Impact of Covid -19 incidence rate and government-initiated risk communication measures on individual’s NPI practices

Abstract

Background Non-pharmaceutical interventions (NPI) are the most widely recognized public health measures recognized globally to prevent the spread of Covid-19. NPIs’ effectiveness may depend on the type, combination of applied interventions, and the level of proper public compliance with the NPIs. The expected outcome of behavioural practices varies relative to the intervention duration. Objectives This study aimed to assess the trend of community compliance to NPI with Covid-19 incidence and government-initiated interventions, and its variation by residence and sociodemographic characteristics of people. Methods A weekly non-participatory field survey on individuals’ NPI practices was observed from the 41st epidemiological week of October 5th, 2020, to the 26th epidemiological week of July 4th, 2021, a total of 39 weeks. The survey covered all 14 regional and national capital cities in Ethiopia. Data collection for the three NPI behaviours (i.e., respiratory hygiene, hand hygiene, and physical distance) was managed weekly at eight public service locations using the Open Data Kit (ODK) tool. The Covid– 19 incidence data and public health measures information from August 3rd, 2020 to July 4th, 2021 were obtained from the Ethiopian Public Health Institute (EPHI). Results More than 180,000 individuals were observed for their NPI practice, with an average of 5,000 observations in a week. About 43% of the observations were made in Addis Ababa, 56% were male and 75% were middle age group (18–50 years). The overall level of NPI compliance was high at the beginning of the observation then peaked around the 13th– 15th epidemiological weeks then declined during the rest of the weeks. The peak NPI compliance periods followed the high Covid-19 death incidence and government-initiated intensive public health measures weeks. Respiratory hygiene had the highest compliance above 41% whereas hand hygiene was the lowest (4%). There was a significant difference between residents of the capital city and regional cities in their level of compliance with NPI. Females comply more than males, and individuals had increased NPI compliance at the bank service and workplaces compared to those in the transport services at P = 0.000. Conclusion An increased level of compliance with NPI was observed following intensive government-initiated Covid-19 prevention measures and an increased Covid-19 death incidence. Therefore, the intensity of government-initiated risk communication and public advocacy programs should be strengthened, possibly for similar respiratory disease pandemics in the future.

Ethical implications of COVID-19 management—is freedom a desired aim, or a desired means to an end?

“…Since no single NPI is effective in controlling COVID-19 spread, curfews, lockdowns, as well as restricting locations for public gatherings, were the most effective NPIs reported in large studies (10,11). Other studies have also assessed the efficacy of different NPIs related to case identification, environmental measures, healthcare, public health capacity, resource allocation, risk communication, social distancing, travel restriction, and returning to normal life, demonstrating that risk communication had the greatest impact on the population, especially highlighting the importance of efficient communication during a crisis (11,12). Risk communication addressed and educated the population on hazards, exposures, vulnerability and disease control, showing that psychology-driven positive and negative feedbacks generate opposing behavior in large populations.…”

“…However unprecedented, these interventions seemed necessary as the fundamental role of the state is to protect its citizens. The portfolio of initial interventions relied on environmental health (12,13). Introduction of massive tracing, identification and quarantine strategies implied that the effectiveness for this intervention is without dispute, but was not seen in Japan, while present for other countries, such as USA and Italy.…”

“…Introduction of massive tracing, identification and quarantine strategies implied that the effectiveness for this intervention is without dispute, but was not seen in Japan, while present for other countries, such as USA and Italy. Case identification and contact tracing effectiveness was negative for European countries with elevated incidence such as France and Germany, as well as Asian countries such as India and South Korea, but the latter, after being praised as a great example of successful contact tracing was hit by a second pandemic wave that eliminated effective tracing (10)(11)(12).…”