Public Preferences for Government Response Policies on Outbreak Control

ObjectivesTo assess the extent to which public support for outbreak containment policies varies with respect to the severity of an infectious disease outbreak. MethodsA web-enabled survey was administered to 1,017 residents of Singapore during the COVID-19 pandemic, and was quota-sampled based on age, gender 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 5 policies restricting local movement and 4 border control policies) they would support in 5 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. ResultsLikelihood of support varied across government response policies; however, was generally higher for border control policies compared to 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. ConclusionsOur 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.

Anxiety and perceived risk during COVID-19 outbreak

The uncertainty around coronavirus disease-19 (COVID-19) has triggered anxiety among public. We aimed to assess the variation in anxiety and risk perceptions of COVID-19 among adults in Singapore. We administered a web-survey to a panel of residents between 31 March and 14 April 2020. We assessed anxiety using general anxiety disorder (GAD) scale and assessed participants risk perceptions regarding severity of the outbreak. Of the 1,017 participants, 23% reported moderate to severe anxiety [GAD score[≥]10]. A high proportion reported perceived likelihood of ICU admission (46%) and death (30%) upon getting COVID-19. Results from path analysis showed that younger participants, those with chronic conditions, those living with children and low perceived trust in government response to COVID-19 had a significantly higher anxiety mediated by their perceived risk of dying upon getting COVID-19. These results highlight the need for management of anxiety through adequate and effective risk communication for the general public.

Palliative Care Awareness Among Advanced Cancer Patients and Their Family Caregivers in Singapore

INTRODUCTION@#We investigated the awareness of palliative care (PC) services in advanced cancer patients and their family caregivers and whether negative perceptions was a possible barrier to PC utilisation in Singapore.@*MATERIALS AND METHODS@#Patients with stage 4 solid cancer and their caregivers were interviewed between July 2016 and March 2018 at outpatient clinics located in the medical oncology departments of 2 major public hospitals in Singapore. Patients and caregivers were asked whether they were aware of PC services, how they first learned about them, who first recommended PC to the patient, whether the patient had received PC, and reasons for not receiving PC.@*RESULTS@#Awareness of PC was lower in patients compared to caregivers (43% vs 53%; <0.01). The odds of being aware in patients was higher if they had higher education (odds ratio [OR] = 2.927; <0.001) and higher income (OR = 1.798; = 0.005). Compared to patients, more caregivers reported that a healthcare provider recommended PC to the patient (10% vs 20%; <0.012). Furthermore, 7% of patients and 15% of caregivers reported that the patient received PC ( = 0.031). The most common reasons for not receiving PC reported by patients and caregivers (respectively) were that the patient was still receiving treatment (68% and 78%), it is not time for PC (76% and 59%) and PC would not be of help (18% and 19%).@*CONCLUSION@#Less than half of patients indicated an awareness of PC. Our findings suggest that efforts should be made to increase awareness of PC and promote its acceptance in cancer patients and their family caregivers in Singapore.