Influence of trust on two different risk perceptions as an affective and cognitive dimension during Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea: serial cross-sectional surveys

Interacting particle models on the impact of spatially heterogeneous human behavioral factors on dynamics of infectious diseases

Human behaviors have non-negligible impacts on spread of contagious disease. For instance, large-scale gathering and high mobility of population could lead to accelerated disease transmission, while public behavioral changes in response to pandemics may effectively reduce contacts and suppress the peak of the outbreak. In order to understand how spatial characteristics like population mobility and clustering interplay with epidemic outbreaks, we formulate a stochastic-statistical environment-epidemic dynamic system (SEEDS) via an agent-based biased random walk model on a two-dimensional lattice. The "popularity" and "awareness" variables are taken into consideration to capture human natural and preventive behavioral factors, which are assumed to guide and bias agent movement in a combined way. It is found that the presence of the spatial heterogeneity, like social influence locality and spatial clustering induced by self-aggregation, potentially suppresses the contacts between agents and consequently flats the epidemic curve. Surprisedly, disease responses might not necessarily reduce the susceptibility of informed individuals and even aggravate disease outbreak if each individual responds independently upon their awareness. The disease control is achieved effectively only if there are coordinated public-health interventions and public compliance to these measures. Therefore, our model may be useful for quantitative evaluations of a variety of public-health policies.

Association Between Risk Perceptions of COVID-19, Political Ideology, and Mask-Wearing Behavior After the Outbreak: A Cross-Sectional Survey in South Korea

Purpose

After the declaration by the World Health Organization signaling the conclusion of the COVID-19 pandemic, most countries lifted mandatory mask-wearing regulations. This study aimed to investigate factors such as risk perception and political ideology associated with continued adherence to mask-wearing among specific populations, particularly when it is no longer deemed necessary.

Methods

We conducted a cross-sectional study including a sample of 1001 respondents stratified by sex, age (≥ 18 years), and region from January 31 to February 2, 2023, after the mandatory mask regulation was lifted in South Korea. Multivariate logistic regression models were applied to estimate the relationships between risk perceptions, political ideology, and mask-wearing maintenance, adjusting for factors such as sex, age, occupation, and trust in the government.

Results

Our results indicated significant associations between age, self-reported household economic status, political ideology, affective risk perception, and perceived effectiveness of the government's COVID-related measures with indoor mask-wearing. Specifically, liberals were more likely to keep mask-wearing indoors than conservatives (adjusted odds ratio [aOR]: 2.19; 95% confidence interval [CI]: 1.33-3.59); and those who perceived a greater affective risk of COVID-19 (aOR: 2.47; 95% CI: 1.96-3.10), along with those who perceived the government's countermeasures as inadequate, were more inclined to maintain the habit of wearing masks indoors (aOR: 1.90; 95% CI: 1.19-3.03).

Conclusion

Our study highlighted the multifaceted factors influencing mask-wearing behavior in the post-COVID-19 era. Even after adjusting for various confounding factors, such as age, sex, and trust in the government, an association remained between affective risk perception, political ideology, and mask-wearing behavior. However, further research for psychological mechanisms is needed to foster a culture of preventive behaviors proportional to the risk of infection.

The association between the risk perceptions of COVID-19, trust in the government, political ideologies, and socio-demographic factors: A year-long cross-sectional study in South Korea

Risk perception research, targeting the general public, necessitates the study of the multi-faceted aspects of perceived risk through a holistic approach. This study aimed to investigate the association between the two dimensions of risk perception of COVID-19, i.e., risk as a feeling and analysis, trust in the current government, political ideologies, and socio-demographic factors in South Korea. This study used a year-long repeated cross-sectional design, in which a national sample (n = 23,018) participated in 23 consecutive telephone surveys from February 2020 to February 2021. Most factors differed in the magnitude and direction of their relationships with the two dimensions of risk perception. However, trust in the current government, alone, delineated an association in the same direction for both dimensions, i.e., those with a lower level of trust exhibited higher levels of cognitive and affective risk perception. Although these results did not change significantly during the one-year observation period, they are related to the political interpretation of risk. This study revealed that affective and cognitive risk perceptions addressed different dimensions of risk perception. These findings could help governments and health authorities better understand the nature and mechanisms of public risk perception when implementing countermeasures and policies in response to the COVID-19 pandemic and other public health emergencies.

