The recent pandemic which has gripped the world is responsible for a severe respiratory illness known as COVID-19 – short for Corona Virus Disease-2019. Arriving recently in Bangladesh, the virus has awakened all and sundry to the need to halt its intrusion into people’s lives that could make them pay dearly.
Bangladesh has likely entered into the “community spread” category and the need to understand the transmissibility, severity, and related features associated with COVID-19 is serious. It is also important to have a comprehensive communication strategy to build public awareness that can spell the difference between success and failure of containment.
Here we report the findings of a quick study to address two key issues: People’s awareness of this life-threatening disease and their perceptions and concerns. After all, it is people’s knowledge, perceptions, and behaviours that can play a decisive role in containing the virus or enabling it to spread and cause havoc.
The findings are being reported for a small time-slice (two days) as the nature of KAP is likely to change with the virus making not just physical, but also social, economic, cultural and demographic impact. A survey was sent on March 22 using Google Forms to obtain quick feedback. By March 24 we received 139 responses.
The respondents were mainly students (40%) and the employed community (60%) with a sizeable proportion having graduate and post-graduate degrees; around 50% were from middle to upper income households. Also, 30% consisted of females and 70% males within the age range of 18-56 years. Incomes ranged from Tk50,000 and above. We term this group the educated elite. It is useful to study this group because if their knowledge, attitudes and behaviours are deficient, one might imagine the situation prevailing in the larger population that does not have similar advantages of education, a decent job, and decent incomes. The onerous implications can be easily surmised.
Knowledge
How comprehensive is people’s knowledge about “how” COVID spreads?
There are two main mechanisms of virus transmission -- person to person (P2P) (respiratory droplets) and from affected surfaces (the virus can remain active for different time periods on different surfaces). The responses indicated only partial knowledge: P2P figured most prominently among the educated elite (respiratory droplets; coming in close contact with a virus infected person; by air, touch, sneeze, etc.). Very few identified possible transmission from the surfaces where the virus can also survive. The need to disinfect one’s home thus seemed to be a low priority among the respondents.
How long does it take for the symptoms to appear after the infection?
Knowledge levels of our respondents varied quite a bit on this question and were categorized as comprehensive, partial, minimal, and no knowledge. Statements such as “1-14 days” was categorized as comprehensive, while just “14 days” was labeled partial. Only about 40% of the respondents had a clear idea of the time it takes for the symptoms to show up; the rest had vague ideas that were partial or minimal.
Knowledge about prevention
Comprehensive knowledge on prevention was reflected in respondent statements such as: “Wash hands for 20 seconds, avoid touching eyes, mouth, and hand, covering mouth and nose during cough or sneeze, maintain social distance, avoid large crowd, not going out if it is not necessary.” Only 13.7% of the respondents seemed to have comprehensive knowledge about prevention; 31% had partial knowledge, while more that 50% reflected minimal knowledge, reflected in one-dimensional and limited views. The low numbers of the educated elite having comprehensive knowledge of prevention was surprising and concerning; policy personnel, health officials, and frontline workers ought to be aware of this. It also behooves us to think about knowledge of prevention in the larger population in Bangladesh and its wider implications.
Perceptions
Information available to the public: When asked to indicate on a scale of 1-7 (Strongly disagree to Strongly agree) how much the respondents agreed with the statement “Information available to the public about Covid-19 is inadequate,” the chart shows great variation. Roughly 18.4% (providing a rating of 1-3) disagreed with the statement, 16.2% were ambivalent (at 4), and the rest (nearly two thirds) agreed with the statement in various degrees: 31% agreed strongly. This perceived lack of information suggests the need for a comprehensive IEC strategy that must be devised by the government in concert with communication experts, the media, and other bodies to address the information gaps.
Role of Media: Respondents were asked on the same 7-point scale to indicate their level of agreement with the statement “Media must do more to keep the public informed about Covid-19.” The large majority of respondents did not see the media as playing as pro-active a role as anticipated. Issues such as timing of information delivery and designing special program segments purely to communicate Corona updates ought to be looked into. It is imperative that critical information is made available with continuous updates and at regular intervals.
Know where to go for help: When asked about “knowledge of where to go for help,” the results are quite discouraging and seem to confirm the public’s lack of information and media’s not-so-vigorous role in providing adequate direction to the general public.
One can only surmise the state of the general public who lack many of the resources that the educated elite possess and yet feel this level of uncertainty about where to seek help.
Conclusions
This is a time of special urgency. The nation must come together, discarding various agendas and interests, to safeguard its people. The month of independence makes it doubly imperative to unite against a common and deadly enemy.
Our research suggests that there are serious knowledge gaps among the educated elite concerning COVID-19. Their perceptions on critical issues also suggest the need to move into high gear to inform, educate, and communicate to the general public about the notoriety of the Covid-19 virus and the need to stop it in its track.
Special attention needs to be devoted to delivering information on how the virus spreads and how to prevent it from spreading. Through the use of fear appeals and fact sharing, diffusion of information can slow the spread of the virus until a cure or immunity is ensured. Communicators from all walks must come forward to influence desired behaviour. Use of role models, demonstration effects, and celebrity endorsements are essential at this moment. Special attention must be devoted to the low-income groups who are at risk, especially given their lack of options to earn a living.
At this time of heightened ambiguity and uncertainty, the role of IEC is paramount to alleviate fear and stem irrational behaviour. It is particularly vital to coordinate and align communication strategies of the leaders, the government, health organizations, news organizations, and the medical community to provide a clear and consistent message. Communication is vital in this war against an invisible foe; we must win or accept extermination -- there is no middle ground, no room for negotiation.
Syed Saad Andaleeb, PhD is Distinguished Professor Emeritus, Pennsylvania State University, USA the Founder and Chair of Research A2Z, an organization providing research services. This study is a public service initiative of the organization. Dr. Andaleeb may be reached at [email protected] or [email protected]. This article was written with assistance from Mahreen Mamoon and Rahma Akhter.
