Public perceptions and reactions to H7N9 in Mainland China

Psychophysical Risk Perceptions and Sleep Quality of Medical Assistance Team Members in Square Cabin Hospitals: A Repeated Cross-Sectional Study

Objective: This study aimed to evaluate the association between the perceptions of psychophysical risks and sleep quality of Medical Assistance Team Members (MATMs) in Square Cabin Hospitals. Methods: Repeated cross-sectional data collection was conducted in Square Cabin Hospitals during two large-scale lockdowns. The first wave was sampled from MATMs dispatched to Wuhan and the second was from MATMs dispatched to Shanghai. Participants completed online questionnaires comprised of the Risk Perception Questionnaire (RPQ), Positive and negative emotions scale (PANAS), and Sleep Quality Scale (SQS), measuring the psychophysical risk perceptions about the MATMs' current work, emotional states, and sleep quality. Changes across two waves of data collection were statistically parsed using the exploratory factor analysis and regression models. Results: Data of 220 participants from first-wave samples [S1] and 300 from second-wave samples [S2] were analyzed. Participants reported more worries about physical risks, such as inadequate protection methods and being infected, and S1 rated higher on all risks compared with S2 (as the biggest p-value was 0.021). Across the different situations, the dominant emotional states of MATMs were positive; a higher level of psychophysical risk perceptions, negative emotional states, and poor sleep quality were consistently interrelated. The psychophysical risk perceptions predicted sleep quality. Negative emotions as a state variable intensified the relationship between physical risk perceptions and sleep quality (bindirect effect = 1.084, bootstrapped CI = [0.705, 1.487]). Conclusions: The results provide important evidence that MATMs' higher level of psychophysical risk perceptions associated with negative emotions could indicate worse sleep quality.

For better or worse: Relationship change in Thailand during COVID-19

Objective

Novel infectious diseases have the potential to both strengthen or weaken interpersonal relationships within a society. In a collectivist setting such as Thailand amplification of relationships may be particularly marked, but may be associated with individual factors, including personal values and perceived control over the virus.

Methods

A national on-street survey in Thailand (April 2020, N = 1,000), collected data from five regions across the country (response rate 82.6%). Participants reported demographics, anxiety, perceived control, and personal values of security and universalism, and indicated changes, from negative to positive, across four relationship types (relationship partners, family, friendships and neighbourhood).

Results

While relationship changes were small overall, there was an improvement in close relations (partners, family members) but not amongst friends and neighbours. Respondents who were married without children recorded less enhancement of partnerships, friendships and neighbourhood relations. Those with less perceived control over the infection reported relationship decline, while single people reported fewer positive changes in their partnership or family relations. Multiple regression analyses demonstrated the prioritisation of security was associated with a decline in each of the relationships, while universalism was positively associated with change in the family, in friendships and neighbourly relations.

Conclusions

Personal values and marital status may impact on relationship functioning during a national health crisis. These issues should be considered by clinicians and health practitioners when trying to assist those struggling with interpersonal relations during a pandemic.

Transmission dynamics and optimal control of H7N9 in China

H7N9 avian influenza is a highly pathogenic zoonotic disease. In order to control the disease, many strategies have been adopted in China such as poultry culling, the closure of live poultry markets (LPMs), the vaccination of poultry, and the treatment for humans. Due to the limited resource, it is of paramount significance to achieve the optimal control. In this paper, an epidemic model incorporating the selective culling rate is formulated to investigate the transmission mechanism of H7N9. The threshold dynamics and bifurcation analyses of the model are well investigated. Furthermore, the problem of optimal control is explored in line with Pontryagin’s Maximum Principle, with consideration given to the comprehensive measures. The numerical simulations suggest that the vaccination of poultry and the closure of LPMs are the two most economical and effective measures.

