What people know and how they behave during COVID-19: Canadian perspective

The global outbreak of COVID-19 has prompted a slew of measures to prevent or at least limit viral spread so as to reduce the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a high-risk population.

Now, a new study by researchers in Canada and published on the preprint server medRxiv* in July 2020 shows that national news is the primary source of information about the pandemic. This finding will help architects of public health to refine their communication during such periods to create maximum positive health impact on the community.

Communication Methods in the COVID-19 Period

Some of the ways in which public health organizations have attempted to convey messages, instructions, and warnings about the current pandemic have included media such as the television, internet, radio, and newspapers or magazines. These messages have included details of handwashing strategies, keeping hands off the face, and maintaining the right social distance, as well as information on schools, business, and public space closures.

The researchers rightly note that “Effective and transparent communication of evolving information related to COVID-19 is needed to ensure the public understands how and why to adapt their behaviors to bolster public safety.” On the other hand, misinformation is rife, causing more significant degrees of fear, avoidance of health services, and suspicion of public health messages. The World Health Organization (WHO) has rightly called this an infodemic, where there is so much information overload on one subject that solutions are hard to find or apply.

Like many other researchers, the current study relies on online surveys of a cross-section of the population, in order to understand how the public thinks and behaves in the face of a given issue, where it gets its information, and what incentives drive public behavior, whether compliant or defiant of public health recommendations.

Some issues that have come to light in earlier surveys in the UK and the USA include not knowing how to prevent transmission while believing in a lot of circulating false information. Again, misinformation is more likely to be believed if the socioeconomic status is low. The current study is aimed at understanding these questions, using an online national survey of adults in Canada, to gather data on public perceptions, state of knowledge, and behavior.

The study period was from April 26, 2020, to May 1, 2020. The sample contained almost 2,000 respondents. About 12% were present or recovered COVID-19 patients. The mean age in this group was 49 years, and just over half were women. Most of them earned less than 100,000 Canadian dollars.

About half of them were essential workers, and 14% attributed their current unemployment to the pandemic of COVID-19.

Difference in five domains of overall health at the start of 2020 compared to the time of questionnaire completion.
Difference in five domains of overall health at the start of 2020 compared to the time of questionnaire completion.

Severity Perceptions

About 62% of the respondents thought the issue was very serious. More people were concerned with the risk to others than about their own risk (45% vs. 30%). About half were also worried that the current supply of personal protective equipment (PPE) for medical workers would run low than whether hospital facilities were available to COVID-19 patients.

About half thought it was stressful, while 28% said it roused a sense of helplessness. Almost half expressed a sense that their health was suffering in social dimensions, and 40% said it had affected their emotional/mental wellbeing. This relates to changes in daily routine, livelihood, and behavior during this period of lockdown, along with the paucity of human connection.

Public Knowledge

Most (86%) said they were well-informed about the possibility of asymptomatic infection.

Source of Information

Almost 68% said they looked for COVID-19 information online, at least once a day, relying on Canadian rather than US sources or other international news platforms. Canadian news, television, and websites were felt to be trustworthy while social media and US media was rated least trusted by over half (55% and 50%, respectively). Over half said they verified the correctness of information directly from health authorities or government sources.

Most searchers succeeded in their search for COVID-19 information. Almost half said they did not trust the information on vaccines and therapies, while the same number felt they could distinguish misinformation.

Public Behavior

About 43% said they were self-isolating, and of the rest, 95% said they were always maintaining physical distancing. About 40% said they could keep up physical distancing for six months or more, and this was linked to a sense of efficacy in preventing viral spread. About 70% felt they were successfully hindering transmission. Motivations for this behavior included self-protection in 81%, protecting family, and other people in about half of the respondents. Over 75% were looking forward to vaccine availability.

Regional differences were marked, with Ontario and Quebec expressing more significant concern than those in other regions about how COVID-19 affected hospitals and patients, and their own risk of the infection.

Overall, the study provides a birds-eye-view of how the Canadian public views the impact of the pandemic, the level of public knowledge, and behavior. These findings should be used to shape public health communications during COVID-19 and future pandemics.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:
Dr. Liji Thomas

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.

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