Awareness of Coronavirus Disease 2019 Pandemic among Adult Population of Tamil Nadu - A Cross-sectional Study - Annals of Community Health
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ORIGINAL ARTICLE
Awareness of Coronavirus Disease 2019 Pandemic among Adult Population
of Tamil Nadu – A Cross-sectional Study
R. Rajkamal1, S. Jayakiruthiga2, E. Muthurajesh3, H. Swetha1, K. Swetha1
Department of Community Medicine, ACS Medical College and Hospital, Chennai, Tamil Nadu, India, 2Department of Community
1
Medicine, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India, 3Department of Community Medicine, Madurai Medical
College and Hospital, Madurai, Tamil Nadu, India
ABSTRACT
Background: Coronaviruses (CoVs) infections are emerging respiratory viruses and known to cause illness ranging from the
common cold to severe acute respiratory syndrome. Knowledge on awareness of the current pandemic and effective preventive
measures is needed to prevent community spread. Objectives: The objectives of the study were to assess the awareness of
CoV disease 2019 (COVID-19) pandemic among the adult population in Tamil Nadu (TN). Materials and Methods: A cross-
sectional study was carried out among the adult population in TN in April 2020. A pre-designed questionnaire was used as
a study stool circulated through Google forms and data were analyzed by Statistical Package for the Social Science 21.0
version. Results: In our study, we found that 95.5% (95% confidence interval 94.3–96.7%) of the study population were
aware of the COVID-19 pandemic, 65.3% said COVID-19 is transmitted by droplet infection, 61.3% knows that proper
handwashing should be done for a minimum 20 s, and 96.3% of them aware that alcohol-based sanitizer is effective against
COVID-19, 94.9% supported the extension of the lockdown period. Conclusion: Our study has described that the majority of
the population are aware of the current pandemic of COVID-19 and are effectively following the preventive measures, which
has prevented community spread of the infection and thereby entering Stage 3 of the pandemic.
Key words: Coronavirus disease 2019, cross-sectional, pandemic, World Health Organization
INTRODUCTION (WHO) declared COVID-19 as a public health emergency of
C
international concern.[6]
oronaviruses (CoV) infections are emerging
respiratory viruses and known to cause illness ranging Amidst the increasing deaths in China, the first death outside
from the common cold to severe acute respiratory China was (of a Chinese man from Wuhan) reported in the
syndrome (SARS).[1] CoV is zoonotic pathogens that can Philippines on 02 February. On 11 February, WHO announced
be transmitted through animal-to-human and human-to- a name for the new CoV disease: COVID-19[7] and declared
human.[2] CoV, so named due to the outer fringe of envelope CoV disease as a pandemic on March 11, 2020.[8] The virus
proteins resembling crown (“corona” in Latin), are a family that causes COVID-19 was initially called as 2019-nCoV
of enveloped RNA viruses.[3] and was then termed as syndrome CoV 2 (SARS-CoV-2)
by the International Committee on Taxonomy of Viruses.[9]
Multiple epidemic outbreaks occurred during 2002 (SARS) It is a new strain discovered in 2019 which was not found
previously in humans. The highly contagious SARS-CoV-2
with ~800 deaths and 2012 (Middle East Respiratory virus is an additional hazard for the health-care system
Syndrome-Coronaviruses: MERS-CoV) with 860 apart from the burden of extended work hours, physical and
deaths.[2,4] Approximately 8 years after the MERS-CoV psychological stress, burnout, and fatigue.[10]
epidemic, the current outbreak of novel CoV (CoV disease
WHO reported that more than 80% of COVID-19 patients
2019 [COVID-19]) in Wuhan City, Hubei Province of China,
showed mild symptoms and recovered without any medical
has emerged as a global outbreak and significant public health intervention, approximately 20% of infected cases had a
issue.[5] On January 30, 2020, the World Health Organization severe illness such as shortness of breath, septic shock, and
Correspondence: Dr. S. Jayakiruthiga, Department of Community Medicine, Sree Balaji Medical College and Hospital, Chrompet,
Chennai - 600 044. Phone: +91-9444464140. E-mail: jaikeerthi07@gmail.com
Annals of Community Health • Apr-Jun 2020 • Vol 8 • Issue 2 46Rajkamal, et al.: Awareness about COVID19 in Tamil Nadu
multi-organ failure, and it has been reported that an estimated they filled up the questionnaire. All adult population above
2% of cases can be fatal.[11] 18 years who were willing to fill the online Google form, able
to understand English and willing to give informed consent
The state of lockdown in many parts of the world, which are were included in the study. The sample size was calculated,
contributing largely to the global economy, has led to the halting assuming that 50% of the adult population had awareness
of services and products. This has led to a break in the global regarding COVID-19 infection and 6% of relative precision.
supply chains and thus, affected the global economy brutally.[12] Calculated sample size was 1111, which were rounded of
At present, no antiviral medication or vaccine is available for to 1200. Data were entered in MS Excel and analyzed by
2019-nCoV infection and infected patients are managed with Statistical Package for the Social Science 21.0 version.
supportive care.[13] India braces for the COVID-19 pandemic.