Three dimensions of COVID-19 risk perceptions and their socioeconomic correlates in the United States: A social media analysis

Social media analysis provides an alternate approach to monitoring and understanding risk perceptions regarding COVID-19 over time. Our current understandings of risk perceptions regarding COVID-19 do not disentangle the three dimensions of risk perceptions (perceived susceptibility, perceived severity, and negative emotion) as the pandemic has evolved. Data are also limited regarding the impact of social determinants of health (SDOH) on COVID-19-related risk perceptions over time. To address these knowledge gaps, we extracted tweets regarding COVID-19-related risk perceptions and developed indicators for the three dimensions of risk perceptions based on over 502 million geotagged tweets posted by over 4.9 million Twitter users from January 2020 to December 2021 in the United States. We examined correlations between risk perception indicator scores and county-level SDOH. The three dimensions of risk perceptions demonstrate different trajectories. Perceived severity maintained a high level throughout the study period. Perceived susceptibility and negative emotion peaked on March 11, 2020 (COVID-19 declared global pandemic by WHO) and then declined and remained stable at lower levels until increasing once again with the Omicron period. Relative frequency of tweet posts on risk perceptions did not closely follow epidemic trends of COVID-19 (cases, deaths). Users from socioeconomically vulnerable counties showed lower attention to perceived severity and susceptibility of COVID-19 than those from wealthier counties. Examining trends in tweets regarding the multiple dimensions of risk perceptions throughout the COVID-19 pandemic can help policymakers frame in-time, tailored, and appropriate responses to prevent viral spread and encourage preventive behavior uptake in the United States.

How older adults’ health beliefs affect intention to perform COVID-19 self-examination: A reasoned action approach

BACKGROUND: COVID-19 self-examination is a significant part of the national recovery plan against the virus. Although it is easier to perform COVID-19 self-examination (CSE), only a small percentage of people prefer it. There are no precise statistics on CSE in Malaysia, but informal data from news agencies imply low CSE. Lack of awareness and conflicting information about the reliability of CSE results may have raised concerns about CSE’s efficacy and effectiveness. OBJECTIVE: This study investigates how Malaysian older adults’ health beliefs influence their intention to perform CSE. The study developed a framework combining illness threats (ITH), perceived barriers (PBA), medical motivations (MMO), and control over illness (COI) from the Health Belief Model (HBM) with the Reasoned-Action Approach’s attitude (ATT), perceived control (PCO), and intention (INT). METHODS: Structural Equation Modelling (SEM) analyses were conducted with AMOS 26 software to determine the influence of HBM on older adults’ attitude, perceived control, and intention. The study collected 200 data for the pilot study and 400 data for hypotheses testing. RESULTS: ITH, MMO, and COI have positive effects, whilst PBA affects ATT negatively. ITH and COI positively impact PCO, and PCO has a greater significant effect on INT than ATT. CONCLUSION: Given the HBM’s role in influencing older adults’ intention to perform COVID-19 self-examination, providing different levels of care and emphasising the perception of knowledge of illness are especially beneficial. Several recommendations are made to ensure that CSE remains relevant for older adults’ well-being, although COVID-19’s impact has become more stabilised.

Association Between Self-Rated Political Orientation and Attitude Toward the Cash Transfer Policy During the COVID-19 Pandemic: A Nationwide Cross-Sectional Survey Conducted in South Korea

Objective

This study assessed the relationship between self-rated political orientation and attitude toward the cash transfer policy during the COVID-19 pandemic.

