The role of risk communication in public health interventions. An analysis of risk communication for a community quarantine in Germany to curb the SARS-CoV-2 pandemic

Abstract

Background: Separating ill or possibly infectious people from their healthy community is one of the core principles of non-pharmaceutical interventions. However, there is scarce evidence on how to successfully implement quarantine orders. We investigated a community quarantine for an entire village in Germany (Neustadt am Rennsteig, March 2020) with the aim of better understanding the successful implementation of quarantine measures.

Methods: This cross-sectional survey was conducted in Neustadt am Rennsteig six weeks after the end of a 14-day mandatory community quarantine. The sample size consisted of 562 adults (64% of the community), and the response rate was 295 adults, or 52% (33% of the community).

Findings: National television was reported as the most important channel of information. Contact with local authorities was very limited, and partners or spouses played a more important role in sharing information. Generally, the self-reported information level was judged to be good (211/289 [73.0%]). The majority of participants (212/289 [73.4%]) approved of the quarantine, and the reported compliance was 217/289 (75.1%). A self-reported higher level of concern as well as a higher level of information correlated positively with both a greater acceptance of quarantine and self-reported compliant behaviour.

Interpretation: The community quarantine presented a rare opportunity to investigate a public health intervention for an entire community. In order to improve the implementation of public health interventions, public health risk communication activities should be intensified to increase both the information level (potentially leading to better compliance with community quarantine) and the communication level (to facilitate rapport and trust between public health authorities and their communities).

Fig 1. Overview of the confirmed cases of SARS-CoV-2 in Neustadt am Rennsteig and the interventions of the local authorities.

The beginning of the community quarantine was announced via loudspeaker as well as the screening of every inhabitant (symptomatic or asymptomatic) in the second week. The third day of quarantine (24.03.2020) a leaflet was handed out with all the necessary information. You can find the issued order and the leaflet in the Supplementary Material. [number of confirmed cases according to https://www.ilm-kreis.de/Landkreis/Ver%C3%B6ffentlichungen/Pressearchiv/index.php?ModID=255&object=tx%2C2778.5.1&La=1&NavID=2778.25&text=&kat=&monat=202003&jahr= (accessed: 28.04.2020)].

Fig 2. Use of media and sources/channels of information before and during quarantine.

The graph shows the percentage of the combined results of occasional, frequent and very frequent use.

Fig 3. Distribution of information by the local authorities.

Fig 4. Level of concern and level of information in correlation to age.

The graph shows the average answers of the participants according to their age group. 1 is no concern/very basic level of information, 5 is the highest level of concern/information.