ObjectiveThis study explored UK public perceptions and experiences of social distancing and social isolation related to the COVID-19 pandemic.DesignThis qualitative study comprised five focus groups, carried out online during the early stages of the UK’s stay at home order (‘lockdown’), and analysed using a thematic approach.SettingFocus groups took place via online videoconferencing.ParticipantsParticipants (n=27) were all UK residents aged 18 years and older, representing a range of gender, ethnic, age and occupational backgrounds.ResultsQualitative analysis revealed four main themes: (1) loss—participants’ loss of (in-person) social interaction, loss of income and loss of structure and routine led to psychological and emotional ‘losses’ such as loss of motivation, loss of meaning and loss of self-worth; (2) criticisms of government communication—participants reported a lack of trust in government and a lack of clarity in the guidelines around social distancing and isolation; (3) adherence—participants reported high self-adherence to social distancing guidelines but reported seeing or hearing of non-adherence in others; (4) uncertainty around social reintegration and the future—some participants felt they would have lingering concerns over social contact while others were eager to return to high levels of social activity.Most participants, and particularly those in low-paid or precarious employment, reported feeling that the social distancing and isolation associated with COVID-19 policy has had negative impacts on their mental health and well-being during the early stages of the UK’s ‘lockdown’.ConclusionsA rapid response is necessary in terms of public health programming to mitigate the mental health impacts of COVID-19 social distancing and isolation. Social distancing and isolation ‘exit strategies’ must account for the fact that, although some individuals will voluntarily or habitually continue to socially distance, others will seek high levels of social engagement as soon as possible.

OBJECTIVE: Explore the perceptions and experiences of the UK public of social distancing and social isolation measures related to the COVID-19 pandemic.

Background During the 2020 COVID‐19 pandemic, one of the key components of many countries’ strategies to reduce the spread of the virus is contact tracing. Objective To explore public attitudes to a COVID‐19 contact tracing app in the United Kingdom. Setting Online video‐conferencing. Participants 27 participants, UK residents aged 18 years and older. Methods Qualitative study consisting of six focus groups carried out between 1st‐12th May, 2020 (39‐50 days into the UK ‘lockdown’). Results Participants were divided as to whether or not they felt they would use the app. Analysis revealed five themes: (1) lack of information and misconceptions surrounding COVID‐19 contact tracing apps; (2) concerns over privacy; (3) concerns over stigma; (4)concerns over uptake; and (5) contact tracing as the ‘greater good’. Concerns over privacy, uptake and stigma were particularly significant amongst those stated they will not be using the app, and the view that the app is for the ‘greater good’ was particularly significant amongst those who stated they will be using the app. One of the most common misconceptions about the app was that it could allow users to specifically identify and map COVID‐19 cases amongst their contacts and in their vicinity. Conclusions Our participants were torn over whether digital contact tracing is a good idea or not, and views were heavily influenced by moral reasoning. Patient or Public Contribution No patients were involved in this study. The public were not involved in the development of the research questions, research design or outcome measures. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Summary results were disseminated via email to participants prior to publication for feedback and comment.

OBJECTIVE:To explore public attitudes to the proposed COVID-19 contact tracing app in the United Kingdom. DESIGN:Qualitative study consisting of five focus groups carried out between 1 st -4 th May, 2020 (39-42 days after the official start of the UK lockdown). SETTING: Online video-conferencingPARTICIPANTS: 22 participants, all UK residents aged 18 years and older, representing a range of different genders, ages, ethnicities and locations. RESULTS:Participants were split roughly equally in number across three groups: will use the app; will not be using the app; and undecided as to whether they will use the app.Analysis revealed five main themes: (1) Lack of information and misconceptions surrounding COVID-19 contact tracing apps; (2) concerns over privacy; (3) concerns over stigma; (4) concerns over uptake; and (5) contact tracing as the 'greater good'. These themes were found across the sample and the three groups. However, concerns over privacy, uptake and stigma were particularly significant amongst those state they will not be using the app and the view that the app is for the "greater good" was particularly significant amongst those who stated they will be using the app. One of the most common misconceptions about the app was that it could allow users to specifically identify and map COVID-19 cases amongst their contacts and in their vicinity. : medRxiv preprint CONCLUSIONS: We offer four recommendations: (1) To offset the fact that many people may not be accessing, or might be avoiding, news coverage on COVID-19, authorities must communicate to the public via a range of methods including but not limited to: social media ads, postal information, text messaging and other emergency alert systems. (2) Communications should emphasise that the app cannot enable the user to identify which of their contacts has reported COVID-19 symptoms or tested positive. (3) Communication should emphasise collective responsibility ('the greater good') to promote social norms around use of the app (4) Communication should provide a slogan that maximises clarity of message, for example: 'Download the app, protect the NHS, save lives'.

