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Public Perceptions and Experiences of Social Distancing and Social Isolation During the COVID-19 Pandemic: a UK- Based Focus

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Public Perceptions and Experiences of Social Distancing and Social Isolation During the COVID-19 Pandemic: a UK- Based Focus Open access Original research BMJ Open: first published as 10.1136/bmjopen-2020-039334 on 20 July 2020. Downloaded from Public perceptions and experiences of social distancing and social isolation during the COVID-19 pandemic: a UK- based focus group study Simon N Williams ,1 Christopher J Armitage,2 Tova Tampe,3 Kimberly Dienes2 To cite: Williams SN, ABSTRACT Strengths and limitations of this study Armitage CJ, Tampe T, Objective This study explored UK public perceptions et al. Public perceptions and experiences of social distancing and social isolation ► A strength of this this study is that it can help inform and experiences of social related to the COVID-19 pandemic. distancing and social social distancing and isolation ‘exit strategies’, since Design This qualitative study comprised five focus isolation during the COVID-19 it provides evidence of how people are likely to be- groups, carried out online during the early stages of the pandemic: a UK- based focus have when these measures are removed or relaxed. UK’s stay at home order (‘lockdown’), and analysed using a group study. BMJ Open ► Another strength of this study is that it is the first thematic approach. 2020;10:e039334. doi:10.1136/ qualitative study of its kind to provide evidence on Setting Focus groups took place via online bmjopen-2020-039334 the current mental health impacts of COVID-19- videoconferencing. Prepublication history for related social distancing and isolation. ► Participants Participants (n=27) were all UK residents this paper is available online. ► Another strength is its finding of the various forms aged 18 years and older, representing a range of gender, To view these files, please visit of ‘loss’ as a new concept through which to under- ethnic, age and occupational backgrounds. the journal online (http:// dx. doi. stand the practical and emotional impacts of social Results Qualitative analysis revealed four main org/ 10. 1136/ bmjopen- 2020- distancing and isolation on the public. 039334). themes: (1) loss—participants’ loss of (in- person) social ► A limitation of this study is that it does not include interaction, loss of income and loss of structure and participants from vulnerable or ‘high- risk’ groups Received 17 April 2020 routine led to psychological and emotional ‘losses’ such as (eg, over 70s). Revised 06 July 2020 loss of motivation, loss of meaning and loss of self-worth; Accepted 07 July 2020 (2) criticisms of government communication—participants http://bmjopen.bmj.com/ reported a lack of trust in government and a lack of clarity in the guidelines around social distancing and isolation; (3) because of the scientific and medical uncer- adherence—participants reported high self- adherence to tainty that accompanies novel viruses like social distancing guidelines but reported seeing or hearing COVID-19.3 Since COVID-19 is a new virus, of non- adherence in others; (4) uncertainty around social reintegration and the future—some participants felt they pharmaceutical interventions like vaccines would have lingering concerns over social contact while are not presently available. Public health others were eager to return to high levels of social activity. policy is therefore exclusively reliant on Most participants, and particularly those in low- paid or non- pharmaceutical interventions (NPI). on September 25, 2021 by guest. Protected copyright. precarious employment, reported feeling that the social The key NPIs being used in relation to the distancing and isolation associated with COVID-19 policy COVID-19 pandemic in the UK and globally © Author(s) (or their has had negative impacts on their mental health and well- (in addition to personal hygiene advisories; employer(s)) 2020. Re- use being during the early stages of the UK’s ‘lockdown’. eg, emphasising regular and thorough hand- permitted under CC BY-NC. No Conclusions A rapid response is necessary in terms of washing) are social distancing and social isola- commercial re- use. See rights public health programming to mitigate the mental health tion. Social distancing (physical distancing) and permissions. Published by impacts of COVID-19 social distancing and isolation. Social BMJ. in the UK has included the banning of public distancing and isolation ‘exit strategies’ must account for 1 Centre for People and the fact that, although some individuals will voluntarily or gatherings, closure of schools and all non- Organisation, School of habitually continue to socially distance, others will seek essential shops, workplaces and services, and Management, Swansea high levels of social engagement as soon as possible. the