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      Public perceptions and experiences of social distancing and social isolation during the COVID-19 pandemic: a UK-based focus group study

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          Abstract

          Objective

          This study explored UK public perceptions and experiences of social distancing and social isolation related to the COVID-19 pandemic.

          Design

          This 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.

          Setting

          Focus groups took place via online videoconferencing.

          Participants

          Participants (n=27) were all UK residents aged 18 years and older, representing a range of gender, ethnic, age and occupational backgrounds.

          Results

          Qualitative 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’.

          Conclusions

          A 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.

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          Most cited references 13

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          Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science

          Summary The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.
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            Rigour and qualitative research.

             C Pope,  N Mays (1995)
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              Knowledge and Perceptions of COVID-19 Among the General Public in the United States and the United Kingdom: A Cross-sectional Online Survey

              Background: The behavior of the general public will probably have an important bearing on the course of the coronavirus disease 2019 (COVID-19) epidemic. Human behavior is influenced by people's knowledge and perceptions (1). Objective: To assess knowledge and perceptions about COVID-19 among a convenience sample of the general public in the United States and United Kingdom. Methods and Findings: This study is a cross-sectional survey conducted on an online platform managed by Prolific Academic Ltd. The platform's pool of participants numbers approximately 80 000 individuals, of whom approximately 43% reside in the United Kingdom and 33% in the United States (2). For this study, Prolific selected a convenience sample of 3000 participants residing in the United States and 3000 participants residing in the United Kingdom who were chosen to have approximately the same distribution of age, sex, and ethnicity (and each combination thereof) as the U.S. and U.K. general population (by using numbers from the last census in each country). Specifically, Prolific established population strata (Table 1) with a predetermined number of open slots into which eligible participants in the online pool could enroll on a first-come, first-served basis. Table 1. Sample Characteristics Participants, who had to have indicated that they were fluent in English, received US$1.50 for completing the survey. They completed the online questionnaire between 23 February and 2 March 2020. The questionnaire (Supplement, available at Annals.org) consisted of 22 questions on knowledge and perceptions of COVID-19, including specific questions about “myths” or falsehoods listed on the World Health Organization's “myth busters” Web site (3). Supplement. Questionnaire Click here for additional data file. To summarize the survey findings, I dichotomized categorical variables and computed the median and interquartile range for continuous variables. For binomial proportions, I used a score interval (Wilson score interval without continuity correction [4]) to construct a 95% CI. No sampling weights were used given that this was not a probabilistic sample. In total, 2986 and 2988 adults residing in the United States and United Kingdom, respectively, completed the questionnaire. Participants' sociodemographic characteristics are shown in Table 1. Although participants generally had good knowledge of the main mode of disease transmission and common symptoms, the survey identified several important misconceptions on how to prevent acquisition of COVID-19, including beliefs in falsehoods that have circulated on social media (Table 2). A substantial proportion of participants also expressed an intent to discriminate against individuals of East Asian ethnicity for fear of acquiring COVID-19. A more detailed analysis and visualization of all survey responses are available (5). Table 2. Summary of Survey Findings Discussion: The findings of this study could be used to set priorities in information campaigns on COVID-19 by public health authorities and the media. Such information provision could, for instance, emphasize the comparatively low case-fatality rate, the recommended care-seeking behavior, the low risk posed by individuals of East Asian ethnicity living in the United States and United Kingdom, and that children appear to be at a lower risk for a fatal disease course than adults. In addition, to ensure that individuals focus their attention on those prevention measures that are most effective, this study suggests that it will be important to inform the public about the comparative effectiveness of common surgical masks versus frequent and thorough handwashing and avoiding close contact with people who are sick. This study has several limitations. First and foremost, given that participants had to have both chosen to register with Prolific and to take the survey at the time it was published, this convenience sample of adults is unlikely to be representative of the general U.S. and U.K. population. The generalizability of the findings is, therefore, limited. Second, it is possible that some participants may have randomly selected responses to spend the least amount of time to earn the $1.50 reward. I believe this is unlikely to be an important source of bias because only 2 participants (who were excluded from the analysis) completed the survey in under 2 minutes (while it was physically possible to complete it in well under 90 seconds), there was no bimodal distribution in the time taken to complete the survey, and $1.50 is a relatively small monetary incentive. Third, it is possible that participants looked up the answers to some of the questions online before answering. Participants were asked at the end of the survey (while being reassured that their payment is not influenced by their response) for which, if any, questions they searched for an answer online. These responses were set to missing in the analysis. In conclusion, the general public in the United States and United Kingdom appears to have important misconceptions about COVID-19. Correcting these misconceptions should be targeted in information campaigns organized by government agencies, information provision by clinicians to their patients, and media coverage.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2020
                20 July 2020
                : 10
                : 7
                Affiliations
                [1 ] departmentCentre for People and Organisation, School of Management , Swansea University , Swansea, UK
                [2 ] departmentManchester Centre for Health Psychology , University of Manchester , Manchester, UK
                [3 ] World Health Organization , Genève, Switzerland
                Author notes
                [Correspondence to ] Dr Simon N Williams; s.n.williams@ 123456swansea.ac.uk
                Article
                bmjopen-2020-039334
                10.1136/bmjopen-2020-039334
                7387310
                32690752
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

                Product
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001317, Swansea University;
                Award ID: Greatest Need Fund
                Funded by: Manchester Centre for Health Psychology;
                Categories
                Public Health
                1506
                2474
                1724
                Original research
                Custom metadata
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                Medicine

                public health, mental health, qualitative research

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