Methods

This cross-sectional study conducted in South Korea during the pandemic included a stratified sample of 1,004 respondents (aged 19 years and older). We tested the hypotheses that political orientation shapes attitudes toward social policies and that other socioeconomic factors might have relatively minor importance. Logistic regression was used to identify associations between political orientation and attitude toward the cash transfer policy. Average marginal effects were calculated to determine the effect size of each variable.

Results

Political orientation, age, and residential area were correlated with attitudes toward the policy. Compared to the conservatives, the non-committed and the moderate showed about 10% more favorable attitudes, and the progressive group showed robust support. People in their 30s and 40s showed similar attitudes to the 18-29 group, while older people showed much lower support. Compared to the Seoul metropolitan area, residents of the Ho-nam area showed favorable attitudes, and those of the Yeong-nam area had relatively unfavorable attitudes.

Conclusions

This study suggests that attitudes toward the cash transfer policy are mainly associated with political orientation. Although these results illuminate pandemics' social and political dimensions, further efforts are needed to fully understand the determinants and mechanisms of attitudes toward policies outside the traditional health policy scope.

Whistling Through the COVID-19 Pandemic: Optimism Bias and Political Beliefs in the United States

Utilizing a nationally representative survey of Americans from December 2020, we consider the degree to which COVID-19 risk perceptions are related to political factors. We examine the likelihood that one believes they will be infected with COVID-19, the likelihood that a peer will be infected, and the difference between the individual and peer perceived risks, known as optimism bias, and compare these perceptions across partisan characteristics. Results show that Trump voting category is the most important contributor to perceived COVID-19 risks. We find similar partisan differences as prior research, note that these differences persisted through the end of 2020, despite the post-Thanksgiving surge with high and growing rates of COVID in all regions of the United States. Contrary to prior expectations, partisanship does not strongly predict the level of optimism bias, as both assessed personal and general health risks track closely with one another by both political party and ideology.

The role of information quality, trust and anxiety on intention to buy food supplements at the time of COVID-19 outbreak

Purpose

The purpose of this study is to analyze the factors affecting consumer`s intention to buy food supplements during COVID-19 pandemic using the expanding theory of planned behavior model. The variables of perceived information quality, trust and anxiety are integrated in the model of this study.

Design/methodology/approach

A total of 553 valid questionnaire responses were collected via an online survey in the epicenter of the pandemic in Indonesia, such as Jakarta and surrounding cities. To evaluate the causal links between latent variables, structural equation modeling was adopted using LISREL software. Before the research hypothesis had been tested, validity and reliability analysis was carried out to make sure the measurement can be used.

Findings

The findings indicate that perceived information quality influences trust and anxiety, and then both of them influence attitude toward food supplements. Moreover, the intentions to buy food supplements are determined by the consumer`s attitude.

Research limitations/implications

This study assumes all consumers have similar access to information because they are living in the greater Jakarta. Nevertheless, in fact, the access of information is not similar between age groups and locations. Future research may wish to differentiate evaluations of a full-information group from those of the limited-information groups.

Originality/value

This study provides a model of consumers` buying intentions toward food supplement products in the time of a health crisis such as the COVID-19 pandemic as a novelty. The implications of this study provide meaningful direction for marketing decisions and policy interventions in developing food supplement industries.

The impact of stay-at-home orders on vulnerability assessments and precautionary intentions during a pandemic

In 2020, a novel emerging infectious disease - COVID-19 - became a global pandemic and prompted unprecedented social distancing measures. We examined the associations of voluntary stay-at-home (SAH) orders during the COVID-19 pandemic with vulnerability assessments and precautionary intentions (e.g. social distancing, hand washing). A quasi-experimental study using an online adult sample was conducted in U.S. states with and without voluntary SAH orders during the COVID-19 pandemic. Self-report surveys assessed vulnerability assessments and precautionary intentions. Participants living in states with SAH orders showed inflated vulnerability assessments for contracting COVID-19, and this association was stronger for affect-laden than cognitively-based assessments. Moreover, only affect-laden vulnerability assessments were uniquely associated with precautionary intentions and accounted for the relationship between SAH orders and precautionary intentions. Our study was among the first to explore the impact of voluntary SAH orders on vulnerability assessments and precautionary intentions. Results are discussed in terms of their implications for health behavioral models and applications for promoting self-protective actions during a pandemic.

