Australians with health issues are strongly advocating for continued safety measures to prevent COVID-19

Even as government restrictions have eased, a new study shows Australians, particularly those with pre-existing medical conditions, remain steadfast in their support for COVID-19 precautions, showing the public remains vigilant and health-conscious.

Study. Attitudes and behaviours regarding COVID-19 mitigation strategies among Australians with an underlying health condition: a cross-sectional study. Image credit: Ground Picture / Shutterstock

In a recent study published in the journal Health Expectations, The researchers used a large nationwide cross-sectional study design to examine the effects of participants' pre-existing medical conditions on their attitudes and perceptions towards nationally implemented COVID-19 mitigation measures. The survey-based study included 2,867 participants and revealed that nearly three-quarters of participants (74%) believed that the current mitigation measures were too lenient and expressed a desire to return to public mask mandates. Similarly, a large number of people would prefer isolation measures five days per week (66%).

Notably, for people with mental conditions, the majority of individuals with pre-existing health concerns were more cautious and strict in complying with COVID-19 mitigation measures than their healthy counterparts.

background

The Coronavirus disease 2019 (COVID-19) is one of the worst disease outbreaks in human history, having infected more than 770 million individuals and killed more than 7 million since its discovery in late 2019. While the development and government-sponsored dissemination of vaccines played a key role in halting transmission of the disease-causing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, government-mandated social distancing behaviors and similar mitigation public health strategies were critical in slowing the spread of the disease during the early stages of the pandemic.

Recent research has highlighted the links between pre-existing health conditions and COVID-19 infection. People with pre-existing health conditions such as cardiovascular diseases (CVD), respiratory diseases, diabetes and immune deficiencies are at a higher risk of COVID-19 infection than their healthier counterparts, resulting in more adverse outcomes (Australian Chief Medical Officer, World Health Organisation [WHO]Unfortunately, the literature lacks studies examining whether increased risk might translate into changed attitudes and behaviors regarding reversal of policy orders against COVID-19.

“With the achievement of high vaccination rates, public health measures to prevent COVID-19 infection have been relaxed in Australia. Masks are no longer mandatory, even in healthcare settings, and the mandatory isolation period for COVID-19 ends in October 2022… In contrast, in the United States, 5 days of isolation remained in place until March 2024, and 1 day of isolation is still recommended.”

About the study

The current study aims to fill this gap in the literature by describing Australians' attitudes and behaviours towards COVID-19 coping strategies such as wearing masks, washing hands/using sanitisers, avoiding crowds and getting vaccinated. The National Health and Medical Research Council (NHMRC) Centre for Research Excellence (CRE) conducted the current cross-sectional study on Airborne Threats to Health (BREATHE) among 9.^th to 25^th January 2023.

Participants for the study were invited through Dynata using a survey link distributed randomly across all Australian states and territories. The study included participants over the age of 18, while those who did not complete the questionnaire and participants with multiple answers who failed quality checks were excluded. The questionnaire consisted of 38 questions on 13 main topics – demographics (13 questions), social distancing (14 questions), eligibility checks (3 questions), wearing masks (4 questions), sanitisers and hand washing (3 questions), and vaccination (1 question).

The primary outcome of interest in this study was participants' attitudes and behaviors towards COVID-19 mitigation measures. Exposures include underlying health concerns reported by participants prior to COVID-19 infection. Exposures were classified into six categories for statistical analysis – 1. cardiometabolic, 2. respiratory, 3. immune-related, 4. allergy, 5. neurological and 6. mental health.

Statistical analyses included descriptive summaries of participants’ outcomes and the use of logistic regression models to explain relationships between exposures and outcomes.

Study findings

Of the 2,909 participants initially selected for the study, 42 failed to meet study inclusion criteria, leaving a sample group of 2,867 participants (mean age = 47; 54% women). The study group was predominantly English-speaking (85%), with a majority of Australian-born participants (75%), while Aboriginal and Torres Strait Islander individuals were in the minority (4%).

The study findings highlighted that individuals with comorbidities represent a statistical majority (54%), not a minority as previously believed. Cardiometabolic and allergies were found to be the most frequently reported comorbidities (28% and 23%, respectively). A relationship was observed between age and comorbidity frequency, with older individuals being more likely to report pre-existing health concerns. Similar trends were observed among employed versus unemployed participants, with the former group reporting healthier outcomes than the latter.

Notably, the majority of participants called for continued COVID-19 mitigation measures even after an apparent decline in SARS-CoV-2 infection rates. More than 84% of participants reported being vaccinated, 80% regularly washed their hands, and 77% avoided close contact with people who had symptoms.

“Most participants reported that they felt wearing an N95/P2 face mask reduced the risk of contracting COVID compared to a cloth or surgical mask (n = 2143; 75%), and that they would stay home if they experienced COVID symptoms (n = 2121; 74%). Most participants disagreed with the statement that there is no need to wear masks because the pandemic is over (n = 2108; 74%) and they would prefer to keep the 5-day isolation order in place (n = 1903; 66%).”

The data also showed that these results varied slightly by age and pre-existing health conditions, with individuals over 45 years of age and those with comorbidities exercising more caution than their healthier counterparts.

conclusion

The present study sheds light on the attitudes and behaviour of Australians in complying with COVID-19 prevention measures such as wearing face masks, getting vaccinated and maintaining social distancing. Surprisingly, more than 50% of the people under study reported health concerns even before the onset of the COVID-19 pandemic, which is in contrast to previous reports of comorbid individuals representing a minority of the population.

Notably, older and co-morbid participants were observed aligning their behaviour with COVID-19 mitigation measures significantly more often than their healthier counterparts. The findings show that most Australians, regardless of their current health, support the continuation of COVID-19 mitigation measures and continue to follow social distancing and face-mask rules despite the end of government orders.