Descriptive statistics such as proportions were calculated and
95% confidence interval (CI) was calculated appropriately.
In India, the first case of COVID-19 was reported on January
30, 2020, originating from China. After 2 months, this disease
spread in almost all parts of the country.[14] As COVID-19 is a Ethical Considerations
new disease and is having the most devastating effects globally,
Informed consent has been obtained from all participants
its emergence and spread, cause confusion, anxiety, and fear
before they started filling online forms. The very first question
among the general public. Fear is the breeding ground for hatred
and stigma. Social stigma has arisen as certain populations is about giving consent to the study and we had explained
(Indian North-East people) are targeted as being the reason that they were free to take decision whether to participate are
for this outbreak.[8] Considering the relevance of all the above not in the study.
factors, this study was aimed to evaluate the awareness of
COVID-19 among the adult population in Tamil Nadu (TN). RESULTS
MATERIALS AND METHODS A total of 1200 persons were interviewed for the study; among
them, 43.6% (524) belonged to the age group of 18–30 years,
This cross-sectional study was conducted from April 01, 2020
to April 07, 2020, the week immediately after lockdown. Since
Table 1: Sociodemographic characteristics of the study
it was not feasible to do the community-based survey during
respondents (n=1200)
this special period, we decided to collect the data through
online. An online questionnaire was created using Google Characteristics Frequency (%)
forms with a consent form appended to it. The questionnaire Age group
was designed in English and it consists of two parts. In the first 18–30 524 (43.6)
part, we asked about sociodemographic characteristics and in 31–40 256 (21.3)
the second part, questions about awareness of COVID-19, 41–50 248 (20.6)
symptoms, mode of transmission, and practice regarding 51–60 107 (9.0)
COVID-19 infection. These questions were prepared based Above 60 65 (5.5)
on the awareness posters and advertisements released by
Sex
Government of India. The link of the questionnaire was
Male 562 (46.8)
sent through WhatsApp, email to the contact persons of
Female 638 (53.2)
the investigators and on receiving and clicking the link, the
participants got auto directed to the information about the Residence
study and informed consent. After accepting to take the survey, Urban 921 (76.7)
Rural 279 (23.3)
Education
54 Illiterate 16 (1.3)
5.5%
Primary 21 (1.7)
Middle 24 (2.0)
YES
High school 39 (3.2)
1146 Higher secondary 58 (4.9)
NO
95.5% Undergraduate 780 (65.0)
Postgraduate 262 (21.9)
Occupation
Employed 523 (43.6)
Unemployed 677 (56.4
Figure 1: Awareness of coronavirus disease-19 (n=1200)
47 Annals of Community Health • Apr-Jun 2020 • Vol 8 • Issue 2Rajkamal, et al.: Awareness about COVID19 in Tamil Nadu
562 (46.8%) were male subjects and 638 (53.2%) were female Table 3: Awareness of prevention of COVID-19 infection
subjects. About 76.8% (921) of the study participants were (n=1200)
residing in the urban area, maximum study participants were
Characteristics Frequency 95% CI
undergraduates 780 (65.0%), and majority of the participants
(%)
were unemployed 56.4% (677) [Table 1].