It won't happen to me! Psychosocial factors influencing risk perception for respiratory infectious diseases: A scoping review

Understanding the determinants of risk perception for COVID-19 might help to promote self-preventive behaviours. This scoping review aimed to map the extent, variety and characteristics of the evidence on the possible determinants of risk perception for COVID-like diseases. PubMed, Scopus and Web of Science were searched for original, peer-reviewed English-written articles published up to March 2020 and investigating risk perception determinants for respiratory infectious diseases in adults. Titles and abstracts were screened, and full texts were analysed by the first author; when unsure, eligibility was discussed with the last author. Data were collected according to an extraction sheet developed by the first and last authors. The cross-sectional evidence covers a variety of diseases, countries and timings of testing. Mostly, questionnaires recorded socio-demographics, media exposure, trust in institutions, disease proximity and knowledge; psychological variables, including personality traits, distress and self-efficacy, were less investigated. A miscellaneous operationalization of risk perception emerged, including the likelihood of getting sick, perceived dangerousness, concerns or a combination of them. A comprehensive understanding of the substantial amount of evidence may be challenging due to methodological heterogeneity. Referring to uniform theoretical frameworks is recommended; also, longitudinal research may be implemented to probe causal relationships.

Political Ideologies, Government Trust, and COVID-19 Vaccine Hesitancy in South Korea: A Cross-Sectional Survey

This study aimed to assess the correlation between political ideologies, government trust, and COVID-19 vaccine hesitancy in South Korea during the COVID-19 pandemic. A cross-sectional survey was conducted among South Korea’s general population and 1000 respondents (aged 18 years and older) were included. We used multivariate logistic regression models to identify the factors associated with vaccine hesitancy. Respondents who self-identified as liberal or held “no political opinion” had higher rates of vaccine hesitancy than conservative respondents. People’s trust in the government’s countermeasures was associated with vaccination. Respondents who had risk perceptions (affective and cognitive) of COVID-19 had lower rates of vaccine hesitancy. Perceptions that the vaccine was not safe and being aged 18–29, 30–39, or 40–49 were associated with a higher probability of vaccine hesitancy. This study found that even if vaccine safety and risk perceptions toward COVID-19 were adjusted, self-rated political ideologies and government trust was associated with COVID-19 vaccine hesitancy. More effort to communicate with those who are *liberal or “no political opinion”, younger, and have lower level of trust in the government are required to dissolve vaccine hesitancy. Further studies should analyze the mechanism of COVID-19 vaccine uptake for effective herd immunity.

Gender Differences in Fear and Risk Perception During the COVID-19 Pandemic

The COVID-19 pandemic has led many people to suffer from emotional distress. Previous studies suggest that women process and express affective experiences, such as fear, with a greater intensity compared to men. We administered an online survey to a sample of participants in the United States that measures fear of COVID-19, perceptions about health and financial risks, and preventative measures taken. Despite the empirical fact that men are more likely to experience adverse health consequences from COVID-19, women report greater fear and more negative expectations about health-related consequences of COVID-19 than men. However, women are more optimistic than men regarding the financial consequences of the pandemic. Women also report more negative emotional experiences generally during the pandemic, particularly in situations where other people or the government take actions that make matters worse. Though women report taking more preventative measures than men in response to the pandemic, gender differences in behavior are reduced after controlling for fear. These results shed light on how differences in emotional experiences of the pandemic may inform policy interventions.

Correlates of intended COVID-19 vaccine acceptance across time and countries: results from a series of cross-sectional surveys

OBJECTIVE

Describe demographical, social and psychological correlates of willingness to receive a COVID-19 vaccine.

