Uncovering physical and attitudinal barriers to adherence to precautions for preventing the transmission of COVID-19 and anxiety level of people in Wuhan: 2 months after the lockdown

Abstract Background Wuhan, the epicentre of the coronavirus diseases (COVID-19) outbreak, has been locked down on January 23, 2020. We aimed to investigate the barriers to the physical prevention, negative attitudes and anxiety levels. Methods A online cross-sectional survey was conducted with the people living in Wuhan between March 12th and 23rd, 2020. Results Of a total of 2,411 complete responses, the mean and standard deviation (SD) for the total physical prevention barriers score was 19.73 (SD ± 5.3; range 12−45) out of a possible score of 48. Using a cut-off score of 44 for the State-Trait Inventory (STAI) score, 79.9% (95%CI 78.2−81.5) of the participants reported moderate to severe anxiety during the early phase of the outbreak and 51.3% (95%CI 49.2−53.3) reported moderate to severe anxiety after the peak of COVID-19 was over (during the study period). Comparing anxiety levels in the early phase of the outbreak and after the peak of the outbreak, 58.5% (95%CI 56.5−60.5) recorded a decreased anxiety. Females reported a higher likelihood to have decreased levels of anxiety than males (OR=1.78, 95%CI 1.48−2.14). Low negative attitudes score were associated with a higher decrease in anxiety (OR=1.59, 95% CI 1.33−1.89). Conclusions The attitudinal barriers to prevention of transmission of COVID-19 are more prominent than physical prevention barriers after the peak of COVID-19. High anxiety levels even after the peak warrant serious attention.