Public Health ◽

Healthcare Workers ◽

Online Survey ◽

World Health ◽

Noncommunicable Diseases ◽

Middle Income ◽

Middle Income Countries ◽

Health Measures ◽

The Impact ◽

Low And Middle Income

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.

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The Infection Rate of the Coronavirus Disease 2019 (COVID-19) in Wuhan, China

10.1101/2020.05.02.20088724 ◽

2020 ◽

Cited By ~ 1

Author(s):

Hui-Qi Qu ◽

Zhangkai J. Cheng ◽

Zhifeng Duan ◽

Lifeng Tian ◽

Hakon Hakonarson

Keyword(s):

Public Health ◽

Health Policy ◽

Mortality Rate ◽

Infection Rate ◽

Infection Rates ◽

Policy And Practice ◽

Wuhan City ◽

Infected People ◽

Health Measures ◽

New Findings

Summary BoxWhat is already known about this subject?The Wuhan city in China had a much higher mortality rate (Feb 10th statistics: 748 death/18,454 diagnosis =4.05%; Apr 24th statistics: 3,869 death/50,333 diagnosis=7.69%) than the rest of China.What are the new findings?Based on our analysis, the number of infected people in Wuhan is estimated to be 143,000 (88,000 to 242,000) in late January and early February, significantly higher than the published number of diagnosed cases.What are the recommendations for policy and practice?Increased awareness of the original infection rates in Wuhan, China is critically important for proper public health measures at all levels, as well as to eliminate panic caused by overestimated mortality rate that may bias health policy actions by the authorities

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Building Back Better after COVID-19: a systematic scoping review of wicked problems affecting developed countries and implications for global governance

10.1101/2021.04.26.21256126 ◽

2021 ◽

Author(s):

Robin van Kessel ◽

Brian Li Han Wong

Keyword(s):

Public Health ◽

Demographic Change ◽

Scoping Review ◽

Wicked Problems ◽

Developed Countries ◽

Wicked Problem ◽

List Type ◽

Driving Mechanisms ◽

New Findings ◽

Complex Relationships

AbstractThe COVID-19 pandemic is a textbook example of a ‘wicked problem’, one which is complex, open-ended, unpredictable, or intractable and seems resistant to any solution. This presents a window of opportunity to explore other wicked problems and their implications after the pandemic. A systematic scoping review was conducted to investigate the COVID-19 aftermath and identify public health topics which may be of great significance in the years to come. Through the adoption of three megadrivers as fundamental drivers of change (globalisation, demographic change, and digitalisation), it narratively explored how different wicked problems – and the driving mechanisms which sustain them – persist. It further explored the implications of these public health topics on global (health) governance. While the wicked problems mapped in this article show a large variance in where their apparent roots lie, they share one factor in common: health. These wicked problems must be first and foremost addressed if we as a globalised world are to successfully and sustainably build back better from COVID-19.Summary BoxWhat is already known?-COVID-19 is a textbook example of a wicked problem; a problem that is complex, open-ended, unpredictable, or intractable and seems resistant to any solution;-Digitalisation, globalisation, and demographic change are seen as the three megadrivers of change and are theorised to create and sustain modern wicked problems;-The megadrivers respectively have complex relationships with health; this includes both positive and negative associations.What are the new findings?-A series of wicked problems exist in multiple domains of society that continue to obstruct the progress of the 2030 Agenda for Sustainable Development;-These wicked problems each have roots in the three megadrivers: digitalisation, globalisation, and demographic change;-There exists a complex interrelation between the megadrivers, wicked problems, and health.What do the new findings imply?-It currently remains unclear to what extent wicked problems and megadrivers respectively affect health outcomes; therefore, further research is indicated;-A ‘once in a generation’ opportunity has presented itself to build back better from the COVID-19 pandemic by addressing the existing wicked problems; therefore, governance mechanisms should follow and adapt accordingly;-Wicked problems have bidirectional implications for modern policy; this has created an environment for wicked problems to manifest and sustain themselves, which in turn produce further policies that sustain wicked problems.

