The following results are based on an analysis of 579 men (48.3%) and 621 women (51.8%) with a mean age of 52.2 years (range: 18–91).
3.2. Patterns of Implementation of Preventive Measures for COVID-19
To determine the extent to which people are thoroughly implementing countermeasure actions as well as the characteristics and number of combinations of countermeasure actions, a cluster analysis was conducted on the implementation of the 16 preventive measures presented in the questionnaire. As a result, four clusters were extracted (
Table 6). Cluster 3 was the largest, accounting for about 45% of all participants with an average of 3.4 preventive measures implemented. Cluster 4 was the second largest with an average of 7.8 preventive measures. Cluster 1 comprised about 18% of the participants, with an average of 11.0 preventive measures. Cluster 2, the smallest, included about 4% of the participants and had the lowest average number of preventive measures implemented at 1.2.
The table shows which specific preventive measures were practiced. The measures implemented by 50% of the participants in each cluster are hatched. In Cluster 1, more than half of the participants took 13 measures except “wearing gloves” and “PCR test,” whereas in Cluster 2, there were no preventive measures taken by the majority of participants, indicating that the preventive actions taken by each individual varied. Based on the patterns of implementation of preventive actions, I refer to Cluster 1 as the Maximum preventive group, Cluster 2 as the No-preventive group, Cluster 3 as the Minimum group, and Cluster 4 as the Intermediate group.
The vaccination rate was 86.3%, 84.4%, and 77.2% in the Intermediate, Maximum, and Minimum groups, respectively, and 43.2% in the No-preventive group. The proportion of participants who reported that they had not received any vaccination was 4.7% in the Maximum group, 4.4% in the Intermediate group, 8.4% in the Minimum group, and 29.6% in the No-preventive group.
Table 6.
Ratio of the implementation of preventive measures.
Table 6.
Ratio of the implementation of preventive measures.
| Maximum | Intermediate | Minimum | No-Preventive |
---|
Number of observations | 211 (17.6) | 410 (34.2) | 535 (44.6) | 44 (3.7) |
Mean of implementation of preventive measures | 11.0 | 7.8 | 3.4 | 1.2 |
Use of mask | 100.0 | 100.0 | 100.0 | 0.0 |
Infection control measures such as hand washing or cleaning fingers using an antiseptic solution | 99.1 | 95.9 | 80.4 | 31.8 |
Use of gloves | 23.7 | 7.8 | 7.1 | 6.8 |
Use of cashless payments | 70.6 | 46.3 | 24.3 | 11.4 |
Refraining from leaving home for nonurgent or nonessential purposes | 90.1 | 83.2 | 30.3 | 9.1 |
Postponing or canceling travel or leisure activities | 91.0 | 75.6 | 16.3 | 9.1 |
Refraining from eating out | 85.8 | 80.2 | 20.2 | 11.4 |
Having sufficient exercise, nourishment, and sleep | 70.6 | 49.0 | 21.3 | 4.6 |
Refraining from experiential entertainment | 80.1 | 44.9 | 1.9 | 9.1 |
Refraining from physical contact, including handshakes and hugs | 89.1 | 55.4 | 11.0 | 4.6 |
Moving by car or bicycle rather than public transportation | 69.7 | 44.9 | 6.5 | 2.3 |
Communication using online tools rather than face-to-face | 62.6 | 3.7 | 2.2 | 2.3 |
Use of mail order and delivery services | 62.6 | 4.6 | 1.9 | 2.3 |
Avoiding crowded locations and times to the extent possible | 88.2 | 84.6 | 14.6 | 6.8 |
Getting a PCR test | 13.7 | 4.2 | 1.9 | 4.6 |
Nothing | 2.4 | 1.7 | 0.4 | 2.3 |
Table 7 shows the reasons for implementing or not implementing preventive measures by group. The most frequently selected reasons for taking action in the Maximum group were the following: “I think it is effective in preventing infection [effectiveness]” (89.1%), “I don’t want to infect other people [altruism]” (83.4%), and “I don’t know if it has any effect, but I don’t want to regret not doing it [regret]” (61.6%), in that order. The Intermediate group also had a high selection rate for the same order of reasons for implementing measures. The Minimum group selected effectiveness (73.8%) and altruism (52.5%) as the top two reasons, like the other groups, but the third most frequently selected reason was “Everyone around me is doing it [conformity]” (23.0%), indicating a strong tendency to take action in accordance with those around them rather than because they did not want to regret their actions. More than 20% of the participants in both the Maximum (29.9%) and Intermediate (23.4%) groups reported conformity as a motivation, suggesting that the reason people take countermeasures includes a sense of peer pressure. On the other hand, the reason selected most frequently by the No-preventive group was “I don’t think it would be a big deal if I were infected” (31.8%).
Table 7.
Reasons for implementing/not implementing preventive measures.
Table 7.
