Perception, practices and preparedness of the adult population in response to SARS CoV-2 pandemic in India

INTRODUCTION

The microbial world is mysterious, threatening and scary to many people. Addressing these participants is a necessary part of planning for infectious biological disasters. The only counter measures available early in an outbreak of a new infectious disease are behavior interventions such as quarantine, hygiene and isolation.¹ Clinical condition caused by novel corona virus is called as COVID-19.^2,3 On 30^th January 2020, the world health organization declared COVID-19 to be a public health emergency of international concern.⁴

COVID-19 is a highly contagious disease and has affected a large population, the total number of deaths caused due to COVID-19 has exceeded that caused by any of its predecessors.⁵As COVID-19 is a new disease and is having the most devastating effects globally, its emergence and spread cause’s confusion, anxiety and fear among the general public. Social stigma has arisen as certain population is being targeted as being the reason for the outbreak. It is vital to avoid stigma as it can make people hide their illness and do not seek health care immediately.⁵ Therefore, present study was an effort to assess the knowledge, attitude, practice and preparedness of COVID-19 by exploring coping strategies and health behaviors enacted in response to COVID-19 pandemic.

Objectives

Objectives of the study were to know the preparedness measures adopted by the community by large in the beginning of epidemic of COVID-19 and to find out the perceptions and behavioral change of the community regarding COVID-19.

METHODS

Study design

The study design use was cross sectional study.

Study area

All across the country and study participants were citizens of India

Study duration

The study deration was from 11^th of April 2020-to 30^th of May 2020 for one month.

Sampling technique

The sampling technique used is Snowball technique.

Inclusion criteria

The study included the participants with access to WhatsApp, participants with age more than 18 years, able to understand English and willing to give consent.

Study plan

An online semi-structured questionnaire having both open and close ended questions was developed by using Google forms, with a consent form appended to it. The link was sent through WhatsApp. The study started with the first participant and using Snowball sampling technique, the participants were encouraged to roll out the survey to as many known people as possible in their contacts in their respective phones. Thus, the link was forwarded to people apart from the first point of contact and so on. On receiving and clicking the link the participants got auto directed to the information about the study and informed consent. After they accepted to take the survey, they had to fill the first section which constituted details regarding socio-demographic details. Then a set of several questions appeared sequentially, which the participants were to answer which mainly consisted of awareness, knowledge, practices, preparedness for the pandemic, and preventive measures against COVID-19. We received a total of 327 acceptance but only 301 participants responded to the entire question. Hence analyses of only 301 participants were done. Study was approved by the institutional ethical committee. Data was collected in Google form and was reentered in MS excel and analyzed using EPINFO.

RESULTS

Out of 301 study participants majority i.e., 162 (53.8%) of them were male. Majority of the participants were in the age group of 21-30 years with the mean and standard deviation of 30±11.3. Occupation status of the respondents revealed that Doctor accounted for 125 (41.5%), students 69 (22.9%), engineer 17 (5.6%) and business 12 (4%). Only, 24 (8%) had chronic illness.

Awareness regarding COVID-19, regarding the modes of transmission was very well amongst study participants. Regarding people who are at risk of getting COVID-19 infection, participants were well informed about who are more vulnerable and are at a greater risk of getting infection. From the responses elicited from the participants regarding symptoms of COVID-19, fever was the most prominent symptom followed by shortness of breath, cough, sore throat, tiredness, muscle stiffness, headache, anosmia and diarrhea respectively. The availability of drug for COVID-19 was affirmed by very few of the participants of which only i.e., 23 (88.5%) of participants said that HCQ was the drug of choice. Regarding incubation period of COVID-19 most of them knew about the duration 14 days.

Most of the study participants were practicing preventive measures effectively. Majority of the friends and family members were washing their hands, often. Majority of the respondents i.e., 297 (98.7%) practiced social distancing followed by 282 (93.7%) participants avoided crowded areas as they believed that the disease spread could be stopped if they practiced these measures.

Out of 301 participants included in the online survey majority i.e., 284 (94.4%) informed that the source of information regarding COVID-19 is by consulting with the health workers, followed by newspaper, television, conversation with colleagues and with family and friends, radio stations and social media respectively.

On asking about the reason for why they are worried about COVID-19 majority i.e., 223 (74%) responded that the disease is highly contagious, 219 (72.7%) told that no vaccine is available, 183 (60.8%) said that the disease is dangerous and life threatening. This shows that community are really worried and uncertain about the threat of this new disease.

