Researchers track changes over time in responses to Covid-19

Wealthy South Africans worry a lot more about Covid risks than their poorer compatriots do, despite being better able to afford the necessary precautions. 

This was among the findings published in the journal PLOS One by two researchers at the Wits University school of economics and finance, Umakrishnan Kollamparambil and Adeola Oyenubi.

They also found that as the pandemic wore on last year, people appeared to put more faith in face masks than in hand-washing. 

And men are less likely to use sanitisers and wash their hands than women are, but are more likely to socially distance.

“The purpose was to understand behavioural differences across socioeconomic categories in the country in response to the pandemic,” Kollamparambil told the Sunday Times this week.

The study used data from the first two phases or “waves” of the National Income Dynamics Study-Coronavirus Rapid Mobile Survey (Nids-Cram) research project. 

The project’s researchers ask the same nationally representative panel of South Africans a series of questions every two or three months. Three such waves have been completed since the pandemic broke out, and two more are planned by the end of the year. 

In wave 1 (May-June last year), 7,073 people responded and in wave 2 (July-August) 5,676 responded.

There were “significant changes in the preventive measures used between the two waves”, the researchers said.

In wave 1, 92% of the panel reported having changed their behaviour, and hand-washing was the major precaution. 

By the time they were surveyed in wave 2, 99.7% of the panel said they had changed their behaviours and mask-wearing had become a greater priority than hand-washing.

This made it clear “individuals are responding to public messaging”, said Kollamparambil. 

When the airborne nature of the disease was understood more clearly, “expert views available to the public changed in favour of face masks” and use of them surged from under 50% to over 70%.

However, measures such as social distancing, avoiding close contact, avoiding big groups and staying at home declined between the two waves of the study.

Kollamparambil said interviews were conducted telephonically as online surveys tend to skew results “because those without internet access are excluded”.

A main focus was risk perception, and Kollamparambil said this was substantially higher among richer people. 

“Explaining this rationally is difficult, considering that higher-income groups are in a better position to adopt protective measures.”

People in this group changed their behaviour more than those with lower income, but they also reported major declines in mental health and had low confidence in their ability to protect themselves through their own actions. 

“Individuals who had their own transport, for example, still had a higher sense of risk and a lower sense of being able to avoid sickness. That was quite surprising,” said Kollamparambil.

Respondents from lower socioeconomic backgrounds, on the other hand, “are associated with optimism bias” and also “face barriers to the adoption of preventive strategies”.

She said optimism bias “can lead people to risky behaviour because they falsely believe that they are less at risk of negative events than are other people”. 

Kollamparambil said that perhaps for poorer communities, Covid is not a top priority. “Psychology tells us that you can’t be equally worried about a whole lot of things at once, and food and a basic income are top priorities,” she said.

In these same groups “an individual’s living and livelihood conditions might make it unfeasible” to adopt certain strategies.

According to Nomsa Sizani, secretary-general of the shack-dwellers’ movement Abahlali baseMjondolo, “when the president first announced the lockdown, it became clear that he was acting as if everyone in the country is a rich or middle-class person. We do not all have access to water and proper sanitation, or the space to effectively social distance.” 

Dr Keith Cloete, head of health in the Western Cape, said that behavioural change remains the key strategy ahead of the rollout of vaccines, and human behaviour is the main determinant in how the third wave develops.

“We expect the third wave to be lower than the second but it’s conditional on the behaviour of broader society,” Cloete said.

“We need strong collective behaviour for a later and flatter third wave so the vaccines can kick in,” he said.

Kollamparambil and Oyenubi said the study showed the desirability of interventions such as “making sanitisers freely available in public spaces where people tend to congregate [and] making free face masks available to the poorest of the poor”. 

• In the US, researchers using geolocation data from up to 17-million cellphone users found that people with lower incomes and those with Republican political views appeared to be far less likely to observe social distancing now than they were in March last year. 

The findings were published in the American Journal of Preventive Medicine.