SETTING

Series of online surveys undertaken between March and October 2020.

PARTICIPANTS

A total of 25 separate national samples (matched to country population by age and sex) in 12 different countries were recruited through online panel providers (n=25 334).

PRIMARY OUTCOME MEASURES

Reported willingness to receive a COVID-19 vaccination.

RESULTS

Reported willingness to receive a vaccine varied widely across samples, ranging from 63% to 88%. Multivariate logistic regression analyses reveal sex (female OR=0.59, 95% CI 0.55 to 0.64), trust in medical and scientific experts (OR=1.28, 95% CI 1.22 to 1.34) and worry about the COVID-19 virus (OR=1.47, 95% CI 1.41 to 1.53) as the strongest correlates of stated vaccine acceptance considering pooled data and the most consistent correlates across countries. In a subset of UK samples, we show that these effects are robust after controlling for attitudes towards vaccination in general.

CONCLUSIONS

Our results indicate that the burden of trust largely rests on the shoulders of the scientific and medical community, with implications for how future COVID-19 vaccination information should be communicated to maximise uptake.

Attachment, Personality and Locus of Control: Psychological Determinants of Risk Perception and Preventive Behaviors for COVID-19

Background: The understanding of factors that shape risk perception is crucial to modulate the perceived threat and, in turn, to promote optimal engagement in preventive actions. Methods: An on-line, cross-sectional, survey was conducted in Italy between May and July 2020 to investigate risk perception for COVID-19 and the adoption of preventive measures. A total of 964 volunteers participated in the study. Possible predictors of risk perception were identified through a hierarchical multiple linear regression analysis, including sociodemographic, epidemiological and, most of all, psychological factors. A path analysis was adopted to probe the possible mediating role of risk perception on the relationship between the independent variables considered and the adoption of preventive measures. Results: Focusing on the psychological predictors of risk perception, high levels of anxiety, an anxious attachment, and an external locus of control predicted higher perceived risk. Conversely, high levels of openness personality and of avoidant attachment predicted a lower perception of risk. In turn, the higher was the perceived risk the higher was the adoption of precautionary measures. Furthermore, psychological factors influenced the adoption of preventive behaviors both directly and indirectly through their effect on risk perception. Conclusions: Our findings might be taken into high consideration by stakeholders, who are responsible for promoting a truthful perception of risk and proper compliance with precautionary measures.

Race and ethnicity, gender, and age on perceived threats and fear of COVID-19: Evidence from two national data sources

Previous studies find preventative behaviors designed to reduce the number of infections during emerging disease outbreaks are associated with perceived risk of disease susceptibility. Few studies have attempted to identify underlying factors that explain differences in perceptions of risk during an infectious disease outbreak. Drawing from two early waves of American Trends Panel (n=7,441), as well as a National Science Foundation funded, Qualtrics national panel survey from the early stages of the pandemic (n=10,368), we test whether race and ethnicity, gender, and age were associated with six perceived threat and fear outcomes related to COVID-19. Results demonstrate race and ethnicity, gender, and age play a significant role in shaping threat and fear perceptions of COVID-19, but depending on the outcome, relationships vary in direction and magnitude. In some cases, historically marginalized racial and ethnic groups were more likely to report high fear and perceive coronavirus as a major threat to population and individual health, whereas, in others cases, the same marginalized racial and ethnic groups were less likely to perceive coronavirus to be a serious threat to the immune-comprised and the elderly population. We also find women were generally more likely to report high levels of threat and fear of COVID-19. Finally, we observe a clear age difference, whereby adults in older age groups report high-risk perceptions of COVID-19. Findings can inform public health programs designed to educate communities on the benefits of engaging in effective preventative practices during emerging infectious disease outbreaks.