recommendation of keeping a distance University, Swansea, UK of >2 m apart from others.4 Social isolation 2Manchester Centre for Health Psychology, University of (self- isolation) guidelines in the UK have Manchester, Manchester, UK INTRODUCTION included a period of 7 days of quarantine 3World Health Organization, The current coronavirus (COVID-19) for those showing symptoms of, or testing Genève, Switzerland pandemic presents a considerable challenge positive for, COVID-19, and a 14- day quaran- 1 2 Correspondence to to public health in the UK and globally. tine period for others in the same household Dr Simon N Williams; Pandemics are problematic for clinical and (although specific guidelines have varied s. n. williams@ swansea. ac. uk public health agencies and policymakers over time).4 Williams SN, et al. BMJ Open 2020;10:e039334. doi:10.1136/bmjopen-2020-039334 1 Open access BMJ Open: first published as 10.1136/bmjopen-2020-039334 on 20 July 2020. Downloaded from Due to the extent of the social distancing and social Table 1 Demographic details reported by participants isolation measures being implemented in response to COVID-19, social and psychological impacts on the Characteristic n (%) public are anticipated and warrant further attention.5 A Gender recent rapid review of the psychological impact of quar- Female 13 (48) antine found that longer quarantine duration, infection Male 14 (52) fears, frustration and boredom, inadequate supplies, Age range inadequate information, financial loss and stigma were among the major stressors.6 Another systematic review of 18–24 7 (26) the literature on NPIs in relation to pandemic influenza 25–34 6 (22) and severe acute respiratory syndrome (SARS) found that 35–44 8 (30) people actively evaluate NPIs in terms of criteria such as 45+ 6 (22) perceived necessity, efficacy, acceptability and feasibility.7 Ethnicity Public views on social distancing and social isolation are ambivalent in some contexts because of their perceived White—British 16 (59) adverse social and economic impacts and their ability to White—any other White background 6 (22) attract stigma, particularly among those required to self- Asian or Asian British—Pakistani 3 (11) 7 isolate. Existing research on social distancing and isola- Mixed—White and Asian 1 (4) tion highlights a number of challenges for public health Other 1 (4) policymakers, including a lack of trust in government8; concerns over strains in family resources8; gaps and confu- Occupational classification sions in some areas of pandemic information communi- Managers, directors and senior officials 2 (7) 9 cation ; and low adherence to voluntary social isolation Professional occupations 6 (22) and relatively low adherence to non-attendance at public 10 Associate professional and technical 5 (19) gatherings. Although there is existing research from occupations past pandemics on its likely effects,6 and new quantitative Administrative and secretarial occupations 1 (4) research is starting to emerge,11 there is to our knowledge no published qualitative evidence on public perceptions Skilled trade occupations 1 (4) and experiences of the psychological and social impacts Caring, leisure and other service occupations 1 (4) of COVID-19- related social distancing and social isola- Sales and customer service occupations 3 (11) tion, and its relation to adherence. The present study Elementary occupations 1 (4) seeks to address this gap. http://bmjopen.bmj.com/ Full- time student 5 (19) This study explored four main questions: (1) What are Unclassified/occupation not provided 2 (7) the social and psychological impacts of social distancing and isolation experienced by participants during the Occupational classifications coded using the Office for National COVID-19 pandemic? (2) What are participants’ views Statistics (ONS) Occupation Coding Tool. on government communication around social distancing and isolation? (3) What are participants’ current experi- ences of adherence in relation to social distancing and UK. Participants were recruited from all four UK coun- isolation? (4) What are participants’ views on the future tries (England, Wales, Scotland and Northern Ireland). on September 25, 2021 by guest. Protected copyright. in regard to COVID-19 social distancing and isolation? Under normal circumstances, online focus groups can be This study therefore aims to contribute to knowledge a useful way of eliciting public views related to matters on adherence to social distancing and isolation policy to of health and medicine, particularly from diverse and provide insight into how communication with the public geographically dispersed participants12 13 but were neces- on social distancing and isolation may be shaped and sary due to social isolation policy. Participants gave both improved in the future. verbal and written informed consent. Purposive sampling was used to provide a diverse range of ages, genders,
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