Presentation of results

Summary of the survey from 14 October - 16 November 2020

Abstract: Survey of population preferences for the trade-off between health, economy, individual fundamental rights and social/cultural life in the control of the Sars-CoV-2 pandemic. Population-representative survey conducted by the University of Applied Sciences Neubrandenburg with more than 3000 participants on non-pharmaceutical measures to protect the population and avoid overburdening the health care system. The period of the survey was 10/14 – 11/16/2020. Population representativeness was quota based on age, gender, state, and education. Key findings of the study:

  • Acceptance of short-term measures to restrict contact, but disapproval of school and kindergarten closures lasting several weeks and strict curfews.
  • Individual income of great importance. Individual risk of infection is important, although specific information on excess mortality is not understood.
  • Decline in gross domestic product plays a secondary role in individual assessment of measures.
  • 1/3 of the population calls for restrictive measures (motto “safety first”). Almost 2/3 of the population is mainly concerned with the decline in individual income (motto “Please no individual losses”). A small proportion of the population does not like the measures, but is prepared to accept individual losses (motto “Don’t like measures, but accept losses”).

Problem of decision makers: The outbreak of SARS-CoV-2 (coronavirus) poses challenges for political decision makers. Despite lack of knowledge/uncertainty about the effect of measures, politicians are forced to make far-reaching decisions that sometimes mean major cuts in the health and economic as well as social life of the population. Acceptance depends strongly on whether the preferences of the affected population groups are taken into account in the decisions.

Objective of the representative survey: This empirical study uses a representative sample to examine the extent to which citizens support non-pharmaceutical measures to control the Sars-CoV-2 pandemic. This study informs the extent to which the population accepts health, economic, and social consequences.

Method of population preference study: Preferences were elicited using a discrete choice experiment (DCE). The online survey was recruited in cooperation with the market research company Dynata. Participants were asked to make choice decisions about non-pharmaceutical interventions and their consequences. In repeated decision situations, participants were asked to select the alternatives that represented the most beneficial situation from their individual perspective. Participants then assessed the duration of contact and exit restriction measures and facility closures. Finally, participants were asked about personal attitudes and experiences related to the coronavirus pandemic.

The initial results of the population preference study: The results of the aggregate panel data analysis show that negative effects on individual income have the greatest impact on acceptability. A small decrease in income seems to be accepted by a portion of the respondents for the control measures. Excess mortality plays an important role, but we were able to demonstrate that the majority do not understand the scale dimensions (a test showed that respondents are not able to respond to scale differences). This is also true for the understanding of the gross domestic product (GDP) scales. We conclude that the population is overwhelmed with the abstract measures of excess mortality and GDP.

Significantly important are measures of contact restrictions and closures of institutions such as kindergartens and schools. No closures are preferred by the majority of respondents. Regarding measures of exit restrictions, a strict curfew is rejected, while wearing a mouth-nose protection is favored. Regarding data transmission, the population is split between disapproval and support, but no transmission of data on health, encounters or location is preferred by a large proportion.

Regarding the time period of restrictive measures, it appears that the population would accept a 2- to 4-week contact restriction rather than curfews or closure of facilities. In contrast, a 12-week closure of schools and kindergartens and a 12-week curfew are clearly rejected.

Measures on exit restrictions are seen as promising by 51% of the participants, mouth and nose protection by 74%, measures on contact restrictions by 63%, closure of facilities by 37% and transmission and evaluation of personal data by 34%. Facility closures are perceived as least promising by 27% and transmission and evaluation of personal data by 31% of the participants.

Contact restrictions (38%), masking requirements (31%), travel restrictions (30%), and exit restrictions (21%) were perceived as severe restrictions in the past 6 months. 29% did not feel restricted by any of the measures in the last 6 months. When asked for whom the coronavirus posed a threat, 83% mentioned the elderly, 72% the economic situation of the country, 64% the health care system, and 61% their own family members. The participants’ own person was mentioned by 56%.

There were 2% of participants who reported having tested positive for coronavirus. Of the participants who tested positive, 56% were not ill and 10% were ill with severe symptoms. There were 20% with mild symptoms and 14% with no symptoms. Overall, 73% reported not knowing anyone in the immediate area who was ill with coronavirus or who had died.

With the crisis management of the federal government in the current coronavirus crisis 15% of the participants were very satisfied and 36% rather satisfied. Rather dissatisfied or very dissatisfied were 22%. Just less than half of the participants (49%) believe that it will take longer than 12 months to bring the coronavirus under control.

In-depth analysis of different population groups: Not surprisingly, a large preference heterogeneity was found in the sample. The figures below show three different population clusters (Table 1 in yellow, green & blue). It can be seen that all population clusters are largely agreed upon in their assessment of individual income. For participants in Cluster 1, the effect appears to be more significant than for the other clusters (Cluster 1 motto “Please no individual losses in financial terms.”) For the measures exit restrictions, data transmission, and mandatory masks, the divergence in acceptability is apparent. The effects for cluster 3 (motto cluster 3 “Safety first”) are in part diametrically different from the effects of the other clusters. Contrary to clusters 1 and 2, individuals in cluster 3 rate the absence of exit restrictions and the lack of transmission of data as negative. Cluster 2 (motto cluster 2 “Don’t like measures, but accept losses”) does not favor mandatory masks, but is indifferent to mandatory masks inside buildings and on public transportation ( whereas) clusters 1 and 3 tend to favor mandatory masks. Short-term behavior-restricting measures are accepted by a majority. In contrast, closing kindergartens and schools for several weeks or imposing a strict curfew is clearly rejected.

Discussion of the results: Policymakers are challenged (and often overwhelmed) to make decisions with incomplete information. Weighing the pros and cons of measures places an enormous burden on decision-makers. The question is which liberties should be temporarily restricted and which risks can be taken. It would be useful for decision makers to be informed about population preferences. This study will help to systematically document the preferences of the population. Taking these preferences into account in decision-making can improve the acceptance of comprehensive measures that restrict everyday professional and social life and facilitate their implementation. Preference heterogeneity should also be taken into account.

Coefficients for decrease in individual income in the latent class analysis
Coefficients for transmission of personal data in the latent class analysis
Coefficients for curfews in the latent class analysis
Coefficients for mandatory masks in the latent class analysis

Table 1: Effects in the regression model classified into clusters (excerpt)

Presentation of results of the pre-study | Last updated: August 24th, 2020 (N=260)

Here, some of the results of the preliminary study are presented. These include socio-demographic data on the participants, statistical analyses and interpretations. Among other things, the preliminary study was used to gain a first impression of the population’s preferences regarding measures and consequences of the corona pandemic and to adapt and further develop the questionnaire accordingly.

Socio-demographic data of respondents

N= 260 respondents took part in the survey of the preliminary study. Inclusion criteria for participation were a minimum age of 18 years and good to very good German language skills. This is not a representative sample. The majority of participants are students who were easier and faster to recruit for this study (convenience sample).

Table 1 summarizes the sociodemographic data of the participants included in the analysis. The participants have an average age of 32 years (Min: 18 years; Max: 74 years; Median: 26 years). The most frequent value in the sample is 22 years (modal value). The largest part of the sample consists of women (65%). Men are represented with a share of 33.8%. Regarding marital status, 36.5% of the participants are single and 35.4% are in a stable relationship but not married. A slightly smaller part of the participants (22.7%) is married or in a registered partnership. 3.1% are divorced or separated.  Most participants in the survey are students with 47.7% and full-time employees with 20.4%. Of the remaining participants, 11.2% are part-time employees, 6.1% are self-employed and 2.4% are retired. With regard to the highest educational level, the majority of the participants (40%) graduated from a college or university, and 35.4% (35.4%) have a high school diploma or comparable qualification. 10.8% have a vocational school diploma or the advanced technical college entrance qualification, 6.9% have a diploma from a technical college or vocational school and 5% have a secondary school diploma. The monthly net income is 63.3% of the participants under 2000 € and 24.3% over 2000 €. The remaining participants (12.3%) did not provide any information regarding their monthly net income. More than half of the participants (56.9%) come from Mecklenburg-Vorpommern.

Characteristics of participants

SD= standard deviation
Note: Due to missing data, the sum of the percentages in individual categories does not add up to 100.

