Low uptake of COVID-19 prevention behaviours and high socioeconomic impact of lockdown measures in South Asia: evidence from a large-scale multi-country surveillance programme

Abstract

BackgroundSouth Asia has become a major epicentre of the COVID-19 pandemic. Understanding South Asians’ awareness, attitudes and experiences of early measures for the prevention of COVID-19 is key to improving the effectiveness and mitigating the social and economic impacts of pandemic responses at a critical time for the Region.MethodsWe assessed the knowledge, behaviours, health and socio-economic circumstances of 29,809 adult men and women, at 93 locations across four South Asian countries. Data were collected during the national lockdowns implemented from March to July 2020, and compared with data collected prior to the pandemic as part of an ongoing prospective surveillance initiative.ResultsParticipants were 61% female, mean age 45.1 years. Almost half had one or more chronic disease, including diabetes (16%), hypertension (23%) or obesity (16%). Knowledge of the primary COVID-19 symptoms and transmission routes was high, but access to hygiene and personal protection resources was low (running water 63%, hand sanitisers 53%, paper tissues 48%). Key preventive measures were not widely adopted. Knowledge, access to, and uptake of COVID-19 prevention measures were low amongst people from disadvantaged socio-economic groups. Fifteen percent of people receiving treatment for chronic diseases reported loss of access to long-term medications; 40% reported symptoms suggestive of anxiety or depression. The prevalence of unemployment rose from 9.3% to 39.4% (P<0.001), and household income fell by 52% (P<0.001) during the lockdown. Younger people and those from less affluent socio-economic groups were most severely impacted. Sedentary time increased by 32% and inadequate fruit and vegetable intake increased by 10% (P<0.001 for both), while tobacco and alcohol consumption dropped by 41% and 80%, respectively (P<0.001), during the lockdown.ConclusionsOur results identified important knowledge, access and uptake barriers to the prevention of COVID-19 in South Asia, and demonstrated major adverse impacts of the pandemic on chronic disease treatment, mental health, health-related behaviours, employment and household finances. We found important sociodemographic differences for impact, suggesting a widening of existing inequalities. Our findings underscore the need for immediate large-scale action to close gaps in knowledge and access to essential resources for prevention, along with measures to safeguard economic production and mitigate socio-economic impacts on the young and the poor.

Tobacco product use and the risks of SARS-CoV-2 infection and COVID-19: current understanding and recommendations for future research

“… 69 Some of the same studies showed that alcohol use increased and physical activity decreased during the pandemic, 50 , 61 , 76 , 82 , 83 , 84 although others have reported declines in alcohol use. 72 , 85 …”

“…69 Some of the same studies showed that alcohol use increased and physical activity decreased during the pandemic, 50,61,76,[82][83][84] although others have reported declines in alcohol use. 72,85 Perceptions and reasons for changes in tobacco product use Across studies, adolescents, young adults, and adults were concerned about COVID-19 and perceived that use of cigarettes and e-cigarettes increased their risk of infection or severe COVID-19 symptoms, or both. 45,47,52,77,86,87 Such perceived risk of infection or disease severity, or concern over lung health more generally, was associated with reduced tobacco use.…”

Socioeconomic and Health Perspectives on the Quality of Life of Patients with Non-Communicable Diseases During the COVID-19 Pandemic: A Systematic Literature Review

“…The pandemic's influence on chronic illness care, mental health, health-related behavior, job, and family finances is significant. Sociodemographic variations that reflect inequities or gaps in knowledge and access to health care resources are critical for keeping patients' quality of life from deteriorating (Kusuma et al, 2021).…”

Status of Weight Change, Lifestyle Behaviors, Depression, Anxiety, and Diabetes Mellitus in a Cohort with Obesity during the COVID-19 Lockdown: Turk-Com Study Group

“…There were also problems in reaching healthcare services because hospitals were already overwhelmed with patients with COVID-19 and there were difficulties in giving service to other individuals who were seeking care. Second, patients tried to avoid going to hospitals due to the fear of contracting COVID-19 [19].…”