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Public health
Original research
Early perceptions and behavioural responses during the COVID-19 pandemic: a cross-sectional survey of UK adults
  1. Christina Atchison1,
  2. Leigh Robert Bowman2,
  3. Charlotte Vrinten3,
  4. Rozlyn Redd1,
  5. Philippa Pristerà1,
  6. Jeffrey Eaton2,
  7. Helen Ward1,2
  1. 1Patient Experience Research Centre, School of Public Health, Imperial College London, London, UK
  2. 2MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, UK
  3. 3Centre for Health Economics & Policy Innovation, Department of Economics & Public Policy, Imperial College Business School, Imperial College London, London, UK
  1. Correspondence to Dr Christina Atchison; christina.atchison11{at}imperial.ac.uk

Abstract

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.

  • COVID-19
  • epidemiology
  • public health
  • infectious diseases
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2020-043577

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    Footnotes

    • Twitter @profhelenward

    • Contributors CA, LRB, RR, PP and HW designed the study. CA, JE and CV analysed the data and performed the statistical analyses. CA, LRB, RR, CV and HW drafted the initial manuscript. All authors reviewed the drafted manuscript for critical content and approved the final version. CA and HW are the guarantors.

    • Funding The study was supported by Imperial NIHR Research Capability Funding (Award No. P81291). HW is a National Institute for Health Research (NIHR) Senior Investigator (Award No. P75372).

    • Disclaimer The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The Imperial College London Research Ethics Committee approved the study (Ref 20IC5861). Informed consent was obtained from those who chose to complete the survey after having read introductory information on its content and purpose.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. The survey instrument is freely available to download from the School of Public Health, Imperial College London COVID-19 resources webpage: http://www.imperial.ac.uk/medicine/departments/school-public-health/infectious-disease-epidemiology/mrc-global-infectious-disease-analysis/covid-19/covid-19-scientific-resources/ The data used for the analyses are available from the corresponding author on request.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.