Abstract
The health and economic consequences of the COVID-19 pandemic is expected to disproportionately impact residents of lower-middle income countries. Understanding the psychological impact of the pandemic is important to guide outreach interventions. In this study, we examined people’s awareness of COVID-19 symptoms, risk perception, and changes in behaviors and stress levels during the lockdown in peri-urban Tamil Nadu India. Field workers conducted phone call surveys (included n = 2044) in 26 communities from 20–25 May 2020. The majority perceived no (60%) or low (23%) level of risk of personally contracting coronavirus. Common fears were related to health and economic concerns, including loss of income (62%), inability to travel freely (46%), and becoming sick (46%). Residents were well aware of the common symptoms of COVID-19, such as fever (66%) and dry cough (57%), but not the asymptomatic transmission (24%). The majority experienced increased stress about finance (79%) and the lockdown (51%). Our findings emphasize the need to develop context-adequate education and communication programs to raise vigilance about asymptomatic transmission and to sustain preventative behaviors. The evidence on fear and changes in stress levels could inform designing coping strategies and programs focused on mental well-being.
Highlights
On 11 March 2020, the World Health Organization (WHO) declared the novel coronavirus outbreak (COVID-19) a global pandemic [1]
We examined residents’ awareness of COVID-19 symptoms, perceived risk of contracting coronavirus, fear related to the COVID-19 pandemic, and their relationship with changes in behaviors and stress since the lockdown
Relationship between Perceived Risk and Changes in Behavior and Stress Levels. We found those who perceived the risk of contracting coronavirus were more likely to inform others about COVID-19 (OR = 1.94, 95%CI: 1.46–2.59, p < 0.001) (Table 5)
Summary
On 11 March 2020, the World Health Organization (WHO) declared the novel coronavirus outbreak (COVID-19) a global pandemic [1]. Originating from Wuhan, China, COVID-19 has spread to most countries in the world, with its impact spanning health, economics, human behaviors, and mental well-being [1,2]. As the number of deaths increases, evidence regarding people’s psychological reactions to this global public health crisis becomes increasingly important because it provides insights that could help policy-makers and practitioners improve health communication, promote preventive behaviors, and provide social and emotional support to those in need [2,3,4]. Previous studies showed that under ecological threats such as the pandemic, the negative emotional response, including increased risk perception and fear, make threats appear more menacing. In the case of COVID-19, a rapidly growing body of literature shows that awareness of the COVID-19 symptoms, self-perceived risk of contracting diseases, and fear are salient predictors of adopting preventive behaviors [5,6,7]
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