Public Compliance with COVID-19 Quarantine Measures

A mandatory evacuation from Australia cut Fulbright Scholar Mark Czeisler‘s exchange trip short, but rather than give up on his research plans, Mark decided that this was an opportunity to start a new collaboration to help evaluate the effectiveness and impacts of COVID mitigation strategies.

Pre-COVID Plans for 2020

After graduating from Harvard College in May of 2019, in late January of 2020 I travelled to Australia as a 2020 Fulbright Future Scholar excited to pursue a 10-month project evaluating sleep and circadian rhythms as mediators of patient outcomes in the intensive care unit. With supervision by Assistant Professor Mark Howard and Professor Shantha Rajaratnam, I started as an Honorary Research Fellow at the Melbourne-based Institute for Breathing and Sleep at Austin Health while enrolled at Monash University in the School of Psychological Sciences as an MPhil candidate.

Shifting Gears

On 19 March, I received notice that (1) clinical research at the Austin Health was halted, and (2) the Fulbright program was suspended globally and it was recommended that all U.S. Fulbright participants immediately make arrangements to return to the United States. Committed to contributing to the bilateral relationship between Australia and the U.S. that I aspired to enrich during my Fulbright experience, I proposed a collaborative initiative between researchers at Austin Health, Monash University, and Brigham & Women’s Hospital of Harvard Medical School to develop and launch a transnational survey-based study of Australians and Americans amidst the COVID-19 pandemic.

The aim of the ongoing study is to assess changes due to COVID-19 and mitigation strategies alongside associated mental and physical health outcomes, and to identify predictive factors that may be used to reduce potential negative consequences of the pandemic. We partnered with the online survey company Qualtrics to administer surveys to respondents at various times amid the pandemic.

First Round Results: Public Compliance with and Public Support for Stay-at-Home Mitigation Strategies

Public compliance with and support for stay-at-home mitigation strategies were assessed in the survey. Given the ongoing deliberations policymakers are facing about when to reduce or lift COVID-19 mitigation strategies, we made the decision to inform these officials of public compliance, support and attitudes about these tactics as soon as possible by releasing related findings on the preprint server medRxiv along with the life impact of these measures.

Figure 2. Public COVID-19 Mitigation Compliance, Concerns, Policy Support and ExperienceFigure 2. Public COVID-19 Mitigation Compliance, Concerns, Policy Support and Experience

The 5573 respondents demographically representative of Australia/U.S. reported resounding public compliance with and support for stringent mitigation strategies. Consistent across regions with varying COVID-19 prevalence and spanning the political spectrum, respondents reported significant disruptions of social and work life, health, and behaviour. More than 80 percent reported compliance with recommended quarantine or stay-at-home policies, and more than 90 percent supported government-imposed stay-at-home orders. These findings, alongside beliefs, concerns, and experiences related to COVID-19 are displayed above.

The percent of respondents of which COVID-19 and stringent mitigation strategies have disrupted—or improved in a small minority of the sample—various aspects of life is presented to the above-right. Below this, the percent of respondents who reported increases, decreases, or unchanged various behavioural and health measures.

Public Health, Health Policy Implications

As pressures to loosen or lift stringent COVID-19 mitigation strategies continue to mount, surveillance monitoring of public priorities for, compliance with, and life impact of those strategies is paramount.

These timely findings from the first nationally representative survey of Australians and Americans indicate that the vast majority of the public is not only willing to accept current stringent mitigation measures and their associated costs, but that people endorse their continuation until the COVID-19 pandemic is controlled.

We hope that policymakers will be aware of and consider public priorities and attitudes regarding these measures when making decisions about how to proceed with efforts to contain the spread of COVID-19.

Continued Efforts

We are going to further analyse data and report findings from the initial survey. Additionally, we plan to administer a follow-up survey to the same respondents to evaluate what has and has not changed over the past month. We expect that these surveys will provide valuable insights about factors associated with behavioural changes and adverse health outcomes that may be used to inform educational or behavioural interventions to reduce potential negative consequences.

Closing Considerations

As a prospective applicant for physician-scientist training programs with an interest in global health and health policy, my aspirations for 2020 were centered around advancing research in the medical sciences and immersing myself in Australian culture to broaden my perspective of research and medicine. Amid the global COVID-19 pandemic, I am grateful to be involved in setting and achieving joint Australian-American priorities and remain committed to the international partnership that remains at the core of the Fulbright mission.

Mark É Czeisler, AB
2020 Fulbright Future Scholar

Czeisler MÉ, Howard ME, Robbins R, Barger LK, Facer-Childs ER, Rajaratnam SMW, Czeisler CA. COVID-19: Public Compliance with and Public Support for Stay-at-Home Mitigation Strategies. medRxiv. Published online April 24, 2020. [Preprint Manuscript]. doi: