Understanding community’s behavioral responses towards Covid-19: Who comply, who don’t and reasons of incompliance Indonesian Scholars’ Alliance GHMJ (Global Health Management Journal) 2020, Vol. 4, No. 1 Open Access Perspec ves Dyah Anantalia Widyastari Understanding community's behavioral responses towards Covid-19: Who comply, who don't and rea- sons of incompliance Ins tute for Popula on and Social Research, Mahidol University *Corresponding author’s email: dyah.ana@mahidol.ac.th,dyah.anantalia@gmail.com DOI: 10.35898/ghmj-41497 © Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars’ Alliance). This is an open-access following Crea ve Commons License Deed - A ribu on-NonCommercial-ShareAlike 4.0 Interna onal (CC BY-NC-SA 4.0) 1. Introduc on Since it was found as unknown pneumonia-like cases in December 2019 in Wuhan, China (Wang et al., 2020), the coronavirus disease-2019 (COVID-19) has spread to most countries in the world. Follow- ing its rapid transmission, in the end of January 2020 WHO declared a Public Health Emergency to raise international concern. As the major pathogens that targets the upper human respiratory system, COVID�19 has caused more infections and deaths than SARS or MERS, particularly with the majority of asymptomatic individuals who can spread viruses to others (Rothan and Byrareddy, 2020; Wang et al., 2020). The government of all nations have been challenged to implement effective measures to fight the rapid spread of the infection since the evidence found only 3-7 days for the epidemic to double in size (Park et al., 2020). Lockdown, partial shutdown and quarantine for infected individuals are imposed to contain the virus and prevent further infection (Anderson et al., 2020; Kraemer et al., 2020; WHO, 2020). Although it varies by the country’s policy, public testing was also implemented in order to screen the risky individuals (i.e. Italy, Indonesia, Thailand) or general population (i.e. Korea) to control the further increase in the number of new infections (Balilla, 2020; Harper et al., 2020). 2. Behavioral responses towards Covid-19 measures: who comply, who do not and reasons of incompliance Covid-19 is not only challenging the government, but also poses a critical trial to the whole society. Although the government have imposed various measures to contain the virus and prevent further spread of infection, the success of a country in halting the infection depends on the public’s com- pliance towards those regulations. The expected behavioral responses toward Covid-19 comprise of complying the social distancing measure and shifting their outdoor into home-based activities. Pre- ventive measures such as hand washing and wearing mask are deemed important to prevent infection and reduce transmission (Adhikari et al., 2020). Although public health messages have been continuously delivered, there exists a subgroup in the population who are disengaged of information seeking. They feel unaffected by the situation and are being skeptical by showing irrational behavior in non-compliance with COVID-19 policies such as going out or travelling, hang around in groups and ignoring the preventive measures such as wearing mask (Paakkari and Okan, 2020; Wright et al., 2020). In many countries, thousands were arrested for 1 mailto:dyah.ana@mahidol.ac.th,dyah.anantalia@gmail.com https://dx.doi.org/10.35898/ghmj-41497 GHMJ (Global Health Management Journal) 2020, Vol. 4, No. 1 Widyastari DA violating curfew and social distancing measure by loitering on the roads, gathering and consuming alcohol at public grounds, or keeping restaurants open (Colombopage, 2020; Pakpour and Griffiths, 2020; The Star Online, 2020; Xinhuanet, 2020). Scholars have attempted to understand community’s behavior in complying Covid-19 measures. Theoretically driven, individuals will be engaging in new (healthy) behavior depends on their risk perception towards the current health threat. The Health Believe Model which was firstly formulated by Irwin Rosenstock in 1970s suggested perceive susceptibility as one of the underlying causes of be- havior to occur (Rosenstock, 1974a,b). Those who feeling personally susceptible of infection are more likely to engage in hand washing and social distancing behaviors (Kwok et al., 2020; Wise et al., 2020) and practicing superficially helpful behaviors such as buying more food and water (Wise et al., 2020). On the contrary, the feeling a false sense of invulnerability, misperception of risks COVID-19 as being low for themselves and