Table 1: Socio-demographic data

Preference weights for characteristics of pandemic measures

The preference data were estimated by means of logistic regression (conditional logit model). Figure 1 shows coefficients for each level of a property (attribute) in the 95% confidence interval. The coefficients represent the relative importance for each level within an attribute. A positive coefficient means a positive preference for that level. The larger the coefficient, the greater the preference for that level within an attribute. Conversely, a negative coefficient indicates a negative preference for that level. Positive coefficients indicate an increased influence on the choice decision, negative coefficients a reduced influence on the choice decision. The vertical distances (or differences) between the levels within an attribute indicate the preference weight for a change from one level to another. If two considered levels are close together, the change from one level to the other is of little importance. If the levels are far apart, the change is of great importance. For example, for the attribute exit restrictions, the first two levels (1 month state border and 1 month states and state borders) are approximately at the same level. There is no measurable significant distance between the two levels. However, the distance to the third level 1 month curfew is clearly visible. This means that the participants accept a 1-month closing of the state border and a 1-month closing of the federal states and state borders to the same extent. A 1-month strict curfew, however, is rejected. The difference between the first and last level of an attribute shows the importance of this attribute compared to the other attributes. For example, the level difference for the attribute individual risk of infection (1.7 units) is greater than the level difference for the attribute decline of GDP (1.1 units). Thus, for the participants, the risk of infection was more important in their choice than the decline of GDP.

Regression analysis

Figure 1: Coefficients of the most important attributes in the regression model in the 95% confidence interval (extract)

The level coefficients of the remaining attributes contact restrictions, closure of facilities and personal data are close to zero with some overlapping standard errors. Therefore only a trend can be reported here. As an example, the level coefficients of the attribute facility closure are shown in Figure 2. The coefficients for the closure of 1 – 3 months have a positive sign with slightly decreasing preference. This can be interpreted in such a way that a closure of up to 3 months during a pandemic seems acceptable. But the longer the closures last, the lower the preference. A threshold value for the acceptance of closures seems to be between 3 and 4 months. From 4 months on, the signs of the coefficients are negative, indicating a negative preference.

 

Coefficients of Closure of facilities

Figure 2: Level coefficients of the attribute Closure of facilities

Relative Attribute Importance

The graph shows the relative importance of the different attributes of the choice scenarios. The relative importance shows how much a attribute contributes to the overall assessment of a scenario. The greater the importance of an attribute, the greater the influence of the attribute on the participants’ choice. The importance was normalized on a scale of 10. The attribute excess mortality takes first place in the ranking of attribute importance. It is closely followed by the decline of individual income in second place. The risk of infection is ranked 3rd and exit restrictions 4th.

Relative attribute importance

Figure 2: Relative importance of all attributes

Latent class analysis for modeling preference heterogeneity

The pandemic affects the entire population. It can be assumed that there are a large number of groups in the population with different preferences regarding coping with and accepting the consequences of a pandemic. The groups (or classes) may be a cluster of people with different experiences, preferences, characteristics, behavioral patterns or even political attitudes. With the help of latent class analysis, the respondents were divided into different classes according to their choices. Two classes with different preferences could be identified. The following figure 4 compares the relative importance of the attributes for the two classes. In the case of class 1, excess mortality had the greatest impact on the choice decisions. In contrast, the risk of infection was the most important decision criterion for the participants assigned to class 2. Common to both classes is that the decline of individual income had the second largest impact on the choice decisions.

