As Covid-19 spreads across the world, governments turn a hopeful eye towards research and development of a vaccine against this new disease. But it is one thing to make a vaccine available, and it is ...quite another to convince the public to take the shot, as the precedent of the 2009 H1N1 influenza illustrated. In this paper, we present the results of four online surveys conducted in April 2020 in representative samples of the French population 18 years of age and over (N = 5018). These surveys were conducted during a period when the French population was on lockdown and the daily number of deaths attributed to the virus reached its peak. We found that if a vaccine against the new coronavirus became available, almost a quarter of respondents would not use it. We also found that attitudes to this vaccine were correlated significantly with political partisanship and engagement with the political system. Attitudes towards this future vaccine did not follow the traditional mapping of political attitudes along a Left-Right axis. The rift seems to be between people who feel close to governing parties (Centre, Left and Right) on the one hand, and, on the other, people who feel close to Far-Left and Far-Right parties as well as people who do not feel close to any party. We draw on the French sociological literature on ordinary attitudes to politics to discuss our results as well as the cultural pathways via which political beliefs can affect perceptions of vaccines during the COVID-19 pandemic.
•Almost a quarter of the French population would not get vaccinated against COVID-19.•Attitudes are correlated with political partisanship and engagement with politics.•Attitudes do not follow the traditional separation between Left-wing and Right-wing.•Refusal is associated with proximity radical parties and to abstention.
The social profile of reluctant responders is even more worrying: this attitude was more prevalent among low-income people (37%), who are generally more exposed to infectious diseases,4 among young ...women (aged 18–35 years; 36%), who play a crucial role regarding childhood vaccination,5 and among people aged older than 75 years (22%), who are probably at an increased risk for severe illness from COVID-19. When this dimension has been studied, researchers have often found a connection between political beliefs and attitudes to vaccines.6 They highlight a crucial issue for public health interventions: how can we assure the public that recommendations reflect the state of scientific knowledge rather than political interests? Public authorities are setting up fast-track approval processes for a putative vaccine against SARS-CoV-2.9 It is crucial to communicate early and transparently on these processes to avoid vaccines becoming part of political debates.
The Covid‐19 pandemic has disrupted the habits of billions of people around the world. Lockdown at home is mandatory, forcing many families, each member with their own sleep–wake habits, to spend ...24 hr a day together, continuously. Sleep is crucial for maintaining immune systems and contributes deeply to physical and psychological health. To assess sleep problems and use of sleeping pills, we conducted a cross‐sectional study of a representative sample of the general population in France. The self‐reported sleep complaint items, which covered the previous 8 days, have been used in the 2017 French Health Barometer Survey, a cross‐sectional survey on various public health issues. After 2 weeks of confinement, 74% of the participants (1,005 subjects) reported trouble sleeping compared with a prevalence rate of 49% in the last general population survey. Women reported more sleeping problems than men, with greater frequency or severity: 31% vs. 16%. Unusually, young people (aged 18–34 years) reported sleep problems slightly more frequently than elderly people (79% vs. 72% among those aged 35 or older), with 60% of the younger group reporting that these problems increased with confinement (vs. 51% of their elders). Finally, 16% of participants reported they had taken sleeping pills during the last 12 months, and 41% of them reported using these drugs since the lockdown started. These results suggest that the COVID crisis is associated with severe sleep disorders among the French population, especially young people.
The outbreak of COVID-19 has been a major interrupting event, challenging how societies and individuals deal with risk. An essential determinant of the virus' spread is a series of individual ...decisions, such as wearing face masks in public space. Those decisions depend on trade-offs between costs (or benefits) and risks, and beliefs are key to explain these.
We elicit beliefs about the COVID-19 pandemic during lockdown in France by means of surveys asking French citizens about their belief of the infection fatality ratio (IFR) for COVID-19, own risk to catch the disease, risk as perceived by others, and expected prevalence rate. Those self-assessments were measured twice during lockdown: about 2 weeks after lockdown started and about 2 weeks before lockdown ended. We also measured the quality of these beliefs with respect to available evidence at the time of the surveys, allowing us to assess the calibration of beliefs based on risk-related socio-demographics. Finally, comparing own risk to expected prevalence rates in the two successive surveys provides a dynamic view of comparative optimism with respect to the disease.
The risk perceptions are rather high in absolute terms and they increased between the two surveys. We found no evidence for an impact of personal experience with COVID-19 on beliefs and lower risk perceptions of the IFR when someone in the respondent's family has been diagnosed with a disease. Answers to survey 1 confirmed this pattern with a clear indication that respondents were optimistic about their chances to catch COVID-19. However, in survey 2, respondents revealed comparative pessimism.
