Australians, COVID-19 and the question of complacency

New research published in PLOS ONE, surveying 1420 Australians, showed 94% modified their behaviour to be socially responsible, despite only one in five perceiving COVID-19 to have a high risk to their health.
 
Conducted at the height of the pandemic – 18–24 March – researchers from the University of New South Wales (UNSW) surveyed participants’ attitudes and beliefs towards COVID-19, with a particular focus on their willingness and capacity to engage with mitigation strategies. These included washing hands, and covering their cough or sneeze, as well staying away from public areas, work, avoiding public transport and postponing events.
 
Lead author Dr Holly Seale, a social scientist with UNSW Medicine’s School of Public Health and Community Medicine, said the survey results suggest Australians may be more strongly motivated by a sense of social responsibility than blind adherence to rules and regulations.
 
‘We found – somewhat surprisingly – really good compliance with both the hygiene-related behaviours and the avoidance-related behaviours at that time point,’ she said.
 
‘Some factors that influenced whether or not people would adopt those strategies were related to things like whether or not they trusted the government and what was being proposed, whether they felt that those behaviours would have an impact on reducing their risk, and whether or not people thought that they actually had the capacity to adopt those strategies.’
 
The survey showed trust in government and health authorities to be very high, with just under 94% displaying faith in the recommendations made by lawmakers and health professionals.
 
But Victoria is now at a critical crossroads.
 
With a consistent rise in coronavirus cases over the past eight days, leading authorities to postpone plans to loosen restrictions, there are fears Australians are becoming complacent.
 
Victoria confirmed another 20 new cases on Wednesday 24 June, seven of which are linked to known outbreaks, marking the eighth consecutive day of double-digit growth. It brings the state’s total number of active cases to 141.
 
‘The experts tell us that, largely, the numbers are being driven by families – families having big get-togethers and not following the advice around distancing and hygiene,’ Premier Daniel Andrews said.
 
‘In fact, around half of our cases since the end of April have come from transmission inside someone’s home.
 
‘You can see how this could happen. People feeling relaxed at home. Letting their guard down. Letting old habits creep back. But we are still in a pandemic – and people’s lives are still at risk.
 
‘This is a wake-up call. We cannot be complacent.’
 
Victoria also recorded Australia’s first coronavirus-related death in a month, a man aged in his 80s.
 
‘It does point to the fact that when we get additional cases there will be a risk of people dying,’ the state’s Chief Health Officer Professor Brett Sutton said.
 
‘There will be a risk of further cases being hospitalised and going to intensive care.
 
‘That’s why we need to get on top of the numbers in general.’
 
Professor Sutton said one encouraging sign was the slight decrease in community transmission, down from 10 or more in the previous four days to eight on Wednesday.
 
‘It certainly means we’re not getting an increase or an exponential increase in community transmission cases day by day,’ Professor Sutton said.
 
Professor Vasso Apostolopoulos, an immunologist and world-renowned researcher involved in efforts to find a vaccine and treatment for COVID-19 at Victoria University, says it is not surprising that numbers are arising, citing mixed messaging to the public.
 
‘When governments decided to ease restrictions I thought, this is terrible, why are they doing that? People are going to shopping centres, to pubs, people are everywhere – of course there’s going to be a spike, it was obvious,’ she told newsGP.
 
‘People I think are getting confused and don’t realise the severity, and that it will spread.
 
‘This started from one person and we’ve got a pandemic. Now there are three and a half million people that are positive for coronavirus at the moment in the world.
 
‘I understand they want to open the borders and want to try and get some sort of normality because there’s a lot of unemployment but, at the same time, we shouldn’t rush into it.’


Lead study author Dr Holly Seale said the survey results suggest Australians may be more strongly motivated by a sense of social responsibility than blind adherence to rules and regulations.

While there has been talk of the community ‘fatiguing’ from restrictions, Dr Seale disagrees. She believes the current situation is more a reflection of reevaluated perceived risk of COVID-19 based on public messaging.
 