Evaluation of Distress and Risk Perception Associated with COVID-19 in Vulnerable Groups

Preventive behavior developed by the population is essential in the face of the risk of coronavirus infection (COVID-19). However, preventive measures will depend on the risk perception acquired. In addition, lockdown can directly affect mental health, provoking distress. Distress could affect risk perception. This study's objective was to analyze whether experiencing distress had an influence on risk perception with respect to vulnerable groups. The sample consisted of 806 participants. The study was conducted during the first week of lockdown declared by the Spanish Government. The Brief Symptom Inventory BSI-18 and a risk perception questionnaire about vulnerable groups was administered. The study revealed the appearance of distress in 9.6% of the sample (85.7% women). Experiencing distress influenced risk perception. This study's main contribution is the link between experiencing distress and the risk perception with respect to vulnerable groups. Risk perception is relevant since it can influence how the population faces the pandemic. Transmission of accurate information could help to minimize the effect of certain cognitive biases that affect risk perception and foster preventive behavior.

A nomogramic model based on clinical and laboratory parameters at admission for predicting the survival of COVID-19 patients

BACKGROUND

COVID-19 has become a major global threat. The present study aimed to develop a nomogram model to predict the survival of COVID-19 patients based on their clinical and laboratory data at admission.

METHODS

COVID-19 patients who were admitted at Hankou Hospital and Huoshenshan Hospital in Wuhan, China from January 12, 2020 to March 20, 2020, whose outcome during the hospitalization was known, were retrospectively reviewed. The categorical variables were compared using Pearson's χ2-test or Fisher's exact test, and continuous variables were analyzed using Student's t-test or Mann Whitney U-test, as appropriate. Then, variables with a P-value of ≤0.1 were included in the log-binomial model, and merely these independent risk factors were used to establish the nomogram model. The discrimination of the nomogram was evaluated using the area under the receiver operating characteristic curve (AUC), and internally verified using the Bootstrap method.

RESULTS

A total of 262 patients (134 surviving and 128 non-surviving patients) were included in the analysis. Seven variables, which included age (relative risk [RR]: 0.905, 95% confidence interval [CI]: 0.868-0.944; P < 0.001), chronic heart disease (CHD, RR: 0.045, 95% CI: 0.0097-0.205; P < 0.001, the percentage of lymphocytes (Lym%, RR: 1.125, 95% CI: 1.041-1.216; P = 0.0029), platelets (RR: 1.008, 95% CI: 1.003-1.012; P = 0.001), C-reaction protein (RR: 0.982, 95% CI: 0.973-0.991; P < 0.001), lactate dehydrogenase (LDH, RR: 0.993, 95% CI: 0.990-0.997; P < 0.001) and D-dimer (RR: 0.734, 95% CI: 0.617-0.879; P < 0.001), were identified as the independent risk factors. The nomogram model based on these factors exhibited a good discrimination, with an AUC of 0.948 (95% CI: 0.923-0.973).

CONCLUSIONS

A nomogram based on age, CHD, Lym%, platelets, C-reaction protein, LDH and D-dimer was established to accurately predict the prognosis of COVID-19 patients. This can be used as an alerting tool for clinicians to take early intervention measures, when necessary.

Understanding the Community Risk Perceptions of the COVID-19 Outbreak in South Korea: Infodemiology Study

Background

South Korea is among the best-performing countries in tackling the coronavirus pandemic by using mass drive-through testing, face mask use, and extensive social distancing. However, understanding the patterns of risk perception could also facilitate effective risk communication to minimize the impacts of disease spread during this crisis.

Objective

We attempt to explore patterns of community health risk perceptions of COVID-19 in South Korea using internet search data.

Methods

Google Trends (GT) and NAVER relative search volumes (RSVs) data were collected using COVID-19–related terms in the Korean language and were retrieved according to time, gender, age groups, types of device, and location. Online queries were compared to the number of daily new COVID-19 cases and tests reported in the Kaggle open-access data set for the time period of December 5, 2019, to May 31, 2020. Time-lag correlations calculated by Spearman rank correlation coefficients were employed to assess whether correlations between new COVID-19 cases and internet searches were affected by time. We also constructed a prediction model of new COVID-19 cases using the number of COVID-19 cases, tests, and GT and NAVER RSVs in lag periods (of 1-3 days). Single and multiple regressions were employed using backward elimination and a variance inflation factor of <5.

