Built environment factors moderate pandemic fatigue in social distance during the COVID-19 pandemic: A nationwide longitudinal study in the United States

Abstract

Non-pharmaceutical interventions (NPIs) remain some of the most effective measures for coping with the ever-changing coronavirus disease 2019 (COVID-19) pandemic. Pandemic fatigue, which manifests as the declined willingness to follow the recommended protective behaviors (e.g., keeping social distance policies, wearing masks), has commanded increasing attention from researchers and policymakers after the prolonged NPIs and COVID-19 worldwide. However, long-term changes in pandemic fatigue are not well understood, especially amidst the ever-changing pandemic landscape. Built environment factors have been shown to positively affect mental and physical health, but it is still unclear whether built environments can moderate pandemic fatigue. In this study, we used Google mobility data to investigate longitudinal trends of pandemic fatigue in social distance since the onset of NPIs enforcement in the United States. The results indicated that pandemic fatigue continuously worsened over nearly two years of NPIs implementation, and a sharp increase occurred after the vaccination program began. Additionally, we detected a significant moderation effect of greenspace and urbanicity levels on pandemic fatigue. People living in areas with high levels of greenness or urbanicity experienced lower levels of pandemic fatigue. These findings not only shed new light on the effects of greenness and urbanicity on COVID-19 pandemic fatigue, but also provide evidence for developing more tailored and effective strategies to cope with pandemic fatigue.

Keywords: Built environment; Green space; Moderation effect; Pandemic fatigue; Social distance; Urbanicity.

Fig. 1

The main behavioral manifests of pandemic fatigue.

Fig. 2

The moderation effect of built environment factors on pandemic fatigue in social distance.

Fig. 3

Longitudinal pandemic fatigue trends in different urbanicity levels over the 18 months since NPIs implementation. (Time 0 represents the baseline period (the first 30 days after NPIs implementation). Urbanicity level 1 represents the most urbanized areas and level 6 represents the most rural areas.)

Fig. 4

Longitudinal pandemic fatigue trends in areas with high or low NDVI in six urbanicity levels over the 18 months since NPIs implementation.

Fig. 5

The NDVI moderates the effect of NPIs stringency on mobility. (0.538 is the mean value of NDVI, 0.397 and 0.679 are one standard deviation below and up the mean level of NDVI. As NPIs stringency decreased (from left to right), mobility rebounded faster in low-NDVI areas than in high-NDVI areas.).

Fig. 6

Urbanicity levels moderate the effect of NPIs stringency on mobility. (As NPIs stringency decreased (from left to right), mobility rebounded faster in rural areas (level 6 represents the most rural areas) than in urbanized areas (level 1 represents the most urbanized areas).

Fig. 7

Decreasing the COVID-19 cases, and increasing of pandemic fatigue levels. (The dotted line denotes the first COVID-19 vaccination in the US on December 14th, 2020 (BBC, 2020).)

Fig. 8

Core mechanisms underlying the moderation effect of built environment factors on pandemic fatigue.