Abstract

BackgroundThe Coronavirus Disease 2019 (COVID-19) that first occurred in Wuhan, China, is currently spreading throughout China. The majority of infected patients either traveled to Wuhan or came into contact with an infected person from Wuhan. Investigating members of the public with a travel history to Wuhan became the primary focus of the Chinese government’s epidemic prevention and control measures, but several instances of withheld histories were uncovered as localized clusters of infections broke out. This study investigated the public’s willingness and beliefs associated with reporting travel history to high-risk epidemic regions, to provide effective suggestions and measures for encouraging travel reporting.MethodsA cross-sectional study was conducted online between February 12 and 19, 2020. Descriptive analysis, chi-squared test, and Fisher’s exact test were used to identify socio-demographic factors and beliefs associated with reporting, as well as their impact on the willingness to report on travel history to high-risk epidemic regions.ResultsOf the 1344 respondents, 91 (6.77%) expressed an inclination to deliberately withhold travel history. Those who understood the benefits of reporting and the legal consequences for deliberately withholding information, showed greater willingness to report their history (P < 0.05); conversely, those who believed reporting would stigmatize them and feared being quarantined after reporting showed less willingness to report (P < 0.05).ConclusionsAs any incident of withheld history can have unpredictable outcomes, the proportion of people who deliberately withhold information deserves attention. Appropriate public risk communication and public advocacy strategies should be implemented to strengthen the understanding that reporting on travel history facilitates infection screening and prompt treatment, and to decrease the fear of potentially becoming quarantined after reporting. Additionally, social support and policies should be established, and measures should be taken to alleviate stigmatization and discrimination against potential patients and reporters of travel history. Reinforcing the legal accountability of withholding travel history and strengthening systematic community monitoring are the measures that China is currently taking to encourage reporting on travel history to high-risk epidemic regions. These non-pharmaceutical interventions are relevant for countries that are currently facing the spread of the epidemic and those at risk of its potential spread.

Highlights

  • Since the emergence of the first case of coronavirus disease (COVID-19) infection on December 31, 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread rapidly throughout China [1]

  • Reinforcing the legal accountability of withholding travel history and strengthening systematic community monitoring are the measures that China is currently taking to encourage reporting on travel history to high-risk epidemic regions

  • Our study indicated that the belief of the benefits of reporting, obstacles to reporting, and legal consequences of withholding travel history would affect willingness to report

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Summary

Introduction

Since the emergence of the first case of coronavirus disease (COVID-19) infection on December 31, 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread rapidly throughout China [1]. By March 26, 2020, the number of confirmed cases in the city of Wuhan had reached 50,006 people, and accounted for 61.48% of all confirmed cases in the country [3] This made Wuhan a high-risk region for the epidemic in China. The Chinese government implemented appropriate and timely response measures to contain the outbreak, by quarantining Wuhan City and setting up inspection points in other regions for people with a travel history to Wuhan or its surrounding regions [2]. This method of inspection relies on the public to submit reports voluntarily, but its effectiveness does not appear to be satisfactory. This study investigated the public’s willingness and beliefs associated with reporting travel history to high-risk epidemic regions, to provide effective suggestions and measures for encouraging travel reporting

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