The results show that respondents overestimated the probabilities to catch or die from COVID-19, which is not unusual and does not necessarily reflect a strong deviation from rational behavior. While a rational model explains why the own risk to catch COVID-19 rose between the two surveys, it does not explain why the subjective assessment of the IFR remained stable. The comparative pessimism in survey 2 was likely due to a concomitant increase in the respondents' perceived chances to catch the disease and a decreased expected prevalence rate.
...more than 3 billion unprepared people worldwide had to cope with living under stringent lockdown measures for weeks or months, depending on the country. Multivariate logistic models analysed the ...associations of the four mental health outcomes (moderate to severe depressive symptoms, severe anxiety, sleep problems and reported need for psychological support from a health professional) with sociodemographic characteristics and exposure to both the virus and the media. Notably, this prevalence had peaked at 74% 2 weeks after lockdown.9 The prevalence of moderate depressive symptoms (PHQ9≥10) reached 22.9% in the present survey, compared with 7% in the French version of the European Health Interview Survey conducted in 2014.5 This large difference underlines the major impact of this sanitary crisis on mental health.Table 1 Mental health in the French general population after 8 weeks of lockdown (COCONEL survey, France, n=2003, 7–10 May 2020) Depressive symptoms Anxiety Sleep problems Perceived need for psychological support PHQ9≥15 GAD≥15 few, a lot % (95% CI) Proportion in the whole sample 8.8 (7.6 to 10.0) 8.7 (7.5 to 9.9) 68.1 (66.1 to 70.1) 12.2 (10.8 to 13.6) Row % Gender: (P<0.001)* Male (n=954) 7.8 7.9 60.7 11.8 Female (n=1049) 9.7 9.4 74.8 12.6 Age (in years): (P=0.001) (P<0.001) (P<0.001) 18–25 (n=229) 11.8 7.9 76.4 16.2 26–45 (n=629) 11.8 9.2 70.5 16.7 46–65 (n=695) 7.2 8.3 65.7 7.6 >65 (n=450) 5.3 8.9 64.2 11.3 Education level: <High-School (n=1017) 8.2 10 66.1 11.8 High-school, first university degree (n=634) 9.8 8 70.5 12 >2 years completed at university (n=352) 8.8 6.3 69.6 13.9 Household income level† (P=0.003) Low income (n=473) 12.3 13.3 71.2 15.2 Medium income (n=1076) 8 7.5 69.1 10.6 High income (n=454) 6.8 6.6 62.6 13 Confined in an overcrowded dwelling ‡ (P=0.022) No (n=1826) 8.5 8.3 67.7 11.3 Yes (n=177) 11.2 12.9 72.3 21.3 Occupational status since lockdown: (P=0.031) (P=0.039) (P<0.001) Still working full time out of home (n=357) 6.4 6.2 56 10.1 Teleworking (n=282) 10.6 5.7 72.2 14.2 Not working, other (n=1364) 9.3 10 70.5 12.5 Respondent diagnosed with COVID-19: (P=0.001) (P<0.001) (P<0.001) No (n=1950) 8.3 8.2 68 11.5 Yes (n=53) 25.9 26.4 72.2 39.6 Someone close sent to intensive care unit: (P=0.003) No (n=1870) 8.3 8.5 68 11.3 Yes (n=133) 14.3 12 70.7 24.8 Daily media exposure to COVID-19: (P<0.001) (P<0.001) (P=0.001) (P<0.001) <1 hour (n=478) 5.6 8.2 60.8 8.6 1 to 2 hours (n=617) 5.2 6.2 68.1 10.1 2 to 4 hours (n=421) 6.9 6.2 71.2 10 ≥4 hours (n=489) 18 14.3 72.6 21.4 95% CI: 95% Confidence Interval; COCONEL: ‘Low income’ refers to the first quartile, ‘medium income’ to the second and third quartiles, ‘high income’ to the fourth quartile. ‡<194 square feet per capita. ...contrary to previous observations among the French population,8 young people (aged 18–25) reported the highest prevalence of sleep problems, while respondents aged 18–45 were more likely to report depressive symptoms than their older counterparts.
The outbreak of the Covid-19 pandemic and the accompanying lockdown measures have had a major impact on societies around the world, leading to sleep problems for a large part of the population. In ...order to assess the sustainability of sleeping troubles related to the sanitary crisis, it was crucial to measure its prevalence after the end of the Covid-19 confinement.
As part of an epidemiological survey on Covid and Confinement (COCONEL), we enquired on sleep disorders using two items in 4 repetitive cross-sectional surveys. The first took place during the first week of the French confinement (March 31 to April 2; N = 1005 participants). The second took place in the middle of this period (April 15–17; N = 1005). The two last surveys were held at the end of the confinement (May 7–10; N = 2003) and one month after the end (June 10–12; N = 1736). Using a random constant, the mixed model took into account the longitudinal character of the last two waves (intra-individual correlations for individuals surveyed in waves 3 and 4).