Anxiety, perceived control and pandemic behaviour in Thailand during COVID-19: Results from a national survey

Anxiety, perceived control and trust in information sources have all been shown to significantly influence health and social behaviours during pandemics. We measured these factors in a nationally representative on-street survey collected across five regions of Thailand (N = 1000, May 2020, response rate 82.6%). Anxiety was positively associated with stocking up on food (OR 2.62 (95% CI 1.88-3.66)) and taking vitamins (OR 2.37 (1.59-3.54)); perceived control with (recommended) coughing into an elbow (OR 2.42 (1.80-3.26)), checking on others (OR 1.52 (1.00-2.31)), and negatively with stockpiling (OR 0.72 (0.55-0.96)). Those relying on family/friends, doctors online or foreign sources were more likely to take vitamins (ORs 4.11, 2.88. 2.82), respondents using TV news less likely to stock up on food (OR 0.57 (0.37-0.86)) and to wear a mask for self-protection (OR 0.27 (0.10-0.73)). Comparing findings with analogous cross-sectional data on anxiety collected at the start of the pandemic (Feb 2020, Goodwin et al., 2020) there was no significant difference between personal anxiety in the two surveys (F (1, 1197) = 0.72, p = .40)) but perceived control was lower in the later survey (F (1, 1197) = 6.72 p = .01)). Findings suggest reduced perceived control as the pandemic developed and illuminate possible negative impacts of anxiety and low sense of control on pandemic behaviours.

Investigating Preventive Behaviors Toward COVID-19 Among Iranian People

Background: Considering the importance of preventive behaviors in reducing the transmission of COVID-19, this study was conducted to determine the preventive behaviors toward the spread of COVID-19. Methods: This cross-sectional study was performed 7 weeks after the confirmation of the first case of Covid-19 by the Ministry of Health and Medical Education in Iran. Data were completed online using a researcher-made questionnaire, the validity and reliability of which were confirmed, for 1,200 Iranians from 8 April 2020 to 9 May 2020. Results: The mean age of study participants was 37.77 ± 11.20 years. The mean score of preventive behaviors was 62.67 ± 8.53. The results showed that there was a significant relationship between the variables of gender, education, economic status, and preventive behaviors of COVID-19. The highest frequency is related to not using hookah and cigarettes and then avoiding losing and rubbing (78%) and the lowest percentage is related to exercising behavior (16%). Conclusion: Due to the low level of prevention behaviors during the outbreak of the disease, it is important to design educational and supportive interventions to improve and perform coronavirus prevention behaviors with more focus on men, illiterate people, and poor economic status.

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

OBJECTIVE

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.

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

OBJECTIVE

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.

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

OBJECTIVE

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.

Risk communication on behavioral responses during COVID-19 among general population in China: A rapid national study

•

Exposed to risk communication messages were positively associated with engaging in preventive behaviors.

•

Believing in misinformation were negatively associated with wearing masks.

•

Inadequate supplies of personal protection materials were negatively associated with outdoor hygiene behaviors.

Objectives

To describe the risk perception and behavioral responses among Chinese adults and to assess the associations of risk communication, risk perception, and behavioral adherence during the COVID-19 epidemic.

Methods

A national cross-sectional survey was conducted in 31 provinces in China with a total number of 5039 effective questionnaires collected. The questionnaire included sociodemographic characteristics, COVID-19 risk communication factors, mask and soap supply, and engagement in preventive behaviors during the epidemic. Multivariable Logistic regression was used.

Results

An overwhelmingly high prevalence of Chinese people was exposed to COVID-19 related risk communication messages (86.5%) and an overwhelming majority of respondents reported engagement in preventive behaviors (88.3%). Exposed to risk communication messages were positively associated with engaging in preventive behaviors, whereas, believing in misinformation were negatively associated with wearing masks when in public (p < 0.01). Respondents encountered an inadequate supplies of personal protection materials were negatively associated with their outdoor hygiene behaviors. People who were male, in an older age group, minorities, with lower education, with lower income, and lived in rural area showed lower exposures to risk communication messages.

Conclusions

Future risk communication practices are recommended to better monitor population risk perceptions and pay attention to socio-demographically disadvantaged people.

The association of being in quarantine and related COVID-19 recommended and non-recommended behaviors with psychological distress in Chinese population

•The world health organization (WHO) guidelines needs to be empirically examined. •The study sought to look at the recommended and non-recommended behaviors. •The results of the study show that psychological distress was negatively associated with recommended behaviors and positively with non-recommended behaviors.

Epidemiological features and trends of influenza incidence in mainland China: A population-based surveillance study from 2005 to 2015

OBJECTIVES

To investigate epidemiological features and trends of influenza incidence with 1,173,640 cases in mainland China from 2005 to 2015.