others have lead individuals to disengage in protective behaviors (Paakkari and Okan, 2020). The perceived susceptibility also could be expressed in the form of fear. Studies documented a moderate positive correlation between adoption of new behavior and fear of Covid-19, suggesting that negative emotion also motivate a range of behaviors that reduce the engagement in risky behaviors in response to the current pandemic, and could predict compliance (Harper et al., 2020; Pakpour and Griffiths, 2020). Females, older person and healthy individuals are more likely to adopt a greater degree of social- distancing measures (Atchison et al., 2020; Barari et al., 2020; Kwok et al., 2020; Zhong et al., 2020) whereas younger males (Kwok et al., 2020) and individuals with poor health are reported to have less compliant toward staying home policy, although it could be due to their frequent visits to hospitals or pharmacy (Barari et al., 2020). Individual’s economic status, knowledge and educational attainment appear to affect their re- sponses toward Covid-19 measures. Those with relatively high level of socioeconomic status–in par- ticular women–and have had good knowledge are more likely to perform appropriate practices to- wards COVID-19 (Atchison et al., 2020; Barari et al., 2020; Zhong et al., 2020) whereas younger males aged 16-29 years, never-married, bachelor’s degree or lower education and students were significantly associated with lower knowledge (Zhong et al., 2020). Those from economically disadvantage pop- ulation and were less likely to work from home showed a less willingness to comply suggesting the influence of structural barriers in adopting preventive behaviors (Atchison et al., 2020). 3. Has the government convey the right messages to the public? Despite the incompliance by a sub group of population, the public health messages have been heard. People understand how to keep themselves and others safe from the virus, and practicing the new behaviour. Even the skeptical group who doubt the government policies are reportedly believe the public health messages and engage in the expected behaviours (Barari et al., 2020). The informa- tion seeking behaviour also could inform the government on how the public respond the pandemic. Google searches on ‘face mask’ and ‘hand washing’ including hand sanitizer brands and steps of hand washing not only indicating an increasing promotion of goods but might also reflecting an increasing awareness and engagement of the public (Lin et al., 2020). There is no absolute approach that has been proven effective in combating Covid-19. Every gov- ernment has selected the best policy fits to its context, culture, and socioeconomic condition both in macro and micro level, to ensure low fatality rate and minimize the socioeconomic impact of the pan- demic. It is individual and community commitment in complying the measures that will define how long a country will be in the risky zone before gradually reached the new normal. 2 Widyastari DA GHMJ (Global Health Management Journal) 2020, Vol. 4, No. 1 REFERENCES Adhikari, S. P., Meng, S., Wu, Y.-J., Mao, Y.-P., Ye, R.-X., Wang, Q.-Z., Sun, C., Sylvia, S., Rozelle, S., Raat, H., et al. (2020). Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (covid-19) during the early outbreak period: a scoping review. Infectious diseases of poverty, 9(1):1–12. Anderson, R. M., Heesterbeek, H., Klinkenberg, D., and Hollingsworth, T. D. (2020). How will country-based mitigation measures influence the course of the covid-19 epidemic? The Lancet, 395(10228):931–934. Atchison, C. J., Bowman, L., Vrinten, C., Redd, R., Pristera, P., Eaton, J. W., and Ward, H. (2020). Perceptions and behavioural responses of the general public during the covid-19 pandemic: A cross-sectional survey of uk adults. medRxiv. Balilla, J. (2020). Assessment of covid-19 mass testing: the case of south korea. Available at SSRN 3556346. Barari, S., Caria, S., Davola, A., Falco, P., Fetzer, T., Fiorin, S., Hensel, L., Ivchenko, A., Jachimowicz, J., King, G., et al. (2020). Evaluating covid-19 public health messaging in italy: Self-reported compliance and growing mental health concerns. medRxiv. Colombopage (2020). Sri lanka : Police arrest 559 people for violating curfew in last 24 hours. http://www. colombopage.com/archive_20A/May16_1589612422CH.php. Harper, C. A., Satchell, L. P., Fido, D., and Latzman, R. D. (2020). Functional fear predicts public health com- pliance in the covid-19 pandemic. International Journal of Mental Health and Addiction, page 1. Kraemer, M. U., Yang, C.