Majority of the respondents have brought changes in their lifestyle which is evident from the above answers. Participants were practicing social distancing fully. Measures like avoiding touching eyes, nose and mouth, covering mouth when coughing, and washing with soap and water, wear facemask and avoid gathering respectively, avoiding close contact with someone who is infected, was practiced very effectively. Other measures were Staying home when sick, self-quarantine, ensuring a balanced diet, using disinfectant doing regular exercise, drinking warm water taking food supplements, avoided meat, and use of antibiotics (Figure 1).

The Table 5 describes the perceived benefits towards complying to the restrictions regarding the pandemic of COVID-19. Majority of respondents agreed to get the vaccine if available and if people who have visited outbreak should be quarantined, community facilities such as schools or kindergartens should be closed and major events should be cancelled and international trips should be avoided. One should leave the house only for urgent reasons and not unnecessarily.

Above Figure 2 shows the perceptions of affect assessed as affect towards COVID-19. The affects illustrated were mainly stress, feeling helpless, fear about novel corona virus, rate of spread, media hyped the situation about the news of COVID-19. It was observed that 36.5% participants felt that that disease was spreading fast and majority participants i.e., 38.5% did not have any fear regarding the disease. 13% participants felt that there was quite media hype while 16.6% also felt that there was no media hype and the disease is indeed dangerous. 18.3% felt helpless while 28.6% did not feel stressed.

Above Figure 3 illustrates the preparedness measures adopted by the study participants towards impending pandemic. About 33.9% of the participants bought extra medicines, 36.5% bought extra food, 46.8% bought extra medicines that they usually take, 31.9% bought disinfection on a large scale, 86% participants stayed away from social events, 88% of them cancelled flights or train rides, 91.7% of them cancelled holiday trips, 88% of the study participants-imposed restrictions on children going out of the house.

Perceived susceptibility was found to be moderate and accounts for 33.9% and 26.2% of the study participants perceived that the severity of contracting novel corona virus is very less accounting for 26.2% (Figure 5).

DISCUSSION

In the present study 301 majority of the participants i.e., 162 (53.8%) of them were male. Majority were in the age group of 21-30 years with the mean and standard deviation of 30±11.3. According to Nazli et al, the mean age of the respondents 38.38±12.34.⁶ Majority i.e., 125 (41.5%) were Doctor by occupation. Only 24 (8%) had chronic illness. 98.7% of the study participants were aware about COVID-19 which is similar to the finding of a research conducted by Jose et al, in which 99.3% of the participants were aware.⁷ In the present study majority i.e., 293 (97.4%) knew that COVID-19 is transmitted via respiratory droplets, followed by 219 (72.8%) touching contaminated surface/object. According to Roy et al, it was observed that only 29.5% of the participants responded that the virus spreads through multiple modes like touching, kissing, sneezing, and food study.⁸ In the present study, 299 (99.3%) informed that people aged more than 60 years are at risk of getting COVID-19 infection followed by individual who have chronic lung diseases. In the present study majority i.e., 288 (95.7%) of the study participants responded fever as a symptom of COVID-19 followed by shortness of breath, cough which is similar to the findings of the study conducted by Cvetkovic et al in which majority of the respondents (98.2%) noted that common symptoms include fever, dry cough.⁹ Roy et al, conducted a study and observed that only 18.2% regarded fever as a symptom of COVID-19, which is a major symptom.⁸ 98.7% practiced social distancing followed as they believed that the disease spread could be stopped if they practice this measure. 88.7% of the study participants-imposed restrictions on children going out of the house. Among 301 participants included in the study majority i.e., 284 (94.4%) informed that the source of information regarding COVID-19 is by consulting with the health workers, followed by newspaper, television. In the present study majority i.e., 223 (74%) responded that the disease is highly contagious, 219 (72.7%) told that no vaccine is available.

Limitations

The study is limited to the people who had smartphone’s, and who were well versed with English. Study has been done amongst educated population hence it cannot be generalized to the whole population.

CONCLUSION

The study participants had adequate awareness and knowledge regarding the novel corona virus. Perceptions have a great role in behavioral change therefore

All efforts should be focused on improving the perceived susceptibility, severity, benefits, the cues for action, especially in a new pandemic scenario which requires a quick behavioral change.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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