METHODS

Incidence and mortality data for influenza from 2005 to 2015 were provided by the data-center of China public health science and covered a population of about 1.3 billion people from 31 provinces and regions in mainland China. Joinpoint regression and exploratory spatial data analyses were used to examine the incidence trends from 2005 to 2015.

RESULTS

The first upsurge in influenza cases occurred in 2009, and the highest incidence of influenza occurred in 2014 (15.9045 cases/100,000 people). The average incidence per year from 2009 to 2015 was threefold higher than that from 2005 to 2008 (10.5308 vs 3.4589 cases/100,000 people; incidence rate ratio=3.0446). The joinpoint regression results showed that there was an increasing influenza incidence trend from 2005 to 2015 (annual change in percentage=13.6%, 95%CI 2.2-26.3, p=0.0236). The seasonal pattern analysis showed that influenza typically occurred in winter and spring during each monitoring year, peaking from November to March the next year.

CONCLUSIONS

This study will help governments to make valuable decisions in allocating scarce resources and providing strategies to limit the spread of influenza.

Willingness to accept a future influenza A(H7N9) vaccine in Beijing, China

•

To optimize coverage, public willingness of H7N9 vaccination needs to be understood.

•

59.5% of the general adults would be willing to accept a future H7N9 vaccine.

•

Demographics and public perceptions are the predictors of vaccination willingness.

•

Many people doubt about vaccine’s effectiveness and don’t concern about disease risk.

•

Targeted education programs on disease risk and vaccine’s effectiveness are needed.

Background

The present study aimed to estimate residents’ willingness to accept a future H7N9 vaccine and its determinants in the general adult population in Beijing, China.

Methods

We conducted a multi-stage sampling, cross-sectional survey using self-administered anonymous questionnaires from May to June, in 2014. The main outcome variable was residents’ willingness to accept a future H7N9 vaccine. Logistic regression was used to identify the predictors of vaccination willingness.

Results

Of the 7264 eligible participants, 14.5% of Beijing residents reported that they had not heard of H7N9. Among those who had heard of H7N9, 59.5% of the general adult population would be willing to accept a future H7N9 vaccine, and approximately half of them reported ‘I am afraid of being infected by H7N9’ and ‘H7N9 vaccine can prevent infections’, and 28.1% reported ‘my daily life is affected by H7N9’. The variables that were significantly associated with a higher likelihood of reporting willingness were being younger adults (aged 18–29 years: OR = 1.52, 95% CI: 1.17–1.97; aged 30–39 years: OR = 1.39, 95% CI: 1.08–1.78), being farmers (OR = 1.61; 95% CI: 1.32–1.96), being unemployed people (OR = 1.36; 95% CI: 1.04–1.78), living in suburban areas (OR = 2.18; 95% CI: 1.89–2.51), having ≥2 children in the family (OR = 1.41; 95% CI: 1.03–1.92), perceived risk in China (OR = 1.30; 95% CI: 1.15–1.48), perceived susceptibility to disease (OR = 3.13; 95% CI: 2.73–3.58), perceived negative effect on daily life (OR = 1.32; 95% CI: 1.13–1.55), perceived effectiveness of vaccination (OR = 2.34; 95% CI: 2.07–2.64), and recent uptake of influenza vaccine (OR = 2.26; 95% CI: 1.92–2.66).

Conclusions

A great number of Beijing residents had doubts about the vaccine’s effectiveness and were not concerned about disease risk, which were the factors affecting willingness to be vaccinated. Targeted education programs on disease risk as well as vaccine’s effectiveness are needed to improve the willingness of vaccination for potential H7N9 pandemic preparedness.

