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Title: Early public adherence with and support for stay-at-home COVID-19 mitigation strategies despite adverse life impact: a transnational cross-sectional survey study in the United States and Australia.
Austin Authors: Czeisler, Mark É;Howard, Mark E ;Robbins, Rebecca;Barger, Laura K;Facer-Childs, Elise R;Rajaratnam, Shantha M W;Czeisler, Charles A
Affiliation: Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, 02115, USA
Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, 02115, USA
Division of Sleep Medicine, Harvard Medical School, Boston, MA, 02115, USA
Department of Medicine, University of Melbourne, Melbourne, VIC, 3010, Australia
Institute for Breathing and Sleep
Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, 3800, Australia
Issue Date: 15-Mar-2021
Date: 2021-03-15
Publication information: BMC Public Health 2021; 21(1): 503
Abstract: Governments worldwide recommended unprecedented measures to contain the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As pressure mounted to scale back measures, understanding public priorities was critical. We assessed initial public adherence with and support for stay-at-home orders in nations and cities with different SARS-CoV-2 infection and COVID-19 death rates. Cross-sectional surveys were administered to representative samples of adults aged ≥18 years from regions with different SARS-CoV-2 prevalences from April 2-8, 2020. Regions included two nations [the United States (US-high prevalence) and Australia (AU-low prevalence)] and two US cities [New York City (NY-high prevalence) and Los Angeles (LA-low prevalence)]. Regional SARS-CoV-2 and COVID-19 prevalence (cumulative SARS-CoV-2 infections, COVID-19 deaths) as of April 8, 2020: US (363,321, 10,845), AU (5956, 45), NY (81,803, 4571), LA (7530, 198). Of 8718 eligible potential respondents, 5573 (response rate, 63.9%) completed surveys. Median age was 47 years (range, 18-89); 3039 (54.5%) were female. Of 5573 total respondents, 4560 (81.8%) reported adherence with recommended quarantine or stay-at-home policies (range of samples, 75.5-88.2%). Additionally, 29.1% of respondents screened positive for anxiety or depression symptoms (range of samples, 28.6-32.0%), with higher prevalences among those of younger age, female gender, and those in quarantine or staying at home most of the time versus those who did not report these behaviours. Despite elevated prevalences of adverse mental health symptoms and significant life disruptions, 5022 respondents (90.1%) supported government-imposed stay-at-home orders (range of samples, 88.9-93.1%). Of these, 90.8% believed orders should last at least three more weeks or until public health or government officials recommended, with support spanning the political spectrum. Public adherence with COVID-19 mitigation policies was highly prevalent, in both highly-affected (US, NY) and minimally-affected regions (AU, LA). Despite disruption of respondents' lives, the vast majority supported continuation of extended stay-at-home orders. Despite common support, these two countries diverged in stringent mitigation implementation, which may have contributed to subsequent outcomes. These results reveal the importance of surveillance of public support for and adherence with such policies during the COVID-19 pandemic and for future infectious disease outbreaks.
DOI: 10.1186/s12889-021-10410-x
ORCID: 0000-0003-3100-7347
Journal: BMC Public Health
PubMed URL: 33722226
Type: Journal Article
Subjects: COVID-19
Mental health
Mitigation strategies
Public health policy
Stay-at-home orders
Appears in Collections:Journal articles

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