Fear of COVID-19 and its sociodemographic and personal and family psycho-behavioural correlates

Abstract

Fear of COVID-19 is associated with public health compliance but also with negative well-being. Such fear also leads to delays in seeking medical care at a time when pandemic information overflows, increasing morbidity and mortality risks. No articles have reported associations of such fear with perceived benefits and harms, and little is known about the role of fear, attention to information, and fact-checking in delay in doctor consultation.

Under the Hong Kong Jockey Club SMART Family-Link Project, two population-based Family Amidst COVID-19 online surveys were conducted in May 2020 and February 2021 to investigate the positive and negative impacts of the pandemic on personal and family well-being in Hong Kong. The target population was Hong Kong residents aged 18 years and above with one or more family members.

The objectives of this thesis are to i) assess the level of fear of COVID-19 in Hong Kong adults after the second wave of the pandemic in May 2020; ii) examine fear of COVID-19 by different sociodemographic factors; iii) analyse the associations of fear of COVID-19 with perceived benefits and harms of COVID-19, and personal and family well-being; iv) analyse the associations of fear of COVID-19 with delay in doctor consultation and information-related attention and fact-checking; iv) explore the associations of fear of COVID-19 with other psycho-behavioural correlates to support its validity as a one-item tool; and v) discuss public health implications and suggestions for future research on fear of COVID-19.

The pandemic had led to a moderate level of fear (6.3 out of 10) in Hong Kong adults, even after the first two waves of outbreak were contained. Using simple questions on fear, perceived benefits and harms and information-related attention and fact-checking, this thesis shows sociodemographic differences in the fear of COVID-19 and that such fear was associated with both perceived personal and family benefits and harms, and the effect sizes of associations were greater for harms (0.08–0.37) than benefits (0.03). Females, younger age groups, and those with lower education or more cohabitants had greater fear. Higher levels of fear were associated with lower personal happiness and increased family conflicts and negative emotions. Delay in doctor consultation increased with fear and decreased with fact-checking.

This thesis also shows fear of COVID-19 was associated with other psycho-behavioural correlates including pandemic fatigue, loneliness, anxiety and depressive symptoms, personal happiness and adversity coping capability, supporting its validity as a one-item tool. Future research to validate the tool using other data in our FamCov surveys is needed.

This thesis adds evidence to further support the dichotomous role of fear with positive and negative impacts on emotions and behaviours, and highlight the importance of the assessment, monitoring and management of fear as crucial components of outbreak control and health promotion. Further studies on fear of COVID-19 and its impact are warranted.