Perception of Threat from COVID-19 Among the US Public During the Period of Rapid Spread of the COVID-19 Outbreak

Background The period of the rapid spread of the coronavirus disease 2019 (COVID-19) pandemic in the United States made people uncertain about their perception of the threat from COVID-19 and the response measures. To mount an effective response to this epidemic, it is necessary to understand the public's perceptions, behaviors and attitudes. Objective To test hypotheses that the perception of a threat from COVID-19 influences attitudes and behaviors. Methods This study used an open dataset of online questionnaires about COVID-19 provided by Nexoid, and selected the results of a questionnaire on behaviors, attitudes and perceptions related to COVID-19 among the US public from March 29 to April 20, 2020. In the end, a total of 24547 people living in the United States took part in the survey. Results The average self-assessed probability of contracting COVID-19 in this study was 33.2%, and 49.9% of the respondents thought their chance of getting COVID-19 was less than 30%. The predicted self-assessed probability of contracting COVID-19 among females was 1.35 times that of males. An increase of 5% in perceived infection risk was associated with being 1.02 times (OR=1.02, 95% CI = 1.02-1.02) more likely to report close contact with more than 10 people, and with being 1.01 times (OR=1.01, 95% CI = 1.01-1.01) more likely to report their cohabitants disagree with taking steps to reduce the risk of getting COVID-19, while there was no significant association with more than 5 cohabitants. In general, the participants who lived in states with 1001 to 10000 cases, were between 20 and 40 years old, were obese, smoke, drink alcohol, had never used drugs and had no underlying medical conditions were more likely to be in close contact with more than 10 people. Most of the participants were agreed with washing hands and maintaining social distancing, but only 20.2% of participants often wore masks. Additionally, male participants and participants under the age of 20 were most resistant to washing hands, maintaining social distancing and wearing masks. Conclusions This survey is the first attempt to describe on a large scale the determinants of the US public's perception of the threat from COVID-19. The self-assessed probability of contracting COVID-19 differed significantly based on the respondents' gender, state of residence, age, BMI, smoking habit, alcohol consumption, drug use, disease, environment and behaviors. These findings have certain value as a reference for public health policy makers and healthcare workers seeking to identify target populations for COVID-19 prevention and health education.