Assessment of Quarantine Understanding and Adherence to Lockdown Measures During the COVID-19 Pandemic in Palestine: Community Experience and Evidence for Action

Abstract

Background: Containment of the coronavirus pandemic relied extensively on the combination of early implementation of quarantine and massive behavioral changes to ensure effectiveness. Decision-makers need to constantly monitor the outbreak situation and the impact of the measures implemented. Yet little is known about the factors influencing adherence and understanding of lockdown measures among the Palestinian community. This study aimed to assess the impact and factors affecting these early public health interventions.Materials and Methods: A cross-sectional web-based questionnaire was distributed throughout social media (Facebook and Instagram). We used a snowball recruiting technique to target Palestinian adult citizens during the coronavirus pandemic quarantine between 6 and 16 April 2020, which corresponded to almost the middle interval of the strict massive lockdown measures in Palestine that lasted from 22 March to 5 May 2020. Multivariate logistic regression models were developed for the outcome variables (staying home adherence, in-home precautions adherence, and quarantine understanding).Results: Our questionnaire was completed by 2,819 participants. The mean (range) age was 29.47 (18–71) years. Of them, 1,144 (40.6%), 1,261 (44.7%), and 1,283 (45.5%) reported low levels of staying home adherence, in-home precautions adherence, and quarantine understanding, respectively. Females, city residents, those with higher educational levels, and those informed by official government sources were associated significantly with higher levels of both staying home adherence and quarantine understanding. Adequate food supply was associated with a higher level of staying home adherence. Higher levels of in-home precautions adherence were noticed in the elderly and those with a high-risk group living at home. Higher monthly income was inversely associated with higher levels of in-home precautions adherence and lower levels of quarantine understanding (P < 0.05).Conclusions: The socio-economic and financial status of the general population and coordination between the major information resources (official government), social media, and the press were the major factors affecting the community in regard to quarantine adherence. For maximum effectiveness and commitment levels amongst the people to decrease the spread of infection, policymakers need to address all those factors. In addition, clear communication between policymakers and the population is essential for reassuring the people and minimizing their fears regarding the unknown future.

Adherence and Psychosocial Well-Being During Pandemic-Associated Pre-deployment Quarantine

“…Main factors found are knowledge respective clear information about the disease and quarantine procedure (24,25), respective health literacy (23,26), social norms in favor of quarantine adherence (or even social pressure) (16), perceived risk of the disease and perceived benefits of quarantine (16) as well as the practicability of the quarantine, including sufficient supply with food and necessary daily goods, and access to medical treatment, as well as financial security (16,24,27) and level of psychological distress (16,23). Single studies indicate that the endorsement of ethical principles, including "citizen's duty, " "community mindedness, " and the "greater good" based on free will, could facilitate adherence (28)(29)(30)(31).…”

Sociodemographic factors and self-restraint from social behaviors during the COVID-19 pandemic in Japan: a cross-sectional study

“…Legally binding lockdown policies have been implemented in many countries in response to the spread of coronavirus disease 2019 (COVID- 19) infections, which has led to the control of human flow and thus to improved control of infection transmission. In China, the first lockdown reduced inflows to the city of Wuhan by 76%, outflows by 56%, and movement within Wuhan by 54% [1].…”

“…When Japan's government declares a state of emergency, the citizens are required to refrain from unnecessary and nonurgent social behaviors, including traveling and returning home, eating and drinking at a restaurant for extended periods of time, and socializing with groups of more than five people [6]. However, in the first state of emergency, when sufficient information about COVID- 19 was not available, the government sought to forestall an emergency by prohibiting at least 70% of all people from going out of their homes [7]. As a result, movement across prefectures was suppressed by about 50% to 70% throughout Japan [8].…”

“…The impact of sociodemographic factors on social behaviors-specifically the act of leaving one's home to visit public spaces-during lockdowns has been investigated mainly in Western countries. It has been reported that women [9][10][11][12][13][14][15][16][17][18] highly educated people, and high-income individuals [11,[19][20][21] are more likely to refrain from going out during a lockdown. Whether a person is married or lives with their family [12,18,19], and whether or not they have a pre-existing condition [13,20], are reportedly not associated with social behaviors during a lockdown.…”

“…It has been reported that women [9][10][11][12][13][14][15][16][17][18] highly educated people, and high-income individuals [11,[19][20][21] are more likely to refrain from going out during a lockdown. Whether a person is married or lives with their family [12,18,19], and whether or not they have a pre-existing condition [13,20], are reportedly not associated with social behaviors during a lockdown. Reports implicating age as a factor vary: many show that older people refrain from going out more than younger people [11][12][13][14]22], while others indicate the reverse [9,10].…”