The World Health Organization recently declared South America the new center of the coronavirus pandemic as cases continue to rise dramatically in Brazil and other countries in the region. Several of these countries were also affected by the 2015-2016 Zika outbreak, and we were curious to see how contributors were handling the current health crisis, and if dealing with a previous disease outbreak made these populations feel better prepared when COVID-19 hit. In late May, Premise Data surveyed more than 2,300 people in Brazil, Colombia and Venezuela, asking them about their experiences with both Zika and COVID-19.
Of the 80% of respondents who were aware of the Zika outbreak, about 85% were more concerned about COVID-19 than they were about Zika. The primary risk of Zika is to pregnant women as infection during pregnancy can lead to serious birth defects and other associated problems. Since the primary at-risk population was smaller for Zika than it is currently for COVID-19, that may be why the overwhelming majority of respondents indicate COVID-19 as the more prevalent concern. 60% of respondents were neutral or disagreed with the statement “ ‘I believe my country is better prepared to deal with COVID-19 because of what was learned from the Zika outbreak’. COVID-19 is on a much larger scale than Zika is disrupting more aspects of people’s daily lives and livelihoods so it stands to reason in this case that respondents did not feel that Zika prepared them to deal with the Coronavirus on a national level. Overall, 61% of contributors indicated that they had enough information about Zika to protect themselves and their families but the main sources of information varied by country with newspapers in Brazil, local and national TV in Colombia, and internet and social media in Venezuela.
One similarity that can be seen with the current COVID-19 pandemic and Zika is the spread of fake news. During the Zika outbreak, widespread misinformation was extremely problematic to executing an effective public health response as there were several instances of false information spreading on Whatsapp, Facebook and other social media/internet platforms. While only 13% of respondents were sure they were exposed to false information concerning Zika, 50% of respondents answered ‘I don’t know’ meaning it is possible they had encountered it. Examples of false information that people had come across included how it was transmitted, how to cure it, and the effects of the disease; the major source of this misinformation was reported to be from the internet and social media.
Fortunately, 58% of respondents across all three countries said that they were more likely to listen to both their local and national health authorities now after experiencing the Zika epidemic. It is notable that there was a 20 percentage point difference between Brazilian respondents (68%) and Venezuelan respondents (48%). People’s trust in these institutions is key, especially in settings with limited resources and health care capacity when prevention and behavioral interventions are essential to stopping the spread of a disease before it overwhelms the health system. Proper messaging and efforts to combat and misinformation are some of the most effective tools available to scale a response nationally.
In addition to learning more about the impacts of the Zika outbreak as compared to COVID-19, we also asked respondents about their current experiences with the coronavirus pandemic. Uniformly 84% of respondents state that they are either ‘Concerned’ of ‘Very Concerned’ about the spread of coronavirus in their communities. There seems to be much more awareness about misinformation regarding COVID-19 as compared to Zika with as much as 40% of Brazilian respondents and 31% of overall respondents claiming that they had come across false information regarding the disease.
The main source of this misinformation was again social media and internet sources which presents a major challenge for health authorities since unverified or false information disseminated in this manner can reach a large portion of the population quickly.
Overall, there seems to be major concern about adequate access to healthcare should one contract COVID-19 with 79% of respondents claiming that they were ‘Concerned’ of ‘Very Concerned’ about this issue. Additionally, an average of 64% of respondents were concerned about the availability of testing for the disease and 75% of respondents were worried about the lack of protective equipment (PPE) for healthcare workers.
Although we found that a majority of people would be more likely to listen to healthcare providers after the Zika outbreak, there still seems to be major challenges with perceived trustworthiness of local healthcare providers—an average of 35% of contributors responded that they thought their local health workers were either ‘Trustworthy’ or ‘Very Trustworthy.’ This question did show some noticeable difference across countries, with 40% of Brazilian contributors responding affirmatively compared to only 25% of Venezuelan. Venezuela is going through a major humanitarian crisis that is having far-reaching consequences for its entire healthcare system which is likely to impact respondents’ answers on this front.
Unfortunately, there is also low confidence in the information and messaging from the national ministries of health and the Pan-American Health Organization (PAHO) with about 21% of respondents overall stating that they were either ‘Extremely Confident’ or ‘Very Confident’ in these communications. This may prove challenging for combating false information and promoting correct preventative measures. About 35% of respondents also attributed a moderate to high amount of confidence in their local leadership to deal with COVID-19. On this particular question, there was again a striking difference between responses from Venezuela and those from Brazil, with 44% of Brazilians falling into the ‘Trustworthy’ or ‘Very Trustworthy’ category compared to 22% of Venezuelans. Interestingly, this changes significantly compared to opinions on national leadership. Colombia seems to have the highest amount of satisfaction with its national leadership with 48% of contributors responding as ‘Very Satisfied’ or ‘Satisfied’ with their handling of coronavirus. Conversely, Brazil had the lowest of all three countries with 33% of respondents signaling their satisfaction with country leadership. President Jair Bolsonaro of Brazil has repeatedly downplayed the danger of the virus and the need for social distancing while the local governors have stepped in and taken a larger role in managing the health crisis which could explain the difference in opinions according to the level of leadership.
Another significant issue reported out of Latin America has been reports of abuse towards healthcare workers due to the perception that their work makes them more likely to contract and spread COVID-19. On average 45% of contributors stated that they had heard of abuse toward healthcare workers as a result of COVID-19 with that number reaching 64% when focusing on Colombia exclusively. 71% of contributors across all three countries also expressed that they ‘Agreed’ or ‘Strongly Agreed’ that sharing public transit with healthcare workers could increase their chances of contracting the coronavirus. It is disheartening that health workers are being stigmatized while still working to protect the health and safety of their communities against COVID-19. 45% of contributors are ‘Agreed’ or ‘Strongly Agreed’ that it would be dangerous to have a COVID testing facility near them which means that on top of limited resources, public opinion could be yet another obstacle to expanding testing in these locations.
You can read more about Premise’s data collection and analysis for Latin America here.
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