Results

The numbers of COVID-19–related queries in South Korea increased during local events including local transmission, approval of coronavirus test kits, implementation of coronavirus drive-through tests, a face mask shortage, and a widespread campaign for social distancing as well as during international events such as the announcement of a Public Health Emergency of International Concern by the World Health Organization. Online queries were also stronger in women (r=0.763-0.823; P<.001) and age groups ≤29 years (r=0.726-0.821; P<.001), 30-44 years (r=0.701-0.826; P<.001), and ≥50 years (r=0.706-0.725; P<.001). In terms of spatial distribution, internet search data were higher in affected areas. Moreover, greater correlations were found in mobile searches (r=0.704-0.804; P<.001) compared to those of desktop searches (r=0.705-0.717; P<.001), indicating changing behaviors in searching for online health information during the outbreak. These varied internet searches related to COVID-19 represented community health risk perceptions. In addition, as a country with a high number of coronavirus tests, results showed that adults perceived coronavirus test–related information as being more important than disease-related knowledge. Meanwhile, younger, and older age groups had different perceptions. Moreover, NAVER RSVs can potentially be used for health risk perception assessments and disease predictions. Adding COVID-19–related searches provided by NAVER could increase the performance of the model compared to that of the COVID-19 case–based model and potentially be used to predict epidemic curves.

Conclusions

The use of both GT and NAVER RSVs to explore patterns of community health risk perceptions could be beneficial for targeting risk communication from several perspectives, including time, population characteristics, and location.

Social Distancing and Transmission-reducing Practices during the 2019 Coronavirus Disease and 2015 Middle East Respiratory Syndrome Coronavirus Outbreaks in Korea

BACKGROUND

The absence of effective antiviral medications and vaccines increased the focus on non-pharmaceutical preventive behaviors for mitigating against the coronavirus disease 2019 (COVID-19) pandemic. To examine the current status of non-pharmaceutical preventive behaviors practiced during the COVID-19 outbreak and factors affecting behavioral activities, we compared to the 2015 Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in Korea.

METHODS

This was a serial cross-sectional population-based study in Korea with four surveys conducted on June 2 and 25, 2015 (MERS-CoV surveys), and February 4, and April 2, 2020 (COVID-19 surveys). Of 25,711 participants selected using random digit dialing numbers, 4,011 participants (aged ≥ 18 years) were successfully interviewed, for the 2020 COVID-19 (n = 2,002) and 2015 MERS-CoV (n = 2,009) epidemics were included. Participants were selected post-stratification by sex, age, and province. The total number of weighted cases in this survey equaled the total number of unweighted cases at the national level. We measured the levels of preventive behaviors (social distancing [avoiding physical contact with others]), and practicing transmission-reducing behaviors such as wearing face mask and handwashing.

RESULTS

Between the surveys, respondents who reported practicing social distancing increased from 41.9%-58.2% (MERS-CoV) to 83.4%-92.3% (COVID-19). The response rate for the four surveys ranged between 13.7% and 17.7%. Practicing transmission-reducing behaviors (wearing face masks and handwashing) at least once during COVID-19 (78.8%, 80.2%) also increased compared to that during MERS-CoV (15.5%, 60.3%). The higher affective risk perception groups were more likely to practice transmission-reducing measures (adjusted odds ratio, 3.24-4.81; 95 confidence interval, 1.76-6.96) during both COVID-19 and MERS-CoV.

CONCLUSION

The study findings suggest markedly increased proportions of non-pharmaceutical behavioral practices evenly across all subgroups during the two different novel virus outbreaks in Korea. Strategic interventions are needed to attempt based on preventive behavior works.