Research explores public reactions to COVID-19 pandemic across diverse ethnic groups

In a recent study published on the medRxiv* preprint server, researchers evaluate the attitudes of diverse ethnic groups in the United Kingdom towards the coronavirus disease 2019 (COVID-19) pandemic.

Study: The public views of and reactions to the COVID-19 pandemic in England- a qualitative study with diverse ethnicities. Image Credit: Ripio / Shutterstock.com

Background

The COVID-19-associated mortality rate in the U.K. was relatively higher than in most countries worldwide. According to the Public Health England (PHE) COVID-19 disparities report 2020, the COVID-19-related death rate was high in people aged 80 years or older, residents of deprived areas, and several minority ethnic groups (MEGs) that had 10-200% higher rates compared to White British groups.

Various surveillance data and systematic reviews have confirmed higher rates of COVID-19-associated deaths among people living in deprived areas and MEGs in the U.K. Diabetes was a frequent comorbidity found in deceased COVID-19 patients and was two times more commonly observed in Black or Asian patients than White patients.

With the help of a rapid PHE literature review and Skype events with local, regional, and national MEGs, stakeholders expressed their anger and fear about the higher susceptibility of MEGS to morbidity and mortality associated with COVID-19.

The review by the stakeholders of MEGs further stated that health inequities in MEGs are not the result of COVID-19. Instead, the pandemic exacerbated and exposed long-standing inequalities that have been present in the U.K. for the past ten years.

A myriad of reasons, including economic status, employment, and health- and biological-related factors, affect the health inequalities faced by MEGs. As a result, the solution for these causes will also be multifaceted.

About the study

In the present study, researchers explore the public reactions and attitudes to the COVID-19 pandemic across a variety of ethnic groups in the general public of the U.K., the facilitators and barriers for COVID-19 infection prevention control (IPC), and the viewpoints of the public on solutions to mitigate the pandemic and control inequities in the society and healthcare sector.

Reported factors contributing to the frustration, dismay, and altruism discussed by participants, and suggested actions placed within the behavior change model as policies and interventions

The study recruited 100 participants from England and Wales comprising people from various MEGs and White British ethnicity, occupations, and religions resulting in 19 self-identified ethnic groups. The participants were recruited through advertisements on social media, Twitter, minority ethnic support groups, COVID-19 charities, and people’s panel of PHE with snowball sampling from June 2020 to October 2020.

The participants were either English or Punjabi speakers and were offered £25 for participation in the study. Data was collected through Skype interviews with or without video and was analyzed through inductive thematic analysis.

Study findings

The study results indicated that through the initial six to nine months of the COVID-19 pandemic, altruism, frustration, and dismay were reported among members of all ethnic groups. The participants were dismayed about being at higher community, family, or individual risks for COVID-19 and not receiving proper medical care for other illnesses during the COVID-19 pandemic. Most participants avoided support groups due to concerns about COVID-19 risk.

The frustration experienced by the subjects was due to several reasons, including the unresponsiveness of the governing authorities to inequities associated with COVID-19, the underrepresentation of MEG efforts in tackling COVID-19, the lack of proper communication regarding COVID-19 through media, the PHE COVID-19 disparities report leading to social isolation and racism, and rule-breaking reported among government advisors. Frustration was also caused by inconsistencies in government rules regarding social distancing, border controls, personal protective equipment, and dining out.

Almost every participant felt that the resilience of the frontline COVID-19 National Health Service (NHS) staff, communities, and families during the ongoing COVID-19 pandemic is altruistic.

The actions suggested by the subjects were incorporated into the interventions and guidelines placed by the U.K. government through the Behavior Change Wheel to mitigate the COVID-19 pandemic and help various communities. The policies suggested by the study population focus on measures to increase social equity, equity among the various ethnic groups in the healthcare sector, and clear guidance in COVID-19-related matters.

The interventions proposed by the participants include enabling different channels to disseminate appropriate COVID-19-related information to the public, working closely with MEGs, environmental restructuring, measures to increase adherence to rules, and training healthcare workers (HCWs) to handle critical illnesses in various ethnic groups.

Conclusions

According to the authors, this is one of the most extensive qualitative studies conducted in the U.K. that focuses on attitudes on the COVID-19 pandemic among the general public addressing various age groups, ethnic groups, and religions.

The study findings indicated that to develop and keep the trust of the public; the governing authorities must address vulnerable groups, produce detailed and accurate COVID-19 mitigation guidelines with contingency, as well as service provision, communication, and fiscal policies to deal with the potential rise in COVID-19 cases in the future. Furthermore, through incentivization and involvement of local communities, the aforementioned policies should be integrated with public interventions like modeling, education, information, and measures for infection prevention.

Furthermore, the current study highlights the need for the government to review and include policies regarding social and town planning that will result in an environmental restructuring and ultimately lead to IPC. The following policies will help environmental restructuring

• Easy access to toilet facilities suggested by the travelers in the study group
• Easily accessible hand-washing facilities at work, home, shopping centers, and every food provider
• Appropriate work environment and living accommodation promoting IPC for all.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.