Best method to prevent COVID-19 (multiple responses)
Most of the study population, i.e., 95.5% (95% CI: 94.3– Handwashing 21 (1.8)
96.7), were aware of COVID-19, 58.3% said that fever, cough, Wearing face mask 13 (1.1)
breathlessness, loss of smell, and taste are the symptoms of Social distancing 40 (3.3)
COVID-19. Regarding spread of COVID-19, 65.3% told that Using hand sanitizer 6 (0.5)
COVID-19 spreads by droplet infection, 17.3% by airborne All of the above 1144 (95.3) 94.1–96.5
[Table 2]. Are you following social distancing
Yes 1190 (99.2) 98.7–99.7
Regarding awareness of prevention of COVID-19 infection,
No 10 (0.8)
1144 (95.3%) of study respondents said that handwashing,
Social distancing means
wearing face mask, social distancing, and using hand
sanitizer are the best methods to prevent COVID-19. About Staying 6 feet away from people 771 (64.2) 61.5–67.0
99.2% (1190) of the study population are following social Staying 2 feet away from people 414 (34.5)
distancing. Many of the study population 64.3% (771) told Attend mass gatherings 8 (0.7)
that social distancing means staying six feet away from Carrying routine travel without 7 (0.6)
people, 61.3% (736) revealed that handwashing should be restrictions
done for minimum 20 s, and most of the respondents 96.3% Handwashing should be done for
(1156) said that alcohol-based sanitizer is effective against Minimum 30 s 232 (19.3)
COVID-19. One min 232 (19.3)
Minimum 20 s 736 (61.4) 58.6–64.1
Only 2 (2.2%) are not following any precautions in view of the
Type of sanitizer effective for COVID19
COVID-19 situation. Most of the participants, 87.4% (1049),
Alcohol-free 44 (3.7)
told that elderly people are most likely to die in COVID-19. A
maximum of the study participants, 97.5% (1170), said that a Alcohol-based 1156 (96.3) 95.3–97.4
lockdown of 21 days is necessary. 94.3% (1134) told that they Precautions taken (multiple responses)
visit the hospital as soon as possible if their family members Staying at home 135 (11.3)
develop any symptoms. Most of the 93.3% (1120) revealed Social distancing 50 (40.2)
that there is no history of travel to any state or country affected Handwashing 39 (3.3)
Wearing mask while going out 08 (0.7)
Table 2: Awareness of mode of transmission and All of above 1047 (87.3) 85.4–89.1
symptoms (n=1200) Not following any restrictions 02 (2.2)
Characteristics Frequency (%) 95% CI Age group most likely to die from COVID19
Are you aware of COVID-19 Children 24 (2.0)
Yes 1146 (95.5) 94.3–96.7 Adolescents 29 (2.4) 85.5–89.3
No 54 (4.5) Adults 98 (8.2)
Symptoms of COVID-19 Elderly 1049 (87.4)
Fever 319 (26.6) 55.5–61.0 Lockdown for 21 days is necessary
Cough 338 (28.2) Yes 1170 (97.5) 96.6–98.4
Breathlessness 349 (29.1) No 30 (2.5)
Loss of smell 4 (0.3) What step you will take when family members develop symptoms
All of above 699(58.3) Visit hospital as soon as possible 1134 (94.5)
None of above 103(8.6) Self-medications 18 (1.5) 93.2–95.8
Mode of transmission for COVID19 Wait for symptoms to worsen 21 (1.8)
Droplet 784 (65.3) 62.6–68.0 Do nothing 27 (2.2)
Feco-oral 194 (16.2) Travel history to any state or country affected by COVID-19
Airborne 208 (17.3) Yes 80 (6.7) 91.9–94.7
Waterborne 14 (1.2) No 1120 (93.3)
COVID-19: Coronavirus disease 2019, CI: confidence interval (Contd...)
Annals of Community Health • Apr-Jun 2020 • Vol 8 • Issue 2 48Rajkamal, et al.: Awareness about COVID19 in Tamil Nadu
Table 3: (Continued) the symptoms of COVID-19. This is due to the constant update
on the pandemic through various communication media.
Characteristics Frequency 95% CI
(%)
In our study, 65.3% said COVID-19 is transmitted by
Period of quarantine for COVID19
droplet infection. Extensive campaigns are carried out across
14 days 734 (61.1) 58.4–63.9
the state, but only 65% is aware of the mode of spread of
28 days 355 (29.6) COVID-19. All the participants in the study are internet users
30 days 111 (9.3) and hence educational status is higher but still around 35%
Daily source of information regarding COVID19 (multiple responses) not aware of the correct mode of transmission.
Television 1014 (84.5) 82.5–86.5
Newspaper 271 (22.6) In our study, 61.3% knows that proper handwashing should
Magazines 51 (4.3) be done for a minimum 20 s and 96.3% of them aware that
alcohol-based sanitizer is effective against COVID-19. This
Radio 56 (4.7)
indicates that the increasing concern of participants toward
Others 304 (25.3)
personal hygienic measures to avoid COVID-19.
Do you think lockdown period needs to be extended
Yes 1139 (94.9) 93.7–96.2 In our study, 97.5% supports the lockdown of 21 days in
No 61 (5.1) view of no direct contact of public and 94.5% assured that
DO you agree that COVID-19 will be successfully controlled in TN they will visit the hospital as soon as possible if their family
Yes 1106 (92.1) members develop any symptoms due to their knowledge
No 94 (7.9) 90.6–93.7 about the intensity of the COVID-19 infection.
Do you have confidence that India can win the battle against COVID-19
virus In our study, 84.5% of the study participants said that television
Yes 1162 (96.8) is the primary source of information about COVID-19 as it is
the mass media communication which is accessible to more
No 38 (3.2) 95.8–97.8
than half of the population and majority (94.9%) supported
COVID-19: Coronavirus disease 2019, CI: confidence interval
the extension of the lockdown period due to the graveness of
by COVID-19, the majority 61.2% (734) said that the period the disease.
of quarantine is 14 days. Maximum of the study participants
1014(84.5) told that television is the source of information Limitations
regarding COVID-19 and a majority 94.9% (1139) of study
The study is limited to people who had smartphones, email
respondents supported the extension of the lockdown period.