-H., Gutierrez, B., Wu, C.-H., Klein, B., Pigott, D. M., du Plessis, L., Faria, N. R., Li, R., Hanage, W. P., et al. (2020). The effect of human mobility and control measures on the covid-19 epidemic in china. Science, 368(6490):493–497. Kwok, K. O., Li, K. K., Chan, H. H., Yi, Y. Y., Tang, A., Wei, W. I., and Wong, Y. S. (2020). Community responses during the early phase of the covid-19 epidemic in hong kong: risk perception, information exposure and preventive measures. medRxiv. Lin, Y.-H., Liu, C.-H., and Chiu, Y.-C. (2020). Google searches for the keywords of “wash hands” predict the speed of national spread of covid-19 outbreak among 21 countries. Brain, Behavior, and Immunity. Paakkari, L. and Okan, O. (2020). Covid-19: health literacy is an underestimated problem. The Lancet Public Health. Pakpour, A. and Griffiths, M. (2020). The fear of covid-19 and its role in preventive behaviors. Journal of Con- current Disorders. Park, M., Cook, A. R., Lim, J. T., Sun, Y., and Dickens, B. L. (2020). A systematic review of covid-19 epidemiology based on current evidence. Journal of Clinical Medicine, 9(4):967. Rosenstock, I. M. (1974a). The health belief model and preventive health behavior. Health education monographs, 2(4):354–386. Rosenstock, I. M. (1974b). Historical origins of the health belief model. Health education monographs, 2(4):328–335. Rothan, H. A. and Byrareddy, S. N. (2020). The epidemiology and pathogenesis of coronavirus disease (covid- 19) outbreak. Journal of autoimmunity, page 102433. The Star Online (2020). Foreigners arrested for violating curfew rules in thailand’s popular tourist island of pha ngan. https://www.thestar.com.my/news/regional/2020/04/18/foreigners-arrested-for- violating-curfew-rules-in-thailand039s-popular-tourist-island-of-pha-ngan. Wang, Y., Wang, Y., Chen, Y., and Qin, Q. (2020). Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (covid-19) implicate special control measures. Journal of medical virology, 92(6):568–576. WHO (2020). Considerations for quarantine of individuals in the context of containment for coronavirus dis- ease (covid-19). https://www.who.int/publications-detail/considerations-for-quarantine-of- individuals-in-the-context-of-containment-for-coronavirus-disease-(covid-19). Wise, T., Zbozinek, T. D., Michelini, G., Hagan, C. C., et al. (2020). Changes in risk perception and protective behavior during the first week of the covid-19 pandemic in the united states. PsyArXiv. Wright, A. L., Sonin, K., Driscoll, J., and Wilson, J. (2020). Poverty and economic dislocation reduce compliance with covid-19 shelter-in-place protocols. University of Chicago, Becker Friedman Institute for Economics Working Paper. Xinhuanet (2020). Over 55,000 arrested in sri lanka for violating curfew. http://www.xinhuanet.com/english/ 2020-05/15/c_139059878.htm. Zhong, B.-L., Luo, W., Li, H.-M., Zhang, Q.-Q., Liu, X.-G., Li, W.-T., and Li, Y. (2020). Knowledge, attitudes, and practices towards covid-19 among chinese residents during the rapid rise period of the covid-19 outbreak: a quick online cross-sectional survey. International journal of biological sciences, 16(10):1745. 3 http://www.colombopage.com/archive_20A/May16_1589612422CH.php http://www.colombopage.com/archive_20A/May16_1589612422CH.php https://www.thestar.com.my/news/regional/2020/04/18/foreigners-arrested-for-violating-curfew-rules-in-thailand039s-popular-tourist-island-of-pha-ngan https://www.thestar.com.my/news/regional/2020/04/18/foreigners-arrested-for-violating-curfew-rules-in-thailand039s-popular-tourist-island-of-pha-ngan https://www.who.int/publications-detail/considerations-for-quarantine-of-individuals-in-the-context-of-containment-for-coronavirus-disease-(covid-19) https://www.who.int/publications-detail/considerations-for-quarantine-of-individuals-in-the-context-of-containment-for-coronavirus-disease-(covid-19) http://www.xinhuanet.com/english/2020-05/15/c_139059878.htm http://www.xinhuanet.com/english/2020-05/15/c_139059878.htm GHMJ (Global Health Management Journal) 2020, Vol. 4, No. 1 Widyastari DA Cite this article as: Widyastari DA. Understanding community’s behavioral responses towards Covid-19: Who comply, who don’t and reasons of incompliance. GHMJ (Global Health Manage- ment Journal). 2020; 4(1):1-4. doi:10.35898/ghmj-41497 4 Introduction Behavioral responses towards Covid-19 measures: who comply, who do not and reasons of incompliance Has the government convey the right messages to the public?