Table 4 Expert and lay model regarding COVID-19 health risk
NIPH messages | Public perceptions, actions and ways of learning |
|---|---|
Virus transmission modes Relevant transmission modes: • droplets • air • contacts | Variably mentioned: • droplets • air • or/and contact Also mentioned: • food • clothes • faeces |
Dominant transmission route • Droplet transmission most likely/significant • Airborne transmission and contact transmission exist but are nonsignificant | • Most did not separate between probable/less probable routes of transmission • Believed in multiple equal important ways of transmission |
Symptomatic, asymptomatic, presymptomatic spread • Can be infected with and transmit SARS-CoV-2 virus without developing COVID-19 • Can be symptomatic carriers with COVID-19 • People with COVID-19 are most contagious for 1–2 days before the onset of symptoms and in the first days after the onset of symptoms | • Emphasise symptomatic transmission • Being sick without symptoms not mentioned by most but emphasised as vital to understand why you should keep distance and quarantine |
Terminology • Terminology used on website: contact transmission, droplet transmission, airborne transmission | • Terms not used by most of the participants • Terms understood differently • Talked about transmission in relations to behaviours for how transmission occurred: • spitting • hugging • kissing • touching • talking |
Virus survival • The virus can survive on surfaces from a few hours to several days • Depends on the amount of virus, temperature, sunlight, and humidity • The role that virus survival on surfaces plays in causing infection in humans is uncertain and constantly changing • Poorly ventilated rooms increase the concentration of particles containing the virus | • Acted on evidence from informal sources, e.g., three-day survival on surfaces • Few mentioned wind, climate and ventilation affected virus spread • Many wanted more knowledge about how far droplets spread and how long they could survive in the air |
Basic infection prevention measures • Maintain social distancing, have fewer contacts, maintain hand hygiene and cough etiquette and use of face masks when not able to keep a distance | • All were informed about the main mitigation measures • Some people wanted to understand why certain behaviour and activities were considered high risk, others preferred simple, clear messages explaining what to do and how to protect themselves • Some sought informal sources to better comprehend the why • Easily accessible, up-to-date online information • Need someone to explain and interpret restrictions • Sometimes enacting mitigation measures was a symbolic action |
Safe distance • The amount of virus exposed at distances of more 1–2 m would rarely be sufficient to cause infection • Mainly infected within 1–2 m reach from infected person • Keep one metre of distance • The greater that the distance that you keep is, the less that the probability is that you will be exposed to infection | • None of the participants talked in terms of probabilities • One of the participants misunderstood the 1-m rule as a clear boundary between safe and unsafe distances • Did not understand why 1 m and not 2 m |
Risky activities • Risky activities due to increased expulsion of aerosols and/or being close to others are ◦ Pubs ◦ Travelling ◦ Exercise centres ◦ Poorly ventilated rooms | • Increased risk of being physically close to others was well understood • Struggling to understand why some activities were not allowed • Some wanted information about risky situations and risky localisations |
Protecting others • The virus is possibly deadly for the oldest and some groups of people with chronic diseases | • All participants understood their collective responsibility to protect others |
Contagiousness • The R-number is how many persons that one corona infected person infects further • A person infected with the coronavirus infects an average of 2–3 others, while one person with the flu infects 1–2 others | • COVID-19 contagiousness was underestimated by all of the participants • To comprehend the contagiousness of the virus, they had to understand that this disease was not influenza |
Control of the spread • The R-value was communicated in terms of numbers, but exponential growth was not explained to the public | • The R-number was perceived as a good indicator regarding the control of the spread • The R-number was often misunderstood • No one understood exponential growth correctly |
Consequences of the pandemic • NIPH communicated the health effects for the individual | • After one year with pandemic restrictions, most emphasised secondary consequences (e.g., economy, mental health) • Information about health consequences produced panic in some interviewees and awareness in others • There were daily trade-offs between social life and the risk of becoming ill |