Abstract

BackgroundNonpharmaceutical interventions (NPIs) (such as wearing masks and social distancing) have been implemented by governments around the world to slow the spread of COVID-19. To promote public adherence to these regimes, governments need to understand the public perceptions and attitudes toward NPI regimes and the factors that influence them. Twitter data offer a means to capture these insights.ObjectiveThe objective of this study is to identify tweets about COVID-19 NPIs in six countries and compare the trends in public perceptions and attitudes toward NPIs across these countries. The aim is to identify factors that influenced public perceptions and attitudes about NPI regimes during the early phases of the COVID-19 pandemic.MethodsWe analyzed 777,869 English language tweets about COVID-19 NPIs in six countries (Australia, Canada, New Zealand, Ireland, the United Kingdom, and the United States). The relationship between tweet frequencies and case numbers was assessed using a Pearson correlation analysis. Topic modeling was used to isolate tweets about NPIs. A comparative analysis of NPIs between countries was conducted.ResultsThe proportion of NPI-related topics, relative to all topics, varied between countries. The New Zealand data set displayed the greatest attention to NPIs, and the US data set showed the lowest. The relationship between tweet frequencies and case numbers was statistically significant only for Australia (r=0.837, P<.001) and New Zealand (r=0.747, P<.001). Topic modeling produced 131 topics related to one of 22 NPIs, grouped into seven NPI categories: Personal Protection (n=15), Social Distancing (n=9), Testing and Tracing (n=10), Gathering Restrictions (n=18), Lockdown (n=42), Travel Restrictions (n=14), and Workplace Closures (n=23). While less restrictive NPIs gained widespread support, more restrictive NPIs were perceived differently across countries. Four characteristics of these regimes were seen to influence public adherence to NPIs: timeliness of implementation, NPI campaign strategies, inconsistent information, and enforcement strategies.ConclusionsTwitter offers a means to obtain timely feedback about the public response to COVID-19 NPI regimes. Insights gained from this analysis can support government decision making, implementation, and communication strategies about NPI regimes, as well as encourage further discussion about the management of NPI programs for global health events, such as the COVID-19 pandemic.

Highlights

  • SARS-CoV-2, the novel virus causing COVID-19, was declared a pandemic by the World Health Organization (WHO) on March 11, 2020

  • Studies have demonstrated that Nonpharmaceutical interventions (NPIs) regimes with a higher degree of public acceptability attract a greater level of public adherence and, reduce the rates of infection within a community [7,8]

  • The effectiveness of COVID-19 NPI regimes is dependent on ongoing public adherence

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Summary

Introduction

SARS-CoV-2, the novel virus causing COVID-19, was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. In the absence of preventative and curative pharmaceutical treatments specific to COVID-19, governments are reliant on the success of strategic response programs to mitigate, delay, or suppress the transmission of SARS-CoV-2 [2] These programs are dynamic regimes of nonpharmaceutical interventions (NPIs) [3]. To do so requires a greater understanding of the trends in the public’s perceptions and attitudes toward these NPI regimes, as well as a means of determining why, and in what contexts, these adherence behaviors arise, decrease, and persist [6] This level of understanding could assist governments in making more informed decisions about NPIs so that they may be made more acceptable to the public.

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