Perceived efficacy of COVID-19 restrictions, reactions and their impact on mental health during the early phase of the outbreak in six countries

Abstract

The COVID-19 pandemic forced millions of people to drastically change their social life habits as governments employed harsh restrictions to reduce the spread of the virus. Although beneficial to physical health, the perception of physical distancing and related restrictions could impact mental health. In a pre-registered online survey, we assessed how effective a range of restrictions were perceived, how severely they affected daily life, general distress and paranoia during the early phase of the outbreak in Brazil, Colombia, Germany, Israel, Norway and USA. Most of our over 2000 respondents rated the restrictions as effective. School closings were perceived as having the strongest effect on daily life. Participants who believed their country reacted too mildly perceived the risk of contracting SARS-CoV-2 to be higher, were more worried and expressed reduced beliefs in the ability to control the outbreak. Relatedly, dissatisfaction with governmental reactions corresponded with increased distress levels. Together, we found that satisfaction with one's governmental reactions and fear appraisal play an important role in assessing the efficacy of restrictions during the pandemic and their related psychological outcomes. These findings inform policy-makers on the psychological factors that strengthen resilience and foster the well-being of citizens in times of global crisis.

Keywords: distress; lockdown; pandemic; perceived risk; protection motivation theory.

Figure 1.

Country-wise restrictions stringency index for the data collection period, based on [43] for Brazil, Colombia, Germany, Norway, Israel and USA. Start date and end date of the survey in the various languages indicated by arrows. Graph modified from ourworldindata.org [44].

Figure 2.

Correlation plot for the perceived efficacy of own, others' or governmental reactions and efficacy of restrictions such as school closings, quarantine and public life restrictions (for a split by country, see electronic supplementary material, figure S2).

Figure 3.

(a) Among those affected by COVID-19, the severity of impact on daily life was highest for school/university closings. (b) Difference in percentage in rating the severity of six restrictions. Positive score: non-affected rated it higher, negative score: higher rating among those who were affected. All values in percentage.

Figure 4.

Perceived efficacy of own, governmental or others' reactions on limiting the outbreak by country.

Figure 5.

Perceived efficacy of reactions per country and action. Filled circles and black in the pie chart inserts: participants were satisfied with how their country fought the outbreak; white circles and grey in pie chart inserts: participants stating do not know whether their country does enough; white squares and white pie: participants were not satisfied.

Figure 6.

Coefficient estimates of the eight predictors for perceived efficacy of self, others' or governmental reaction, with 95% confidence interval. More worry/fear (fear appraisal) increases the efficacy of own reactions but had an opposite effect for rating the efficacy of governmental reactions.

Figure 7.

Perceived efficacy of restrictions by country. Countries with a severe lockdown also perceived the restrictions as efficient. Norway and Germany, with partial lockdowns, rated them as less efficient.