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Risk Perception of COVID-19 Infection and Adherence to Preventive Measures among Adolescents and Young Adults

Children ◽

10.3390/children7120311 ◽

2020 ◽

Vol 7 (12) ◽

pp. 311

Author(s):

Xin Yu Yang ◽

Rui Ning Gong ◽

Samuel Sassine ◽

Maxime Morsa ◽

Alexandra Sonia Tchogna ◽

...

Keyword(s):

Public Health ◽

Young Adults ◽

Risk Perception ◽

Perceived Risk ◽

Online Survey ◽

Preventive Measures ◽

Adolescents And Young Adults ◽

Cross Sectional ◽

Community Partners ◽

Health Measures

To explore factors influencing adolescents and young adults’ (AYAs) risk perception of COVID-19 and adherence to public health measures, we conducted a cross-sectional online survey of AYAs (14–22 years old) from Quebec (Canada) recruited through school and community partners in April 2020 during the first wave of the COVID-19 pandemic. The study included 3037 participants (mean age = 17.7 years, 74.6% female). AYAs had higher mean (standard deviation (SD)) risk perception of COVID-19 for their relatives (8.2 (1.9)) than for themselves (5.6 (2.6)) (p < 0.001). Factors associated with higher risk perception included higher disease knowledge (adjusted odds ratio (aOR) 1.06, 95% CI 1.01–1.11), presence of chronic disease (aOR 2.31, 95%CI 1.82–2.93) and use of immunosuppressants (aOR 2.53, 95%CI 1.67–3.87). AYAs with a higher risk perception (aOR 1.06, 95%CI 1.02–1.10) those wishing to help flatten the disease curve (aOR 1.18, 95%CI 1.12–1.25) or to protect their family/friends (aOR 1.14, 95%CI 1.05–1.24) were more likely to engage in preventive behaviors. Self-perceived risk and desire to protect others were significantly associated with adherence to preventive measures among youth. These findings may help inform public health messaging to AYAs in the current and future pandemics.

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Perceptions of Covid-19 lockdowns and related public health measures in Austria: a longitudinal online survey

BMC Public Health ◽

10.1186/s12889-021-11476-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Agata Łaszewska ◽

Timea Helter ◽

Judit Simon

Keyword(s):

Public Health ◽

Online Survey ◽

Leisure Activities ◽

Well Being ◽

Chi Square ◽

Health Measures ◽

Extended Duration ◽

Negative Impacts ◽

The Impact ◽

Second Wave

Abstract Background Introducing national lockdown has been effective in containing Covid-19. However, several studies indicated negative impacts of lockdowns on the well-being and mental health of many people. In Austria, the first Covid-19-related lockdown was introduced on 16 March 2020 with most restrictions being lifted 1 month later. Seven months after that, in November 2020, the second full lockdown was implemented. The aim of this study was to compare the perceptions and experiences of the general population related to the first and second Covid-19 lockdowns in Austria. Methods Two waves of an online survey were conducted in May and December 2020 asking respondents about their concerns related to the Covid-19 illness, personal experiences of the lockdowns, perceptions of and compliance with imposed public health measures, and the impact of the Covid-19 pandemic on different aspects of life during the two lockdowns. Descriptive statistics including frequency analysis were used to compare respondents’ answers collected in the two waves of the survey. T-test and chi-square tests were used to test differences between the two lockdowns. Results Five hundred sixty participants were included in the first wave and a sub-sample of 134 participants in the second wave of data collection. During the second lockdown, study respondents were more concerned about their family members contracting Covid-19 when compared with the first lockdown. Compliance with public health measures was overall lower during the second lockdown, although it varied according to the type of the measure. Closure of schools was seen as the least essential restriction during the second lockdown, while wearing masks gained additional approval between the first and the second lockdown. Larger negative impacts of the Covid-19 pandemic on friendships, leisure activities, education and community were reported during the second lockdown. Conclusions The study found that the extended duration of the pandemic and recurring lockdowns restricting freedom of movement and social contacts appear to have caused significant disruptions to many areas of life. Furthermore, declining adherence to most public health measures over time raises a question about the effectiveness of future lockdown measures.

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COVID-19: Beliefs in misinformation in the Australian community

10.1101/2020.08.04.20168583 ◽

2020 ◽

Author(s):

Kristen Pickles ◽

Erin Cvejic ◽

Brooke Nickel ◽

Tessa Copp ◽

Carissa Bonner ◽

...