Background Novel viral pandemics present significant challenges to global public health. Non-pharmaceutical interventions (e.g. social distancing) are an important means through which to control the transmission of such viruses. One of the key factors determining the effectiveness of such measures is the level of public adherence to them. Research to date has focused on quantitative exploration of adherence and non-adherence, with a relative lack of qualitative exploration of the reasons for non-adherence. Objective To explore participants’ perceptions of non-adherence to COVID-19 policy measures by self and others in the UK, focusing on perceived reasons for non-adherence. Methods Qualitative study comprising 12 focus groups conducted via video-conferencing between 25th September and 13th November 2020. Participants were 51 UK residents aged 18 and above, reflecting a range of ages, genders and race/ethnicities. Data were analysed using a thematic approach. Results Participants reported seeing an increase in non-adherence in others over the course of the pandemic. Reports of non-adherence in self were lower than reports of non-adherence in others. Analysis revealed six main themes related to participants’ reported reasons for non-adherence in self and others: (1) ‘Alert fatigue’ (where people find it difficult to follow, or switch off from, information about frequently changing rules or advice) (2) Inconsistent rules (3) Lack of trust in government (4) Learned Helplessness (5) Resistance and rebelliousness (6)The impact of vaccines on risk perception. Participants perceived a number of systemic failures (e.g. unclear policy, untrustworthy policymakers) to strongly contribute to two forms non-adherence—violations and errors. Conclusion Findings suggest that latent and systemic failures—in the form of policy decisions that are commonly experienced as too changeable, inconsistent and confusing, and policy makers that are commonly perceived as untrustworthy–may play a significant role in creating the conditions that enable or encourage non-adherence.

OBJECTIVETo explore the perceptions of non-adherence to COVID-19 policy measures by self and others in the UK, focusing on perceived reasons for non-adherence.DESIGNQualitative study comprising 12 online focus groups conducted between 25th September and 13th November 2020.SETTINGOnline video-conferencingPARTICIPANTS51 UK residents aged 18 and above, reflecting a range of ages, genders and race/ethnicities.RESULTSParticipants reported seeing an increase in non-adherence in others and identified a number of challenges to their own adherence to measures. Thematic analysis identified six main themes related to participants’ reported reasons for non-adherence in self and others: (1) Alert fatigue (2) Inconsistent rules (3) Lack of trust in government (4) Helplessness (5) Resistance and rebelliousness (6) Reduced perception of risk and the prospect of a vaccine. Participants also raised concerns that adherence would be impacted by a desire to socialise over Christmas. Two forms of non-adherence were observed: overt rule- breaking and subjective rule interpretation.CONCLUSIONSAdherence may be improved by: less frequent and clearer information on COVID-19 to reduce alert fatigue; implementing a more unified set of measures within and across countries in the UK; role modelling good adherence by authority figures; exploring ways to mitigate the impact that events like Christmas vaccine ‘breakthroughs’ may have on reducing adherence.

Among city inhabitants, the COVID-19 crisis is likely to have disproportionately damaging effects on slum dwellers compared to other urban residents, particularly those in low-and middle-income countries. Due to physical, structural and social aspects of slum environments, prevention efforts, such as hand washing, self-isolation and physical distancing are not feasible. The health impacts of COVID-19 in slums may be intensified by poor access to health services often within those settings. We have an unprecedented opportunity to act now through rapid program and policy response strategies to prevent further destruction and protect the urban poor.

OBJECTIVE: To explore public attitudes to the proposed COVID-19 contact tracing app in the United Kingdom.DESIGN: Qualitative study consisting of five focus groups carried out between 1st-4th May, 2020 (39-42 days after the official start of the UK lockdown). SETTING: Online video-conferencingPARTICIPANTS: 22 participants, all UK residents aged 18 years and older, representing a range of different genders, ages, ethnicities and locations.RESULTS: Participants were split roughly equally in number across three groups: will use the app; will not be using the app; and undecided as to whether they will use the app. Analysis revealed five main themes: (1) Lack of information and misconceptions surrounding COVID-19 contact tracing apps; (2) concerns over privacy; (3) concerns over stigma; (4) concerns over uptake; and (5) contact tracing as the ‘greater good’. These themes were found across the sample and the three groups. However, concerns over privacy, uptake and stigma were particularly significant amongst those state they will not be using the app and the view that the app is for the “greater good” was particularly significant amongst those who stated they will be using the app. One of the most common misconceptions about the app was that it could allow users to specifically identify and map COVID-19 cases amongst their contacts and in their vicinity.CONCLUSIONS: We offer four recommendations: (1) To offset the fact that many people may not be accessing, or might be avoiding, news coverage on COVID-19, authorities must communicate to the public via a range of methods including but not limited to: social media ads, postal information, text messaging and other emergency alert systems. (2) Communications should emphasise that the app cannot enable the user to identify which of their contacts has reported COVID-19 symptoms or tested positive. (3) Communication should emphasise collective responsibility (‘the greater good’) to promote social norms around use of the app (4) Communication should provide a slogan that maximises clarity of message, for example: ‘Download the app, protect the NHS, save lives’.