Public Preferences for Exit Strategies From COVID-19 Lockdown in Germany—A Discrete Choice Experiment

Krauth, Christian; Oedingen, Carina; Bartling, Tim; Dreier, Maren; Spura, Anke; Bock, Freia De; Rüden, Ursula von; Betsch, Cornelia; Korn, Lars; Robra, BP

doi:10.3389/ijph.2021.591027

Cited by 23 publications

(25 citation statements)

References 36 publications

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“…Little evidence is available on preferences around epidemic control measures [ 3 , 14 ], and this paper contributes to this emerging literature. The closest element in the literature is a DCE conducted in France at the end of the first lockdown, which focused on generally applicable measures such as wearing masks, travel limitation, and digital tracking [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…A second approach is to directly account for individuals’ opinions and preferences, using preference elicitation tools such as stated preferences surveys [ 3 , 9 , 14 ]. The usefulness of this second approach relies on the assumption that the closer the measures are aligned with public preferences, the more sustainable and acceptable they will be for individuals and society.…”

Section: Introductionmentioning

confidence: 99%

“…In May 2020, one DCE study has investigated the trade-offs French people were willing to make to avoid a lockdown extension by 8 weeks: wearing masks and limiting interregional travel [ 3 ]. Another DCE study in Germany investigated the trade-offs Germans citizens were willing to make between various exit strategies from lockdown and showed that two attributes dominated the trade-offs: avoiding a mandatory tracing application, and providing sufficient intensive care capacities [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Preferences for COVID-19 epidemic control measures among French adults: a discrete choice experiment

et al. 2022

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In this stated preferences study, we describe for the first time French citizens’ preferences for various epidemic control measures, to inform longer-term strategies and future epidemics. We used a discrete choice experiment in a representative sample of 908 adults in November 2020 (before vaccination was available) to quantify the trade-off they were willing to make between restrictions on the social, cultural, and economic life, school closing, targeted lockdown of high-incidence areas, constraints to directly protect vulnerable persons (e.g., self-isolation), and measures to overcome the risk of hospital overload. The estimation of mixed logit models with correlated random effects shows that some trade-offs exist to avoid overload of hospitals and intensive care units, at the expense of stricter control measures with the potential to reduce individuals’ welfare. The willingness to accept restrictions was shared to a large extent across subgroups according to age, gender, education, vulnerability to the COVID-19 epidemic, and other socio-demographic or economic variables. However, individuals who felt at greater risk from COVID-19, and individuals expressing high confidence in the governmental management of the health and economic crisis, more easily accepted all these restrictions. Finally, we compared the welfare impact of alternative strategies combining different epidemic control measures. Our results suggest that policies close to a targeted lockdown or with medically prescribed self-isolation were those satisfying the largest share of the population and achieving high gain in average welfare, while average welfare was maximized by the combination of all highly restrictive measures. This illustrates the difficulty in making preference-based decisions on restrictions. Supplementary Information The online version contains supplementary material available at 10.1007/s10198-022-01454-w.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Preferences for COVID-19 epidemic control measures among French adults: a discrete choice experiment

et al. 2022

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“…The acceptability of tracing apps has shown mixed results in this review. A study in Germany [ 66 ], found that people preferred to avoid mandatory tracing apps during exit strategy, while a cross-country study [ 67 ] from France, Germany, Italy, the UK, and the US found strong support for use of apps.…”

