Relationship between Perception and Anxiety About COVID-19 Infection and Risk Behaviors for Spreading Infection: Preliminary Report of a National Survey in Japan

Background: The novel corona virus infection (COVID-19) has immediately become a pandemic. Identifying characteristics of possible “super spreaders,” who are assumed to be a dominant cause of rapid transmission, will help in designing proper prevention strategies. Methods: We conducted a nation-wide online survey to investigate the relationship of understanding and anxiety levels about COVID-19 to possible risk behaviors for spreading the virus in Japan. In total, 4,000 citizens responded to our questionnaire during March 27 and 28, 2020. The questionnaire included several questions covering the level of fear and anxiety about COVID-19, infection preventive behaviors, access to media, level of trust in information about the virus, as well as participants’ demographic characteristics. Findings: In total, 13·7% of participants reported that they have a very low understanding of COVID-19. This study defined those participants as “indifferent individuals.” In addition, 10·6% and 12·2% of them indicated that they have no anxiety of being infected and transmission to others, respectively. We also found that 11·2% showed no worry about symptomatic aggravation, and 8·5% had no concern about spreading the infection. Indifferent individuals were less likely to access information sources than others, and do not trust the information they obtained about the virus. They were less anxious about their own health, and less likely to engage in precautionary behaviors (e.g., washing hands and avoiding crowded spaces) than other participants. Interpretation: The present study suggests it is highly important to educate those who have no concerns about COVID-19, and help them to stop their risk behaviors in order to prevent and control this viral pandemic. Funding Statement: This study was funded by a management grant provided by the Ministry of Education, Culture, Sport, Science and Technology to Chiba University Graduate School of Medicine. Declaration of Interests: The authors declare no conflict of interests regarding this study. Ethics Approval Statement: This study protocol was approved by the Ethics Committee of Chiba University Graduate School of Medicine and the Ethics Committee of the International University of Health and Welfare before implementation. Participants were informed that their participation was voluntary.