A longitudinal study of COVID-19 preventive behavior fatigue in Hong Kong: a city with previous pandemic experience

Abstract

Background In addition to high vaccination levels, COVID-19 control requires uptake and continued adherence to personal hygiene and social distancing behaviors. It is unclear whether residents of a city with successive experience in worldwide pandemics such as SARS, would quickly adopt and maintain preventive behaviors. Methods A population-based, longitudinal telephone survey was conducted between in first local wave of the COVID-19 pandemic (April 2020) and third local wave (December 2020) (n = 403). The study examined factors associated with personal hygiene and social distancing behavior fatigue, as measured by reduced adherence. Results Over 9 months, face mask use increased (96.5–100%, p < 0.001). Although habitual hand hygiene remained unchanged (92.0%), blue collar workers and non-working individuals showed higher risk of hand hygiene fatigue. There was a decline (p < 0.05) in avoidance of social gatherings (81.1 to 70.7%), avoidance of public places (52.9–27.5%) and avoidance of international travel (81.9–77.4%) even with rising caseloads. Lowered perception of COVID-19 disease severity was associated with decreased avoidance of social gatherings and public places while lower education was associated with decline in avoidance of social gatherings. Conclusion Even in regions with past pandemic experience, maintaining social distancing behaviors during a protracted pandemic remains a major public health challenge.

The role of collectivism, liberty, COVID fatigue, and fatalism in public support for the zero-COVID policy and relaxing restrictions in China

“…JØrgensen et al found that pandemic fatigue was positively associated with concerns about democratic rights, opposition to COVID-19 restrictions, and support for protests [ 42 ]. Kim et al conducted a population-based longitudinal survey with participants in Hong Kong [ 46 ]. They found that participants showed a decline in compliance with pandemic prevention measures (e.g., avoiding social gatherings or international travel).…”

Heterogeneous risk tolerance, in-groups, and epidemic waves

“…However, prophylactic behavior is often subject to fatigue. Indeed, preventive behavior fatigue during secondary epidemic waves of a disease has been particularly well-documented since the COVID-19 pandemic event [58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75]. Failing to account for prophylactic behavior fatigue in behavior-disease model likely introduces bias in model outputs.…”