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H ong Kong was relatively successful in mitigating transmission early in the outbreak of coronavirus disease . Confirmed cases were first reported in the city of Wuhan, China, in December 2019 (1). Situated at the southern tip of China, Hong Kong was at risk for importing COVID-19, given its shared border and high infrastructural and social connectivity with China. In 2019, >236 million passengers crossed the border between China and Hong Kong by land (2). Hong Kong is also vulnerable to virus transmission owing to its high population density and heavy reliance on public transportation. Despite these risks, as of March 20, 2020, transmission control efforts in Hong Kong, as reflected in the numbers of confirmed cases and deaths (256 cases, 4 deaths) (3), had been relatively successful compared with nearby countries and regions, including mainland China (80,967 cases, 3,248 deaths), South Korea (8,652 cases, 94 deaths), and Japan (950 cases, 33 deaths, in addition to the 712 cases from a cruise ship) (4).Health officials in Hong Kong have enacted multipronged interventions to slow disease spread (5). Adopted strategies include border screening (measuring body temperature, imposing a health declaration form system, imposing a 14-day mandatory quarantine period on persons entering Hong Kong from mainland China; parts of Korea, Japan, France, Germany, and Spain; and all of Italy and Iran), social distancing (shutting down the border, reducing cross-border commuting services, delaying the resumption of classes in schools, arranging telework for civil servants, and suspending of public services), and extending the Enhanced Laboratory Surveillance Program to adult patients with fever and mild respiratory symptoms at emergency departments or general outpatient clinics in the public sector.The behaviors of the public are important for outbreak management, particularly during the early phase when no treatment or vaccination is available and nonpharmaceutical interventions are the only options. The efficacy of nonpharmaceutical interventions depends on persons' degree of engagement and compliance in precautionary behaviors, such as facemask wearing, hand hygiene, and self-isolation. Willingness to engage in precautionary behaviors voluntarily depends on risk perception toward the current health threat. In fact, risk perception is a main theme in common health behavior theories (6,7). In addition, with advanced information technology in recent years comes the uncertainty of how risk perception is shaped by various information sources. Hong Kong's experience with outbreaks of novel pathogens (e.g., 2003 severe acute respiratory syndrome [SARS] and 2009 pandemic influenza) also provides a reference point to evaluate the risk perceptions of COVID-19. In comparison, Hong Kong was more affected by SARS than COVID-19 thus far. In 2003, a total of 1,755 persons in Hong Kong contracted SARS, resulting in 299 deaths (8).

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17 18 Background: Community responses are important for outbreak management during the early phase 19 when non-pharmaceutical interventions are the major preventive options. Therefore, this study aims to 20 examine the psychological and behavioral responses of the community during the early phase of the 21 COVID-19 epidemic in Hong Kong.22 23 Method: A cross-sectional online survey was launched within 36 hours after confirmed COVID-19 24 cases were first reported. Councilors of all 452 district council constituency areas were approached for 25 survey dissemination. Respondent demographics, anxiety level, risk perception, sources to retrieve 26 .CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10. 1101 /2020 COVID-19 information, actual adoption and perceived efficacy of precautionary measures were 27 collected. 29Result: Analysis from 1715 complete responses indicated high perceived susceptibility (89%) and high 30 perceived severity (97%). Most respondents were worried about COVID-19 (97%), and had their daily 31 routines disrupted (slightly/greatly: 98%). The anxiety level, measured by the Hospital Anxiety and 32 Depression Scale, was borderline abnormal (9.01). Nearly all respondents were alert to the disease 33 progression (99.5%). The most trusted information sources were doctors (84%), followed by broadcast 34 (57%) and newspaper (54%), but they were not common information sources (doctor: 5%; broadcast: 35 34%; newspaper: 40%). Only 16% respondents found official websites reliable. Enhanced personal 36 hygiene practices and travel avoidance to China were frequently adopted (>77%) and considered 37 effective (>90%). The adoption of social-distancing measures was lower (39%-88%), and their drivers 38 for greater adoption include: being female (adjusted odds ratio [aOR]:1.27), living in the New 39 Territories (aOR:1.32-1.55), perceived as having good understanding of COVID-19 (aOR:1.84) and 40 being more anxious (aOR:1.07). 41 42 Discussion: Risk perception towards COVID-19 in the community was high. Most respondents are alert 43 to the disease progression, and adopt self-protective measures. This study contributes by examining the 44 psycho-behavioral responses of hosts, in addition to the largely studied mechanistic aspects, during the 45 early phase of the current COVID-19 epidemic. The timely psychological and behavioral assessment of 46 the community is useful to inform subsequent interventions and risk communication strategies as the 47 epidemic progresses.48 49

The emergence and reemergence of coronavirus epidemics sparked renewed concerns from global epidemiology researchers and public health administrators. Mathematical models that represented how contact tracing and follow-up may control Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) transmissions were developed for evaluating different infection control interventions, estimating likely number of infections as well as facilitating understanding of their likely epidemiology. We reviewed mathematical models for contact tracing and follow-up control measures of SARS and MERS transmission. Model characteristics, epidemiological parameters and intervention parameters used in the mathematical models from seven studies were summarized. A major concern identified in future epidemics is whether public health administrators can collect all the required data for building epidemiological models in a short period of time during the early phase of an outbreak. Also, currently available models do not explicitly model constrained resources. We urge for closed-loop communication between public health administrators and modelling researchers to come up with guidelines to delineate the collection of the required data in the midst of an outbreak and the inclusion of additional logistical details in future similar models.