Keyword(s):

Public Health ◽

Online Survey ◽

Digital Health ◽

Herd Immunity ◽

Male Gender ◽

Communication Effectiveness ◽

Younger Age ◽

Public Health Authorities ◽

Lower Education ◽

At Home

Objectives: To investigate prevalence of beliefs in COVID-19 misinformation and examine whether demographic, psychosocial and cognitive factors are associated with these beliefs, and how they change over time. Study design: Prospective national longitudinal community online survey. Setting: Australian general public. Participants: Adults aged over 18 years (n=4362 baseline/Wave 1; n=1882 Wave 2; n=1369 Wave 3). Main outcome measure: COVID-19 misinformation beliefs. Results: Stronger agreement with misinformation beliefs was significantly associated with younger age, male gender, lower education, and primarily speaking a language other than English at home (all p<0.01). After controlling for these variables, misinformation beliefs were significantly associated (p<0.001) with lower digital health literacy, lower perceived threat of COVID-19, lower confidence in government, and lower trust in scientific institutions. The belief that the threat of COVID-19 is greatly exaggerated increased between Wave 1-2 (p=0.002), while belief that herd immunity benefits were being covered up decreased (p<0.001). Greatest support from a list of Australian Government identified myths was for those regarding hot temperatures killing the virus (22%) and Ibuprofen exacerbates COVID-19 (13%). Lower institutional trust and greater rejection of official government accounts were associated with greater support for COVID-19 myths after controlling for sociodemographic variables. Conclusion: These findings highlight important gaps in communication effectiveness. Stronger endorsement of misinformation was associated with male gender, younger age, lower education and language other than English spoken at home. Misinformation can undermine public health efforts. Public health authorities must urgently target groups identified in this study when countering misinformation and seek ways to enhance public trust of experts, governments, and institutions.

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COVID-19 Scientific Facts vs. Conspiracy Theories: Is Science Failing to Pass Its Message?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126343 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6343

Author(s):

Marios Constantinou ◽

Antonios Kagialis ◽

Maria Karekla

Keyword(s):

Public Health ◽

Social Factors ◽

Strong Predictor ◽

Psychological State ◽

Lower Income ◽

Conspiracy Theories ◽

Health Measures ◽

Conspiracy Beliefs ◽

Lower Education ◽

Scientific Facts

Science may be failing to convince a significant number of people about COVID-19 scientific facts and needed public health measures. Individual and social factors are behind believing conspiracy theories. Adults (N = 1001) were asked to rate their beliefs in various conspiracy theories circulating in social media, rate their psychological distress relating to COVID-19, rate their trust in science to solve COVID-19 problems, and rate their willingness to adhere to measures regarding social distancing and quarantine. The findings showed conspiracy theories are widely believed and related to lower age, lower education, living in less densely populated areas, and lower income. Stronger conspiracy theory beliefs predicted science mistrust and unwillingness to adhere to public health measures. Psychological state was a strong predictor of conspiracy beliefs. Recommendations, stemming from the findings, for reducing such beliefs and better serving public health are discussed.

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Attitudes, behaviours and barriers to public health measures for COVID-19: a survey to inform public health messaging

BMC Public Health ◽

10.1186/s12889-021-10790-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Raynell Lang ◽

Jamie L. Benham ◽

Omid Atabati ◽

Aidan Hollis ◽

Trevor Tombe ◽

...

Keyword(s):

