Public preferences for interventions to prevent emerging infectious disease threats: a discrete choice experiment

Abstract

ObjectiveWhen faced with an emergent epidemic with high mortality and morbidity potential, policy makers must decide what public health interventions to deploy at different stages of the outbreak. However, almost nothing is known about how the public view these interventions or how they trade off risks (of disease) with inconvenience (of interventions). In this paper, we aim to understand public perceptions on pandemic interventions, as well as to identify if there are any distinct respondent preference classes.DesignA discrete choice experiment.SettingThis study was fielded in Singapore between November 2012 and February 2013.ParticipantsA random sample of 500 Singapore residents aged 21 and over, including 271 women and 229 men, was analysed.Outcome measuresDemographic information was collected from each participant. Participants were also shown a series of pairs of alternatives, each combining interventions and morbidity, mortality and cost outcomes and declared a preference for one combination. A random utility model was developed to determine the individual’s preference for interventions and a hierarchical cluster analysis was performed to identify distinct respondent preference classes.ResultsOn average, participants preferred more intense interventions, and preferred scenarios with fewer deaths and lower tax. The number of infections did not significantly influence respondents’ responses. We identified two broad classes of respondents: those who were mortality averse and those who were expenditure averse. Education was found to be a predictor of group membership.ConclusionOverall, there was considerable support for government interventions to prevent or mitigate outbreaks of emerging infectious diseases, including those that greatly restricted individual liberties, as long as the restrictions showed a reasonable chance of reducing the adverse health effects of the outbreak.

Lessons learnt from easing COVID-19 restrictions: an analysis of countries and regions in Asia Pacific and Europe

“…The public has also been better conditioned to cooperate with strict rules and invasive surveillance in times of crisis compared with the public in countries without experience of major epidemics, with most people accepting a trade-off between their personal rights and the public good. 20 , 48 …”

Willingness to Self-Isolate When Facing a Pandemic Risk: Model, Empirical Test, and Policy Recommendations

“…SI means symptomatic individuals confine themselves to their homes [10]. Generally, isolation can take two forms: Mandatory and voluntary [11,12]. Voluntary SI means that infected (or possibly infected) individuals choose to confine themselves to their homes; this intervention is generally considered capable of limiting the transmission of pandemic influenza [13,14] and is recommended by the European Centre for Disease Prevention and Control [15].…”

“…To date, many scholars have demonstrated the relationship between SI and the prevention of pandemics [8,10,12,16]. However, the factors involved in SI should not be neglected, and it is important to investigate which factors will encourage infected (or possibly infected) people to choose self-isolation.…”

Understanding public preferences and trade-offs for government responses during a pandemic: a protocol for a discrete choice experiment in the UK

“…The first stage of a DCE defines the attributes and levels. Attributes describe different lockdown scenarios ( table 1 ) and are based on: (1) current and possible future lockdown measures from policy documents, for example, Scientific Advisory Group for Emergencies guidance, government guidance and interventions that have been observed globally in response to the COVID-19 pandemic (see table 2 ); (2) current literature on preferences for lockdown measures 23 24 (i.e., from May to June 2020, we searched Google (Scholar), using the following terms and combinations of them: ‘COVID-19’, ‘coronavirus’, ‘DCE’, ‘pandemic’, and ‘infectious disease’) and (3) a social media analysis (see online supplementary material (OSM-1) ).…”

“…Previous research in Singapore and Australia conducted before the COVID-19 outbreak suggests considerable variation in preferences. Cook et al 23 used a discrete choice experiment (DCE) to investigate public preferences for pandemic interventions for emerging infectious disease in Singapore. While respondents preferred more intense interventions, fewer deaths and lower taxes to fund public health measures, the number of infections did not affect their preferences.…”