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      Economic and social impacts of COVID-19 and public health measures: results from an anonymous online survey in Thailand, Malaysia, the UK, Italy and Slovenia

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          Abstract

          Objectives

          To understand the impact of COVID-19 and public health measures on different social groups, we conducted a mixed-methods study in five countries (‘SEBCOV—social, ethical and behavioural aspects of COVID-19’). Here, we report the results of the online survey.

          Study design and statistical analysis

          Overall, 5058 respondents from Thailand, Malaysia, the UK, Italy and Slovenia completed the self-administered survey between May and June 2020. Poststratification weighting was applied, and associations between categorical variables assessed. Frequency counts and percentages were used to summarise categorical data. Associations between categorical variables were assessed using Pearson’s χ 2 test. Data were analysed in Stata 15.0

          Results

          Among the five countries, Thai respondents reported having been most, and Slovenian respondents least, affected economically. The following factors were associated with greater negative economic impacts: being 18–24 years or 65 years or older; lower education levels; larger households; having children under 18 in the household and and having flexible/no income. Regarding social impact, respondents expressed most concern about their social life, physical health, mental health and well-being.

          There were large differences between countries in terms of voluntary behavioural change, and in compliance and agreement with COVID-19 restrictions. Overall, self-reported compliance was higher among respondents who self-reported a high understanding of COVID-19. UK respondents felt able to cope the longest and Thai respondents the shortest with only going out for essential needs or work. Many respondents reported seeing news perceived to be fake, the proportion varying between countries, with education level and self-reported levels of understanding of COVID-19.

          Conclusions

          Our data showed that COVID-19 and public health measures have uneven economic and social impacts on people from different countries and social groups. Understanding the factors associated with these impacts can help to inform future public health interventions and mitigate their negative consequences.

          Trial registration number

          TCTR20200401002.

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          Most cited references47

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          The psychological impact of quarantine and how to reduce it: rapid review of the evidence

          Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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            Using social and behavioural science to support COVID-19 pandemic response

            The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.
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              Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe

              Following the detection of the new coronavirus1 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics of coronavirus disease 2019 (COVID-19). In response, many European countries have implemented non-pharmaceutical interventions, such as the closure of schools and national lockdowns. Here we study the effect of major interventions across 11 European countries for the period from the start of the COVID-19 epidemics in February 2020 until 4 May 2020, when lockdowns started to be lifted. Our model calculates backwards from observed deaths to estimate transmission that occurred several weeks previously, allowing for the time lag between infection and death. We use partial pooling of information between countries, with both individual and shared effects on the time-varying reproduction number (Rt). Pooling allows for more information to be used, helps to overcome idiosyncrasies in the data and enables more-timely estimates. Our model relies on fixed estimates of some epidemiological parameters (such as the infection fatality rate), does not include importation or subnational variation and assumes that changes in Rt are an immediate response to interventions rather than gradual changes in behaviour. Amidst the ongoing pandemic, we rely on death data that are incomplete, show systematic biases in reporting and are subject to future consolidation. We estimate that-for all of the countries we consider here-current interventions have been sufficient to drive Rt below 1 (probability Rt < 1.0 is greater than 99%) and achieve control of the epidemic. We estimate that across all 11 countries combined, between 12 and 15 million individuals were infected with SARS-CoV-2 up to 4 May 2020, representing between 3.2% and 4.0% of the population. Our results show that major non-pharmaceutical interventions-and lockdowns in particular-have had a large effect on reducing transmission. Continued intervention should be considered to keep transmission of SARS-CoV-2 under control.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2021
                20 July 2021
                20 July 2021
                : 11
                : 7
                : e046863
                Affiliations
                [1 ]departmentMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine , Mahidol University , Bangkok, Thailand
                [2 ]departmentCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine , University of Oxford , Oxford, UK
                [3 ]departmentPaediatric Ethics Committee; Research Ethics Committee , University Hospital of Padua , Padua, Italy
                [4 ]departmentDepartment of Tropical Hygiene, Faculty of Tropical Medicine , Mahidol University , Bangkok, Thailand
                [5 ]departmentFaculty of Arts and Social Science , Universiti Tunku Abdul Rahman , Kampar, Malaysia
                [6 ]departmentEmergency and Trauma Department, Sabah Women and Children’s Hospital , Ministry of Health , Kota Kinabalu, Malaysia
                [7 ]departmentEmergency Department , Loh Guan Lye Specialists Centre , Georgetown, Malaysia
                [8 ]departmentDepartment of Statistical Sciences , University of Padua , Padua, Italy
                [9 ]departmentFaculty of Medicine , University of Ljubljana , Ljubljana, Slovenia
                [10 ]departmentDepartment of Radiation Oncology , Institute of Oncology , Ljubljana, Slovenia
                [11 ]departmentInstitute for Social Studies , Science and Research Centre Koper , Koper, Slovenia
                [12 ]departmentDepartment of Endocrinology, Diabetes and Metabolic Diseases , University Children’s Hospital, University Medical Center Ljubljana , Ljubljana, Slovenia
                [13 ]departmentThe Ethox Centre, Nuffield Department of Population Health , University of Oxford , Oxford, UK
                [14 ]departmentInstitute for Philosophical Studies , Science and Research Centre Koper , Koper, Slovenia
                [15 ]departmentDepartment of Global Health and Development , London School of Hygiene and Tropical Medicine , London, UK
                [16 ]departmentEmergency and Trauma Department, Queen Elizabeth Hospital , Ministry of Health , Kota Kinabalu, Malaysia
                Author notes
                [Correspondence to ] Phaik Yeong Cheah; Phaikyeong@ 123456tropmedres.ac
                Author information
                http://orcid.org/0000-0003-3378-4211
                http://orcid.org/0000-0001-6243-8487
                http://orcid.org/0000-0002-9839-5359
                http://orcid.org/0000-0001-9778-8436
                http://orcid.org/0000-0002-5246-9869
                http://orcid.org/0000-0003-2199-3550
                http://orcid.org/0000-0002-9725-7931
                http://orcid.org/0000-0001-6327-3266
                Article
                bmjopen-2020-046863
                10.1136/bmjopen-2020-046863
                8295020
                34285007
                d47d4a41-0780-4597-8278-826d8c3351ed
                © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/.

                History
                : 15 November 2020
                : 02 July 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100004329, Javna Agencija za Raziskovalno Dejavnost RS;
                Award ID: P6-0279
                Funded by: FundRef http://dx.doi.org/10.13039/100010269, Wellcome;
                Award ID: 096527
                Award ID: 106698
                Award ID: 210559
                Award ID: 220221
                Funded by: http://dx.doi.org/10.13039/501100000780, European Commission;
                Award ID: Sonar Global European Union Horizon 2020, 825671)
                Categories
                Global Health
                1506
                2474
                1699
                Original research
                Custom metadata
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                Medicine
                public health,epidemiology
                Medicine
                public health, epidemiology

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