Early perceptions and behavioural responses during the COVID-19 pandemic: a cross-sectional survey of UK adults

  1. Christina Atchison
  2. Leigh Robert Bowman
  3. Charlotte Vrinten
  4. Rozlyn Redd
  5. Philippa Pristerà
  6. Jeffrey Eaton
  7. Helen Ward

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Abstract

To examine risk perceptions and behavioural responses of the UK adult population during the early phase of the COVID-19 epidemic in the UK.

Design

A cross-sectional survey.

Setting

Conducted with a nationally representative sample of UK adults within 48 hours of the UK Government advising the public to stop non-essential contact with others and all unnecessary travel.

Participants

2108 adults living in the UK aged 18 years and over. Response rate was 84.3% (2108/2500). Data collected between 17 March and 18 March 2020.

Main outcome measures

Descriptive statistics for all survey questions, including number of respondents and weighted percentages. Robust Poisson regression used to identify sociodemographic variation in: (1) adoption of social distancing measures, (2) ability to work from home, and (3) ability and (4) willingness to self-isolate.

Results

Overall, 1992 (94.2%) respondents reported at least one preventive measure: 85.8% washed their hands with soap more frequently; 56.5% avoided crowded areas and 54.5% avoided social events. Adoption of social distancing measures was higher in those aged over 70 years compared with younger adults aged 18–34 years (adjusted relative risk/aRR: 1.2; 95% CI: 1.1 to 1.5). Those with lowest household income were three times less likely to be able to work from home (aRR: 0.33; 95% CI: 0.24 to 0.45) and less likely to be able to self-isolate (aRR: 0.92; 95% CI: 0.88 to 0.96). Ability to self-isolate was also lower in black and minority ethnic groups (aRR: 0.89; 95% CI: 0.79 to 1.0). Willingness to self-isolate was high across all respondents.

Conclusions

Ability to adopt and comply with certain non-pharmaceutical interventions (NPIs) is lower in the most economically disadvantaged in society. Governments must implement appropriate social and economic policies to mitigate this. By incorporating these differences in NPIs among socioeconomic subpopulations into mathematical models of COVID-19 transmission dynamics, our modelling of epidemic outcomes and response to COVID-19 can be improved.

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  1. Version published to 10.1136/bmjopen-2020-043577
  2. ScreenIT

    SciScore for 10.1101/2020.04.01.20050039: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data Analysis: Analyses were conducted in Stata 15 and SPSS version 25.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has three limitations. First, with an online approach, responses of those without internet access were under-represented. Second, the survey tool consisted of predominantly closed-ended questions. Thus, we were unable to explore responses in more depth. Third, surveys collecting self-report data are generally subject to limitations including honesty, introspective ability and interpretation of the questions. Our findings highlight the stark choices faced by those in lower socio-economic groups and suggest that unless the government intervenes to support these individuals, the impact of this epidemic will likely be felt unequally in our society. Not only this, but if a large proportion of the population continues to work while unwell, low compliance will render the various forms of social distancing less effective, as low-income workers are forced to choose between financial and physical health. Indeed, this behaviour has already been observed in the workplace in previous pandemics: workers without access to paid sick leave were more likely to work while unwell than those with paid sick leave (14). A study in China after the H7N9 epidemic found that only 7% of people reported willingness to self-quarantine (15). Also, during the Middle East Respiratory Syndrome (MERS) outbreak in Korea in 2015, there was heterogeneous uptake of preventive interventions (16). Conclusions and policy implications: In the absence of a vaccine and treatments over the short-term, high com...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  3. Version published to 10.1101/2020.04.01.20050039v1 on medRxiv