Abstract
Confidence in the health care system implies an expectation that sufficient and appropriate treatments will be provided if needed. The COVID-19 public health crisis is a significant, global, and (mostly) simultaneous test of the behavioral implications arising from this confidence. We explore whether populations reporting low levels of confidence in the health care system exhibit a stronger behavioral reaction to the COVID-19 pandemic. We track the dynamic responses to the COVID-19 pandemic across 38 European countries and 621 regions by employing a large dataset on human mobility generated between February 15 and June 5, 2020 and a broad range of contextual factors (e.g., deaths or policy implementations). Using a time-dynamic framework we find that societies with low levels of health care confidence initially exhibit a faster response with respect to staying home. However, this reaction plateaus sooner, and after the plateau it declines with greater magnitude than does the response from societies with high health care confidence. On the other hand, regions with higher confidence in the health care system are more likely to reduce mobility once the government mandates that its citizens are not to leave home except for essential trips, compared to those with lower health care system confidence. Regions with high trust in the government but low confidence in the health care system dramatically reduce their mobility, suggesting a correlation for trust in the state with respect to behavioral responses during a crisis.
Highlights
During the first several months of 2020, most countries attempted to implement various social distancing measures and other non-pharmaceutical interventions (NPIs) to combat the spread and transmission of COVID-19; for example, bans on large gatherings, closure of schools, gyms, bars and restaurants, and mandating stay-at-home policies with varying degrees of strictness
When we change the time reference for each region to the number of days since the outbreak in their country, defined as the date of the first confirmed case (Fig 1B) which we normalize to 0, we find that regions with low confidence in the health care system reduce their mobility much more rapidly than regions with high levels of confidence
We found a similar pattern when looking at changes to non-residential mobility; regions with low levels of confidence in the health care system were the first to reduce mobility outside the home after the first confirmed Covid-19 case (S1 Fig)
Summary
Early in the pandemic, Van Bavel et al [24] pointed out the path forward for several of these behavioral interventions. Their overview of knowledge in social and behavioral science explored the potential avenues and channels through which these disciplines can support real-time public health crisis management. Many of the authors’ suggestions are reflected in current policy, and many points remain as further opportunities to improve policy responses
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