Section: Resultsmentioning

confidence: 99%

Exit strategies from lockdowns due to COVID-19: a scoping review

Misra¹,

Joshi²,

Sarwal

et al. 2022

BMC Public Health

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Introduction In response to the ongoing COVID-19 pandemic, countries have adopted various degrees of restrictive measures on people to reduce COVID-19 transmission. These measures have had significant social and economic costs. In the absence of therapeutics, and low vaccination coverage, strategies for a safe exit plan from a lockdown are required to mitigate the transmission and simultaneously re-open societies. Most countries have outlined or have implemented lockdown exit plans. The objective of this scoping review is to (a) identify and map the different strategies for exit from lockdowns, (b) document the effects of these exit strategies, and (c) discuss features of successful exit strategies based on the evidence. Methods A five-step approach was used in this scoping review: (a) identifying the research question and inclusion/exclusion criteria; (b) searching the literature using keywords within PubMed and WHO databases; (c) study selection; (d) data extraction; (e) collating results and qualitative synthesis of findings. Results Of the 406 unique studies found, 107 were kept for full-text review. Studies suggest the post-peak period as optimal timing for an exit, supplemented by other triggers such as sufficient health system capacity, and increased testing rate. A controlled and step-wise exit plan which is flexible and guided by information from surveillance systems is optimal. Studies recommend continued use of non-pharmaceutical interventions such as physical distancing, use of facemasks, and hygiene measures, in different combinations when exiting from a lockdown, even after optimal vaccination coverage has been attained. Conclusion Reviewed studies have suggested adopting a multi-pronged strategy consisting of different approaches depending on the context. Among the different exit strategies reviewed (phase-wise exit, hard exit, and constant cyclic patterns of lockdown), phase-wise exit appears to be the optimal exit strategy.

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“…DCEs have been increasingly applied in public health research to understand citizens' preferences with respect to interventions or programmes [17], and empirical research has demonstrated their robust external validity: for example, they have been used to accurately predict medical treatment [18] and vaccination behaviour [19]. During the pandemic, DCEs have been used to understand which vaccine characteristics are most in uential in decision-making [20]; health and economic trade-offs in lockdowns [21]; and exit strategies [22].…”

Section: Discrete Choice Experiments Designmentioning

confidence: 99%

Location, Location, Location: A Discrete Choice Experiment to Inform Vaccination Programme Delivery in the UK

McPhedran¹,

Gold

Bemand

et al. 2021

Preprint

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BackgroundLarge-scale vaccination is fundamental to combatting COVID-19. In March 2021, the UK’s vaccination programme had delivered vaccines to large proportions of older and more vulnerable population groups; however, there was concern that uptake would be lower among young people. This research was designed to elicit the preferences of 18-29-year-olds with respect to key delivery characteristics.MethodsFrom 25 March - 2 April 2021, an online sample of 2,021 UK adults aged 18-29 years participated in a Discrete Choice Experiment. Participants made six choices, each between two SMS invitations to get vaccinated; each choice also had an opt-out. Each invitation had four attributes (1 x 5 levels, 3 x 3 levels): delivery mode, appointment timing, proximity, and SMS sender. These were systematically varied according to a d-optimal fractional factorial design. Order of presentation was randomised for each participant. Responses were analysed using a mixed logit model.ResultsThe logit model revealed a large alternative-specific constant (β = 1.385, SE = 0.067, p <0.001), indicating a strong preference for ‘opting in’ to appointment invitations. Pharmacies were dispreferred to the local vaccination centre (β = -0.256, SE = 0.072, p <0.001), appointments in locations that were 30-45 minutes travel time from one’s premises were dispreferred to locations that were less than 15 minutes away (β = -0.408, SE = 0.054, p <0.001), and, compared to invitations sent by the NHS, SMSs forwarded by ‘a friend’ were dispreferred (β = -0.615, SE = 0.056, p <0.001) but invitations from the General Practitioner were preferred (β = 0.105, SE = 0.048, p = 0.028).ConclusionsThe results indicated that the existing configuration of the UK’s mass vaccination programme was well-placed to deliver vaccines to 18-29-year-olds; however, some adjustments might enhance acceptance. Local pharmacies were not preferred; long travel times were a disincentive but close proximity (0-15 minutes from one’s premises) was not necessary; and either the ‘NHS’ or ‘Your GP’ would serve as adequate invitation sources. This research informed COVID-19 policy in the UK, and contributes to a wider body of Discrete Choice Experiment evidence on citizens’ preferences, requirements and predicted behaviours regarding COVID-19.

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Public Preferences for Exit Strategies From COVID-19 Lockdown in Germany—A Discrete Choice Experiment

Cited by 23 publications

References 36 publications

Preferences for COVID-19 epidemic control measures among French adults: a discrete choice experiment

Preferences for COVID-19 epidemic control measures among French adults: a discrete choice experiment

Exit strategies from lockdowns due to COVID-19: a scoping review

Location, Location, Location: A Discrete Choice Experiment to Inform Vaccination Programme Delivery in the UK

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