The prevalence of sleep problems significantly decreased during the last weeks of the confinement, and this trend was confirmed one month after the end of confinement. One quarter of the population reported that their sleep was better one month after the end of the confinement. Sleep improvement was reported more often by women and people aged less than 65. Such improvement was less frequent among those who were still highly exposed to the pandemic's media coverage after the end of the confinement.
The possibility of recovering a good sleep largely depends on the type of sleep disorder. The decrease in sleep problems occurred mainly among people with mild sleep problems during the confinement. Further research is needed to assess the long-term effects of the Covid-19 pandemic and its confinement period on sleep quality in the general population.
•There was a high prevalence of sleep problems during the confinement.•This prevalence significantly decreased during the last weeks of the confinement.•This trend was confirmed one month after the confinement.•The prevalence of sleep problems was higher in women and in young adults.
With France one of the European countries most strongly affected by COVID-19 in the spring of 2020, French authorities imposed a nationwide lockdown for 8 weeks (March 17-May 10). This study explored ...the perception of the adult population about the need for-and access to-psychological support from health care professionals (HCP) in response to concerns about the psychological needs during lockdown.
This online cross-sectional survey of a representative sample of the adult general population of mainland France (N = 2,003) took place during the last four days of the French lockdown (May 7-10, 2020).
One in eight respondents (12.2%) perceived a need for psychological support from an HCP during the lockdown; most had symptoms of depression and/or anxiety of at least moderate intensity. Only a third (29.8%, 3.6% of the entire sample) actually obtained this support. Factors associated with this perceived need included: age under 35, economic difficulties due to lockdown, pre-lockdown use of psychological support, infection with COVID-19, serious worries about becoming infected, and heavy media use to obtain information about the disease. Among those who perceived a need for psychological support, the elderly were the most likely not to consult an HCP. People aged 35-64, those with high income, and those seriously worried about developing COVID-19 were the most likely to forgo seeking access to care because of their fear of infection by the coronavirus-2019.
The perceived need for psychological support from an HCP and access to it appeared to be strongly associated with COVID-19 exposure factor. More research about this association is needed to improve the health authorities' understanding of the population's psychological needs in this situation and to enhance HCPs' abilities to meet them. In particular, further research of its specific impact on youth is necessary.
Abstract
Background
In view of experts’ warnings about the potential negative mental health consequences of the sudden nationwide lockdowns implemented in many countries to limit the spread of the ...COVID-19 pandemic, we sought to study the incidence of posttraumatic stress disorder (PTSD) after traumatic events related to this unprecedented lockdown in the French general population.
Methods
This longitudinal study among adults (aged =18) consisted of two surveys: the first during the last days of the lockdown and the second a month later. We estimated PTSD incidence with the PCL-5 and ran multiple Poisson regression models to identify factors associated with PTSD.
Results
Among the 1736 participants, 30.1% reported at least one traumatic event. PTSD incidence was 17.5% (95% confidence interval CI = 15.7–19.3). It was higher in participants who reported multiple traumatic events, who had high COVID-19-related media use, who had general anxiety disorder (GAD-7) during the lockdown, and who had GAD, depression (PHQ-9), or sleep problems 1 month later. In addition, 43.1% of people with PTSD reported suicidal thoughts.
Conclusions
These results should help clinicians to target people who are at high risk of developing PTSD after a pandemic-related lockdown and could benefit from preventive measures. Collaboration between the media and mental health professionals could be envisioned to inform the population about care resources. Follow-up recommendations should also be disseminated to general practitioners to facilitate PTSD screening and ensure that they are aware of the appropriate management.
In March 2020, as the coronavirus disease 2019 (COVID- 19) pandemic was spreading across the globe, many countries have implemented unprecedented lockdown measures. But how populations did react to ...these measures? We examined the case of France. Our aims were threefold: assessing some aspects of their impact on French's daily living conditions; investigating their attitudes toward the lockdown; investigating the factors associated with these attitudes.
A cross-sectional online survey was carried out 10 days after the nationwide lockdown (from March 27th to March 29th 2020), among a representative sample of the mainland French population aged 18 and over. A quota sampling method was applied to achieve a sample of 1012 respondents. We used a cluster analysis to obtain contrasted attitudinal profiles, and logistic regressions to investigated which factors were associated to these profiles.
After 10 days of lockdown, there were already significant consequences regarding respondents' living conditions and mental health. Most respondents supported the current lockdown. However, it appeared as a stopgap measure due to a lack of alternatives, and a large majority acknowledged its heavy drawbacks. We found three contrasted attitudinal profiles: full support (38%), strong but critical support (31%), limited support (31%). Regarding respondents' SES, low-income and low-education respondents were more likely to display critical or limited support to the lockdown, as well as those who reported deteriorated living conditions or psychological distress.
In France, the large public support to the lockdown was fragile. First, it was a critical consensus anchored in current controversies and recent social struggles. Second, it was weaker among people with a lows SES, especially since the lockdown have exacerbated preexisting social inequalities.
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