Public Health ◽

Online Survey ◽

Public Support ◽

Contact Tracing ◽

Cross Sectional ◽

Public Places ◽

Targeted Interventions ◽

Health Measures ◽

Health Authorities ◽

Indoor Spaces

Abstract Background Public support of public health measures including physical distancing, masking, staying home while sick, avoiding crowded indoor spaces and contact tracing/exposure notification applications remains critical for reducing spread of COVID-19. The aim of our work was to understand current behaviours and attitudes towards public health measures as well as barriers individuals face in following public health measures. We also sought to identify attitudes persons have regarding a COVID-19 vaccine and reasons why they may not accept a vaccine. Methods A cross-sectional online survey was conducted in August 2020, in Alberta, Canada in persons 18 years and older. This survey evaluated current behaviours, barriers and attitudes towards public health measures and a COVID-19 vaccine. Cluster analysis was used to identify key patterns that summarize data variations among observations. Results Of the 60 total respondents, the majority of persons were always or often physically distancing (73%), masking (65%) and staying home while sick (67%). Bars/pubs/lounges or nightclubs were visited rarely or never by 63% of respondents. Persons identified staying home while sick to provide the highest benefit (83%) in reducing spread of COVID-19. There were a large proportion of persons who had not downloaded or used a contact tracing/exposure notification app (77%) and who would not receive a COVID-19 vaccine when available (20%) or were unsure (12%). Reporting health authorities as most trusted sources of health information was associated with greater percentage of potential uptake of vaccine but not related to contact tracing app download and use. Individuals with lower concern of getting and spreading COVID-19 showed the least uptake of public health measures except for avoiding public places such as bars. Lower concern regarding COVID-19 was also associated with more negative responses to taking a potential COVID-19 vaccine. Conclusion These results suggest informational frames and themes focusing on individual risks, highlighting concern for COVID-19 and targeting improving trust for health authorities may be most effective in increasing public health measures. With the ultimate goal of preventing spread of COVID-19, understanding persons’ attitudes towards both public health measures and a COVID-19 vaccine remains critical to addressing barriers and implementing targeted interventions and messaging to improve uptake.

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Changes in the Health of Adolescent Athletes: A Comparison of Health Measures Collected Before and During the CoVID-19 Pandemic

10.1101/2021.01.12.20248726 ◽

2021 ◽

Author(s):

Timothy A. McGuine ◽

Kevin Biese ◽

Scott J. Hetzel ◽

Labina Petrovska ◽

Stephanie Kliethermes ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Physical Activity ◽

Online Survey ◽

Depression Symptoms ◽

List Type ◽

Adolescent Athletes ◽

Symptoms Of Depression ◽

Health Measures

ABSTRACTContextIn the spring of 2020, schools closed to in-person teaching and sports were cancelled to control the transmission of CoVID-19. The changes that took place to the physical and mental health among young athletes during this time remain unknown, however.ObjectiveIdentify changes in the health (mental health, physical activity and quality of life) of athletes that occurred during the CoVID-19 pandemic.DesignCross sectional study.SettingSample recruited via social media.Patients or Other Participants3243 Wisconsin adolescent athletes (age=16.2±1.2 yrs., female=58% female) completed an online survey in May 2020 (DuringCoVID-19). Health measures for this cohort were compared with previously reported data for Wisconsin adolescent athletes (n=5231, age=15.7±1.2, 47% female) collected in 2016–2018 (PreCoVID-19).Main Outcome Measure(s)Demographic information included: sex, grade and sports played. Health assessments included the Patient Health Questionnaire-9 Item (PHQ-9) to identify depression symptoms, the Pediatric Functional Activity Brief Scale (PFABS) for physical activity, and the Pediatric Quality of Life Inventory 4.0 (PedsQL) for health related quality of life (HRQoL). Univariable comparisons of these variables between groups were made via t-tests or chi-square tests. Means and 95% confidence intervals (CI) for each group were estimated by survey weighted ANOVA models.RESULTSCompared to PreCoVID-19, a larger proportion of the During-CoVID-19 participants reported rates of moderate to severe levels of depression (9.7% vs 32.9%, p<0.001). During-CoVID-19 participants reported 50% lower (worse) PFABS scores (mean:12.2 [95%CI: 11.9, 12.5] vs 24.7 [24.5, 24.9] p<0.001) and lower (worse) PedsQL total scores compared to the PreCoVID-19 participants (78.4 [78.0, 78.8] vs. 90.9 [90.5, 91.3] p<0.001).CONCLUSIONSDuring the CoVID-19 pandemic, adolescent athletes reported increased symptoms of depression, decreased physical activity and decreased quality of life compared to adolescent athletes in previous years.Key pointsAdolescent athletes during CoVID-19 were three times more likely to report moderate to severe symptoms of depression compared to data collected prior to CoVID-19.Adolescent athletes during CoVID-19 reported significantly lower physical activity and quality of life scores compared to high school athletes prior to the CoVID-19 pandemicPost CoVID-19 policies should be implemented to improve the health of adolescent athletes in the US.

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