Ids, and ability to understand English, so it should not be
About 92.1% (1106) told that COVID-19 will be successfully
generalized to the whole population.
controlled in TN and majority 96.8% (1162) have confidence
that India can win the battle against COVID-19 virus [Table 3].
CONCLUSION
DISCUSSION
The COVID-19 pandemic threat continues to emerge
significantly amidst the preventive measures that are being
Epidemics and pandemics are a periodic phenomenon. The
followed. Our study has described that the majority of the
public will face several challenges during these periods and
population are aware of the current pandemic of COVID-19
lack of awareness often leads to an unconcerned attitude,
and are effectively following the preventive measures which
which may adversely affect the preparedness to meet
has prevented community spread of the infection and thereby
the challenges. This study was conducted among 1200
entering Stage 3 of pandemic.
participants in TN which depicts the status of awareness
of COVID-19 among the study participants with varied
outcomes that are discussed below. ACKNOWLEDGMENTS
In our study, we found that 95.5% of the study population is We thank all the participants, undergraduates, and other
aware of COVID-19 pandemic with a 95% CI: 94.3–96.7%. faculty members, for their guidance and support in conducting
It was possibly due to the preventive measures taken by both this study.
Central and State governments, such as complete lockdown,
awareness programs, active participants of Health departments, REFERENCES
and media emphasizing more on preventive measures.In our
study, 58.3% of the study participants said all of the above 1. Yin Y, Wunderink RG. MERS, SARS and other coronaviruses
(fever, cough, breathlessness, and loss of smell and taste) as as causes of pneumonia. Respirology 2018;23:130-7.
49 Annals of Community Health • Apr-Jun 2020 • Vol 8 • Issue 2Rajkamal, et al.: Awareness about COVID19 in Tamil Nadu
2. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early www.who.int/dg/speeches/detail/who-directorgeneral-s-
transmission dynamics in Wuhan, China, of novel coronavirus- opening-remarks-at-the-media-briefing-on-covid-19---11.
infected pneumonia. N Engl J Med 2020;382:1199-207. [Last accessed on 2020 Mar 19].
3. Burrell CJ, Howard CR, Murphy FA. Coronaviruses. In: 9. Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R.
Burrell CJ, Howard CR, Murphy FA, editors. 5th ed., Ch. 31. Features, Evaluation and Treatment Coronavirus (COVID-19).
Fenner and White’s Medical Virology. London: Academic Treasure Island, FL: Stat Pearls Publishing; 2020.
Press; 2017. p. 437-46. 10. Langade D, Modi PD, Sidhwa YF, Hishikar NA, Gharpure AS,
4. Bhagavathula AS, Shehab A. The story of mysterious Wankhade K, et al. Burnout syndrome among medical
pneumonia and the response to deadly novel Coronavirus practitioners across India: A questionnaire-based survey.
(2019-nCoV): So far! Emirates Med J 2020;1:7-10. Cureus 2016;8:e771.
5. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute 11. WHO. WHO Director-General’s Opening Remarks at the
respiratory syndrome coronavirus 2 (SARS-CoV-2) and Mission Briefing on COVID-19; 2020. Available from: https://
Coronavirus disease-2019 (COVID-19): The epidemic and the www.who.int/dg/speeches/detail/who-director-general-s-
challenges. Int J Antimicrob Agents 2020;55:105924. opening-remarks-at-the-mission-briefing-on-covid-19. [Last
6. Eurosurveillance Editorial Team. Note from the editors: World accessed on 2020 Mar 01].
Health Organization declares novel coronavirus (2019-nCoV) 12. Ebrahim SH, Ahmed QA, Gozzer E, Schlagenhauf P,
sixth public health emergency of international concern. Euro Memish ZA. Covid-19 and community mitigation strategies in
Surveill 2020;25:200131e. a pandemic. BMJ 2020;368:m1066.
7. WHO. Rolling Updates on Coronavirus Disease (COVID-19); 13. Center of Disease Control (CDC). Novel Coronavirus
2020c. Available from: https://www.who.int/emergencies/ (2019-nCoV); 2019. Available from: https://www.cdc.gov/
diseases/novel-coronavirus-2019/events-as-they-happen. [Last coronavirus/2019-ncov/about/index.html. [Last accessed on
accessed on 2020 Mar 31]. 2020 Feb 01].
8. WHO. Director-General’s Opening Remarks at the Media 14. Available from: https://www.who.int/emergencies/diseases/
Briefing on COVID-19; 2020. Available from: https:// novel-coronavirus-2019. [Last accessed on 2020 Mar 30].
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