Reasons for implementing/not implementing preventive measures.
| Maximum | Intermediate | Minimum | No-Preventive |
---|
I think it is effective in preventing infection (effectiveness) | 89.1 | 89.0 | 73.8 | 27.3 |
I don’t want to infect other people (altruism) | 83.4 | 79.5 | 52.5 | 25.0 |
I am at high risk of aggravation (risk perception) | 46.0 | 34.2 | 17.6 | 6.8 |
I live with someone who is at high risk of serious illness | 17.5 | 14.9 | 7.1 | 4.6 |
I don’t know if it has any effect, but I don’t want to regret not doing it (regret) | 61.6 | 50.7 | 15.9 | 6.8 |
Everyone around me is doing it (conformity) | 29.9 | 23.4 | 23.0 | 9.1 |
The procedures and preparations for countermeasures are troublesome | 3.8 | 2.4 | 1.3 | 0.0 |
It is costly | 3.3 | 3.9 | 4.3 | 13.6 |
I do not know what specific measures to take | 5.7 | 3.4 | 2.1 | 6.8 |
I have doubts about how effective the countermeasures will be | 8.1 | 5.9 | 4.7 | 15.9 |
There are few infected people in my area | 8.1 | 5.9 | 6.0 | 6.8 |
I don’t think it would be a big deal if I were infected | 1.9 | 1.0 | 4.5 | 31.8 |
The mean age, gender ratio, and risk perceptions and recognitions concerning COVID-19 for each group are shown in
Table 8. For perceptions and recognitions, I used the average of the responses to the questions comprising each of the aforementioned factors. All responses were given on a 5-point scale, with higher scores indicating a stronger tendency toward that factor.
The mean age of the Maximum and Intermediate groups was 57.2 years old, the highest among the four groups, and both groups had more women than men. The No-preventive group had the lowest mean age and the highest percentage of men. The perception of COVID-19 as a difficulty in responding was highest in the Maximum and Intermediate groups, followed by the Minimum and No prevention groups, with a significant difference in mean values (F(3,1196) = 37.0, p < 0.001). Conversely, the means of perceiving the risk as trivial was highest in the No prevention group, followed by the Minimum, Intermediate, and Maximum groups (F(3,1196) = 12.5, p < 0.001). Infection and social life anxiety were highest in the Maximum and Intermediate groups, followed by the Minimum group, and lowest in the No prevention group (infection anxiety; F(3,1196) = 65.4, p < 0.001; social life anxiety; F(3,1196) = 9.2, p < 0.001). For alertness to COVID-19, the Maximum and Intermediate groups had the highest mean scores, followed by the Minimum and No-preventive groups (F(3,1196) = 92.1, p < 0.001). However, the mean score for omission was highest in the Minimum group and lowest in the Maximum and Intermediate groups (F(3,1196) = 25.0, p < 0.001).
Thus, about half of the Japanese population took only minimal measures, and the other half took an average of seven or more measures in combination, of which 18% took an average of 11 measures in combination. The Maximum and Intermediate groups, who implemented greater combinations of measures, perceived COVID-19 as a major threat and were concerned about infection. They believed that the countermeasures were effective, did not want to infect others with COVID-19, and did not want to regret infecting themselves without taking countermeasures; therefore, they took actions such as wearing masks, disinfecting their hands, reducing face-to-face contact with others, and avoiding going out and visiting crowds. The Minimum group, who took only minimal measures such as wearing masks and sanitizing their hands, recognized COVID-19 as a difficult risk, but were less concerned about infection and less conscious of their own risk of becoming seriously ill, and of not wanting to pass it on to others. The No-prevention group was even less anxious and wary of infection than the Minimum group, and was most likely to perceive COVID-19 as a trivial problem and an exaggerated risk. The No-prevention group was more likely to be optimistic about COVID-19 and underestimate the risk, thereby indicating that they did not believe that action was necessary to prevent COVID-19.
3.3. Differences in the Perception of the Current Situation across Groups
Table 9 shows the results of a 5-point scale for the three actors (national government, medical institutions, and individuals) in terms of how the participants perceived the current situation of the pandemic, and whether the actors were responding well, had the ability to respond appropriately, and were taking the situation seriously. On the scale, 3 points means “can’t say either way,” and a score higher than 3 indicates a positive evaluation.
All groups assigned low ratings to both the government’s response and its ability to respond. In contrast, medical institutions were highly evaluated for their response as well as for their ability and serious commitment in dealing with COVID-19, while individuals were also evaluated as taking the problem seriously and dealing with it well. The average rating given by the No-preventive group was below 3, not only for the government administration, but also for medical institutions and individuals, indicating that the participants in this group believed there was a poor response, lack of ability to respond, and lack of serious efforts.
The questionnaire also asked about the participants’ expectations for the national and prefectural governments. The participants were given 13 answer choices, and the average number of response items chosen was 5.5 were for the Maximum group, 4.6 for the Intermediate group, 2.4 for the Minimum group, and 1.7 for the No-preventive group. In addition, 31.8% of the participants in the No-preventive chose the exclusive option, “I do not expect anything from the government.” In other words, the participants who took many preventive measures against COVID-19 tended to give a higher evaluation of and expect more from administrative agencies, while those who did not take preventive actions had a lower evaluation of and expected less from administrative agencies’ ability to respond.
The Minimum and No-prevention groups, who were less anxious and wary about COVID-19, more strongly perceived the national government and medical institutions’ response to be inadequate than the Maximum and Intermediate groups, thereby suggesting that they were not optimistic about the current status of the pandemic as a social situation, even if they considered measures against the risk personally unnecessary.
The results of the items about feelings in daily life are shown in
Figure 2. The responses measured by the semantic differential method of the 5-point scale with the feelings in the figure placed on both sides were averaged for the groups, with “neither” (middle response option) set at 0, agreement with negative feelings on the left side, and agreement with positive feelings on the right side. As the figure shows, there was a positive tendency in the Maximum and Intermediate groups. In comparison, the No-preventive group had a low reporting of positive feelings, and the Minimum group had a tendency toward negative feelings.