‘If you reflect over the time point from where we were back in March to where we are at now, we hear governments talking about the fact that case numbers were, until probably a week ago or so, on the downward curve,’ she told newsGP.
 
‘If there were new cases, those cases were associated with travellers and they were in quarantine, and with limited ongoing transmission. I even recall one of the health ministers saying that there’s no local transmission.
 
‘So what does that mean to a layperson hearing this? Well, it’s going to fill them with a sense that for them personally their risk is extremely low and that we have done what we needed to do, and it’s now time to shift forward.
 
‘We don’t want to put a negative spin on this because if we talk about fatigue, it means that the community is doing something wrong, but that’s not right. They have done really well and they have been part of this strategy in such a great way … but unfortunately this pandemic keeps throwing curveballs and we are still understanding what’s happening.’
 
To ensure people are adhering to mandated guidelines, Victorian Premier Daniel Andrews said an ‘army’ of officials would commence door-knocking homes in the six identified local government hotspot areas, which include Brimbank, Cardinia, Casey, Darebin, Hume and Moreland.
 
The state health department is expected to soon publish a list of specific Melbourne suburbs that have been affected in recent days.
 
But with many of the hotspots home to high-risk groups, such as migrant communities and temporary visa holders, an expert panel of doctors and politicians reportedly warned the Federal Government of ‘a missed opportunity’ to prevent outbreaks as early as 21 May.
 
The National COVID-19 Health and Research Advisory Committee (NCHRAC) put together a report of recommendations informed by community representatives who told the panel they had not been adequately consulted in the Government’s pandemic response.
 
‘It’s always an afterthought rather than, let’s say, bringing in vulnerable members of the community early to make sure the solution we’re trying to design is inclusive of everyone,’ Mohammad Al-Khafaji, CEO of the Federation of Ethnic Community Councils Australia, told the ABC.
 
While Victoria has one of the highest coronavirus testing capacity rates in the world, able to test more than 20,000 people a day, a surge in demand has resulted in wait times of up to four hours and others being turned away. Some drive-thru testing sites are also at risk of being suspended due to safety and traffic management converns.
 
Authorities have said they are working to open additional testing sites in hotspot areas, and a makeshift testing site has also been set up at the Melbourne Showgrounds, which will be open to the public from Thursday 25 June.
 
‘We do apologise and we ask for people to be patient,’ Professor Sutton said, urging people to ‘shop around’ or go to their GPs instead.
 
In contrast, New South Wales had just 10 new cases confirmed on Wednesday, all identified as returned travellers who are in hotel quarantine. While Queensland recorded no new coronavirus cases for the seventh day in a row.
 
While it is unlikely for NSW to close its borders, Premier Gladys Berejiklian reiterated her advice for people to ‘rethink any travel to Melbourne whatsoever’.
 
So where to from here?
 
Dr Seale believes governments need to continue having a two-way conversation with the community to better understand what is influencing their choices to tailor its messaging.
 
‘Our health ministers are still very much focused on reminding people about staying 1.5 metres away, making sure that they wash their hands. Well, those messages now … are stale,’ she said.
 
‘We need to be tailoring the message to suit the current situation where government has eased or shifted the restrictions.
 
‘This could mean talking with them about why the strategy would be implemented, the end-goal of implementing it, and talking about the potential impact.’
 
But one thing’s for certain, according to Professor Apostolopoulos – the messaging needs to be focused on the reality of life with COVID-19 for the foreseeable future.
 
‘COVID’s here and it’s not going to go away,’ she said ‘Even if there is a vaccine that’s successful and proven to induce immunity in people, it will not be ready for mass worldwide immunisations before 18 months, even two years – that’s at best.
 
‘So until then, we all need to live with COVID-19 and not go back normality as we knew it. We have to change our lifestyle and the way we interact with people in what we do.’
 
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