In order to help reduce the surge of new COVID-19 cases, consistent public education on what is a coronavirus and how it spreads needs to be increased, the results of a new study conducted by UB Associate Professor of Nursing and Allied Health Professions at University of The Bahamas (UB) Dr. Theresa Moxey-Adderley suggests.
According to Dr. Moxey-Adderley, a lack of understanding by the public has the potential to undermine public health efforts to contain the outbreak and delay the effectiveness of prevention and control measures. There were over 1035 COVID-19 positive cases in The Bahamas on nine islands up to 12th August.
“Knowledge is a precursor to behavioral change, and plays a role on how one implements preventative precautions to reduce the spread of the virus,” said Dr. Moxey-Adderley. “If we are going to reduce our numbers, there needs to be greater efficacy on public education on what is a virus. Just providing [public service announcements] on washing hands, maintaining physical distance and wearing a mask may not be enough.”
On 8th July, 2020, Chief Medical Officer Dr. Pearl McMillan announced that The Bahamas had entered the dreaded second wave of COVID-19 infections. As of that date, The Bahamas had recorded 106 confirmed cases, 89 of which had recovered. By 4th August, confirmed cases were more than six times that number, at 679.
In June, Dr. Moxey-Adderley conducted a preliminary study via an online questionnaire to 162 first to fourth year UB students between the ages of 18 and 56 to assess their knowledge of COVID-19 prevention and control practices. Additionally, a pre-test was given to 3,634 members of the general public who had attended a COVID-19 workplace protocols training course to assess their specific knowledge.
The study revealed a widespread misconception about COVID-19, according to Dr. Moxey-Adderley, who said this may have played a role in the recent exponential uptick in cases. Some 80 percent of the UB students, and 98 percent of the non-medical participants responded incorrectly to the question: “Is coronavirus a living organism?” Based on the results, and although 88 percent of the UB students knew COVID-19 spreads via the respiratory droplets of infected people, 58 percent of them didn’t know that the clinical symptoms of COVID-19 included symptoms similar to the common cold or flu.
Dr. Moxey-Adderley noted that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – the virus that causes the COVID-19 disease – is not considered a living organism, but rather a highly contagious virus that is easily spread among people.
“Flu and COVID-19 share many characteristics, but the main symptoms of COVID-19 are a dry cough, fever and fatigue and bad cases include difficulty breathing,” she explained. “It is understandable that since common symptoms of COVID-19 can resemble cold-like symptoms such as a runny nose, sneezing and sore throat, it may be hard to tell the difference between the symptoms of Flu and COVID-19 based on symptoms alone. Testing may be needed to help to confirm a diagnosis.”
Dr. Moxey-Adderley noted that four months into the pandemic, government officials instructed residents to quarantine and self-isolate as much as possible for a 14-day period as an effective way to slow the spread of the virus. The plan was for people to isolate themselves if they were experiencing symptoms and to quarantine themselves if they may have been exposed to someone diagnosed with COVID-19, but were not showing symptoms.
Yet, the study reveals that only two-thirds of the UB students who responded to the survey were able to identify clinical symptoms, and only 75 percent of them understood transmission routes and prevention and control measures.
“One aspect of risk for exposure to the virus is whether or not individuals have a basic knowledge about the virus and understand the value of preventative measures such as hand washing,” noted Dr. Moxey-Adderley. “A lack of understanding of these matters has the potential to undermine public health efforts to contain the pandemic. Successful determinants of prevention depend on knowledge of causation and dynamics of transmission.”
Additionally, 84 percent of the UB students endorsed healthy persons utilizing medical-grade face masks to protect themselves from the COVID-19 virus at a time when the science on face masks was still inconclusive. According to Dr. Moxey-Adderley, the UB students’ position on wearing face masks was actually influenced by what they heard in the media rather than empirical scientific data. And those unclear benefits and usage of face masks could have created a false sense of security amongst the populace, leading to diminished preventative measures such as physical distancing and hand washing.
“This points to a potential danger, that unless the public is trained by professional infection control experts, via a controlled learning environment, their attitudes towards COVID-19 can be guided by less reliable sources, which may jeopardize public safety,” she said.
The survey also revealed that almost half (42 percent) of the UB students surveyed reported that they went into a crowded place and/or joined a long line in the seven days immediately preceding the study, during a time that healthcare officials were urging physical distancing and isolation.
“Physical distancing is an intervention intended to control the spread of the coronavirus,” explained Dr. Moxey-Adderley. “By reducing the frequency of physical contact with a potentially infected person, the disease transmission can be suppressed, resulting in fewer cases.”
Dr. Moxey-Adderley noted that to her knowledge, no study has been done in The Bahamas to assess knowledge and control practices pertaining to COVID-19. As such, the information obtained from the UB students may or may not reflect the knowledge trained nurses or the general population may have of the disease.
“Greater efficacy on public education is highly recommended,” said Dr. Moxey-Adderley. “The almost total lack of knowledge about what a virus is in the group of 3,634 is also of concern. In order to effectively implement prevention and control measures, you must at least have a basic understanding of what the characteristics of the virus you’re trying to prevent and control are. It cannot replicate on a surface, and it requires you as the host to move it around in the environment.
“While various government agencies made mandatory and organized infection prevention and control training to prepare for the reopening of businesses in a COVID-19 world, it is noteworthy that even after they had been living with COVID-19 for four months, the majority of the participants knew very little about viruses. This suggests that there is still much to do to educate the public so they can make informed decisions with regards to their role in the preventing and controlling the surge of cases of COVID-19 in The Bahamas.”