Public Preferences for Government Response Policies on Outbreak Control.

OBJECTIVE: The aim of this study was to assess the extent to which public support for outbreak containment policies varies with respect to the severity of an infectious disease outbreak. METHODS: A web-enabled survey was administered to 1017 residents of Singapore during the coronavirus disease 2019 (COVID-19) pandemic, and was quota-sampled based on age, sex, and ethnicity. A fractional-factorial design was used to create hypothetical outbreak vignettes characterised by morbidity and fatality rates, and local and global spread of an infectious disease. Each respondent was asked to indicate which response policies (among five policies restricting local movement and four border control policies) they would support in five randomly assigned vignettes. Binomial logistic regressions were used to predict the probabilities of support as a function of outbreak attributes, personal characteristics, and perceived policy effectiveness. RESULTS: Likelihood of support varied across government response policies but was generally higher for border control policies compared with internal policies. The fatality rate was the most important factor for internal policies, while the degree of global spread was the most important for border control policies. In general, individuals who were less healthy, had higher-income, and were older were more likely to support these policies. Perceived effectiveness of a policy was a consistent and positive predictor of public support. CONCLUSIONS: Our findings suggest that campaigns to promote public support should be designed specifically to each policy and tailored to different segments of the population. They should also be adapted based on the evolving conditions of the outbreak in order to receive continued public support.

A survey of anxiety and burnout in the radiology workforce of a tertiary hospital during the COVID-19 pandemic.

INTRODUCTION: We aimed to study anxiety and burnout among Division of Radiological Sciences (RADSC) staff during the COVID-19 pandemic and identify potential risk and protective factors. These outcomes were compared with non-RADSC staff. METHODS: A cross-sectional online study was conducted between 12 March and 20 July 2020 in the largest public tertiary hospital receiving COVID-19 cases. Burnout and anxiety were assessed with the Physician Work-Life Scale and the Generalized Anxiety Disorder-7 Scale, respectively. Workplace factors were examined as potential risk and protective factors using multivariable ordinary least squares regression analyses, adjusting for pertinent demographic characteristics. RESULTS: RADSC staff (n = 180) and non-RADSC staff (n = 1458) demonstrated moderate-to-severe anxiety rates of 6.7 and 13.2 % and burnout rates of 17.8 and 23.9 %, respectively. RADSC staff reported significantly lower anxiety (mean ± SD: 4.0 ± 3.7 vs 4.9 ± 4.5; P-value < 0.05), burnout (mean ± SD: 1.9 ± 0.7 vs 2.1 ± 0.8; P-value < 0.01), increased teamwork (82.2% vs 74.1%; P-value < 0.05) and fewer night shifts (36.7% vs 41.1%; P-value < 0.01). Among RADSC staff, higher job dedication was associated with lower anxiety (b (95% CI) = -0.28 (-0.45, -0.11)) and burnout (b (95% CI) = -0.07 (-0.11,-0.04)), while longer than usual working hours was associated with increased anxiety (b (95% CI) = 1.42 (0.36, 2.45)) and burnout (b (95% CI) = 0.28 (0.09, 0.48)). CONCLUSIONS: A proportion of RADSC staff reported significant burnout and anxiety, although less compared to the larger hospital cohort. Measures to prevent longer than usual work hours and increase feelings of enthusiasm and pride in one's job may further reduce the prevalence of anxiety problems and burnout in radiology departments.

Adoption of Preventive Behaviour Strategies and Public Perceptions About COVID-19 in Singapore.

BACKGROUND: The unprecedented severity of coronavirus disease 2019 (COVID-19) constitutes a serious public health concern. However, adoption of COVID-19-related preventive behaviours remain relatively unknown. This study investigated predictors of preventive behaviours. METHODS: An analytical sample of 897 Singaporean adults who were quota sampled based on age, gender, and ethnicity were recruited through a web-enabled survey. Outcomes were adoption of, or increased frequency of preventive behaviours (avoiding social events; avoiding public transport; reducing time spent shopping and eating out; wearing a mask in public; avoiding hospitals/clinics; keeping children out of school, washing hands/using sanitisers; keeping surroundings clean; avoiding touching public surfaces; working from/studying at home). Public perceptions regarding COVID-19 (chances of getting COVID-19; perceived likelihood of COVID-19-related intensive care unit (ICU) admission; government trust; self-efficacy; perceived appropriateness of COVID-19 behaviours; response efficacy), anxiety, and demographic characteristics (age; ethnicity; marital status; education; chronic conditions; current living arrangements) were investigated as predictors of preventive behaviours adopted during COVID-19 in binomial and ordered logistic regressions. RESULTS: Though adoption of preventive behaviours among Singaporeans varied, it was, overall, high, and consistent with government recommendations. Nearly a quarter reported moderate to severe anxiety (General Anxiety Disorder 7-item - GAD-7 scores). Respondents who perceived higher COVID-19 risks, had higher government trust, higher self-efficacy, and perceived that others acted appropriately reported increased adoption/frequency of preventive measures. The strongest indicator of behavioural change was response efficacy. Respondents who were older, highly educated, anxious and married reported higher adoption/frequency of preventive measures. CONCLUSION: To successfully influence appropriate preventive behaviours, public health messages should highlight response efficacy, increase self-efficacy, and promote trust in governmental response. Focus should be on demographic segments with low adoptions, such as younger individuals and those with low education.