Relative attribute importance in the latent class model

Figure 4: Relative attribute importance in class comparison

Table 2 shows the socio-demographic data of participants in both classes. Class 1 with N= 149 participants is larger than class 2 with N= 111. Both classes show a similar age structure. Class 1 has an average age of 31 years (Min: 18; Max: 72; Median: 25; Modal: 21). Class 2 has an average age of 33 years (Min: 19, Max: 74; Median: 28; Modal: 22). In both classes there are more women (Class 1: 65.8%; Class 2: 64%) than men (Class 1: 33.6%; Class 2: 34.2%). Regarding marital status, there are about the same number of unmarried participants in both classes (Class 1: 36.2%; Class 2: 36.9%).  In class 1, 36.9% and in class 2, 33.3% are in a fixed relationship. Both classes consist mainly of students (Class 1: 49.2%; Class 2: 45.7%). Full-time employed are 22% in Class 1 and 18.1% in Class 2. 13% more people in Class 2 are part-time employees than in Class 1 (9.9%) and slightly more self-employed (6.5%) than in Class 1 (5.8%). The proportion of retired participants is low in both classes. With regard to the highest educational level, there are more participants with a college or university degree in Class 1 (Class 1: 46.3%; Class 2: 31.5%) and with a high school diploma or comparable qualification (Class 1: 38.3%; Class 2: 31.5%). In class 2, more participants have acquired a vocational school diploma or an advanced technical college entrance qualification (class 1: 8.1%; class 2: 14.4%). 4.7% of the participants in class 1 and 9.9% in class 2 have a technical college or vocational college diploma. The share of secondary school qualifications is lower in class 1 (2%) than in class 2 (9%). The monthly net income is 48.3% of the participants in class 1 and 42.3% in class 2 under 1000€.  In class 1 22.9% of the participants have a net income between 1000€ and 3000€ per month and in class 2 34.2% of the participants have a net income between 1000€ and 3000€ per month. The percentage of participants with a monthly income of more than 3000 € is higher in class 1 with 17.5% than in class 2 with 9.9%. In both classes more than half of the participants come from Mecklenburg-Vorpommern (Class 1: 51.7%, Class 2: 64%). In class 1 there are more participants from the South (class 1: 13.8%; class 2: 5.4%) and West (class 1: 10.7%; class 2: 7.2%) of Germany.

Characteristics of participants in latent classes

Table 2: Sociodemographic data of the classes

In the survey, participants were also asked to assess and evaluate measures and key figures of the coronavirus pandemic. Below is a comparative overview of the different views of the participants of both classes.

Class 1

  • Greater fear that family members or relatives will be infected.
  • More or less satisfied with the crisis management of the federal government in the current coronavirus crisis.
  • Larger part of the respondents estimate that it will take up to 12 months to get the coronavirus under control.
  • The excess mortality is estimated to be higher (mostly 10%) by the subjects in class 1 than by subjects in class 2.
  • The collapse of GDP for 2020 is mostly estimated at 8%.
  • A majority (48.3%) considers the measures of exit restriction, closure of facilities (43%) and transfer of personal data on (32.9%) to be promising.
  • The coronavirus is considered to be more dangerous for the participants themselves, family members, the economic situation of a country and for the health care system.
  • Larger proportion of positively tested persons among acquaintances and friends.
  • The class contains more people who do not belong to a risk group.

Class 2

  • A larger proportion of participants estimate that it will take 12 months or more before the coronavirus is brought under control.
  • The excess mortality is mostly estimated to be below 5%.
  • The transmission of personal data is considered rather unpromising (18.9%).
  • The coronavirus is considered to be more dangerous for the own financial situation, the basic civil rights and data protection.

First results

Overall, excess mortality is more important than the individual risk of infection. It can therefore be concluded that the health of the general public or the prevention of general mortality is given higher priority among study participants than their own individual risk of infection. This corresponds to the assumption that during the pandemic most people remained at home in self-imposed quarantine to protect not primarily themselves but others, e.g. people with pre-existing conditions and other risk groups. Individual responsibility for the health of others is more important than the risk of infection. In contrast, the focus is on reducing individual income rather than preventing a decline in the country’s overall economic performance (GDP). Data protection, contact restrictions and the closure of facilities take a back seat to expected economic and health losses. However, a strict curfew is more likely to be rejected than the closure of state borders or the closure of federal states and national borders.

In the extended analysis, however, differences between individual classes become clear. While one class is more concerned about excess mortality, the other class is more concerned about the individual risk of infection and its consequences. The difference in preferences is also clear when it comes to the critical issue of personal data.

The results of the study could help decision-makers in government and the health care system to make difficult decisions about the measures to be taken and the consequences of a pandemic in the interest of the population and also of population groups.

When analyzing and interpreting the results, it should be noted that the total number of study participants is not a sample representative of the population.