Limited awareness of animal influenza prevention and control among Dai Lue smallholder farmers in Southwest China

Awareness of animal influenza and its prevention and control is important for ensuring livestock health, production and welfare. In China, a country stereotyped as a major source of emerging zoonotic infectious diseases, research on the public understanding of animal influenza is limited to the Han, the main ethnic group. The present qualitative study in Southwest China investigated awareness of animal influenza among the Dai, an ethnic minority. The participants (15 men and 10 women, ages 18–83) were smallholder farmers of pigs and poultry in rural areas of Jinghong, Xishuangbanna, Yunnan Province. A mixture of interviews and group discussions took place in homes and villages. The participants were asked about their knowledge of avian influenza (H7N9), swine influenza (H1N1), precautions taken to protect against influenza, procedures when animals were sick and perceived risk of animal influenza. The data were analysed following coding and thematic analysis. The findings demonstrated a limited understanding of animal health and welfare among participants. Specifically, they were largely unaware of animal influenza (H7N9, H1N1) including its causes, symptoms, prevention and treatment. The farmers were also uninformed of the risks they faced and unknowingly engaged in behaviours which increased direct or indirect exposure to infected animals, a risk factor for human infection. They also reported poor usage of veterinary services. In order to guarantee the health, welfare and production of their livestock, immediate action is needed to enable Dai smallholder farmers to prevent and respond to animal influenza effectively and timely.

Epidemic spreading on adaptively weighted scale-free networks

We introduce three modified SIS models on scale-free networks that take into account variable population size, nonlinear infectivity, adaptive weights, behavior inertia and time delay, so as to better characterize the actual spread of epidemics. We develop new mathematical methods and techniques to study the dynamics of the models, including the basic reproduction number, and the global asymptotic stability of the disease-free and endemic equilibria. We show the disease-free equilibrium cannot undergo a Hopf bifurcation. We further analyze the effects of local information of diseases and various immunization schemes on epidemic dynamics. We also perform some stochastic network simulations which yield quantitative agreement with the deterministic mean-field approach.

Perceptions on the risk communication strategy during the 2013 avian influenza A/H7N9 outbreak in humans in China: a focus group study

Objective

To identify the general public’s perceptions of the overall risk communication strategy carried out by Chinese public health agencies during the first wave of avian influenza A(H7N9) outbreak in humans in 2013.

Methods

Participants were recruited from communities in Beijing, Lanzhou and Hangzhou, China in May and June 2013 by convenience sampling. Demographics and other relevant information were collected using a self-administered questionnaire. Focus group interviews were conducted using a set of nine pre-developed questions and a tested moderator guide. The interviews were audio recorded and were transcribed verbatim. The constant comparative method was used to identify trends and themes.

Results

A total of nine focus group interviews, with 94 participants recruited from nine communities, were conducted. Most participants received H7N9 information via television and the Internet. Most the participants appreciated the transparency and timeliness of the information released by the government. They expressed a sense of trust in the recommended public health advice and followed most of them. The participants suggested that the government release more information about clinical treatment outcomes, have more specific health recommendations that are practical to their settings and expand the use of new media channels for risk communication.

Conclusion

The public perceived the overall risk communication strategy by the Chinese public health agencies as effective, though the moderator had a governmental agency title that might have biased the results. There is a need to expand the use of social media for risk communication in the future.

Rumor-Related and Exclusive Behavior Coverage in Internet News Reports Following the 2009 H1N1 Influenza Outbreak in Japan

OBJECTIVE

We sought to elucidate news article reporting of adverse public psychosocial behaviors, in particular, rumor-related coverage (eg, panic, demagoguery) and exclusive behavior coverage (negative behaviors, eg, discrimination, bullying) during the 2009 influenza A (H1N1) influenza pandemic in Japan.

METHODS

We examined 154 Internet news-site articles reporting adverse public psychosocial responses in the first 60 days of the outbreak. Rumor-related coverage and exclusive behavior coverage were dichotomously coded as included or not. Moreover, we assessed whether or not health information (eg, coping methods, virus toxicity information) or emphasis on information quality (eg, importance of information, cautions about overreactions) were simultaneously reported.

RESULTS

Rumor-related coverage (n=120, 77.9%) was less likely to simultaneously report public health information (eg, toxicity information, health support information, and cautions about overreactions; P<.05). Conversely, exclusive behavior coverage (n=41, 26.6%) was more likely to report public health information (P<.05).

CONCLUSIONS

Rumor-related coverage was less likely to have accompanying public health information, whereas exclusive behavior coverage was more likely to include it. During public health crises, it is essential to understand that rumors and exclusive behaviors have adverse effects on the public and that accompanying public health information may help people take proactive coping actions.