Testing the waters - The public acceptability of key population-level infection control measures in post-pandemic Australia.

Abstract

Background: From 2020 to 2022 Australia supressed community transmission of SARS-CoV-2 by imposing a range of population-level measures. This limited mortality and created time to achieve high levels of vaccination, but also caused indirect harms. Our study aimed to capture lay perspectives on the implications of using lockdowns, masking mandates, and school and border closures to supress transmission in future pandemics.

Methods: We report on 9 dialogue groups (n = 53) with residents of Sydney, Melbourne and Adelaide. Each location had different epidemiological conditions and health policy settings during the pandemic. Dialogue group methods allow data collection on questions in applied ethics.

Results: We found that mandating masking indoors was broadly accepted in all group discussions, but attitudes to other measures varied depending on participants' past experiences. All groups accepted lockdowns and school closures might be necessary but wanted greater flexibility in policy implementation based on a broader range of health and social risks. Groups from cities that experienced the tightest public health controls during COVID-19 tended to have greater tolerance of future use of stringent measures (with conditions).

Conclusions: Public compliance during future infectious disease emergencies likely depends on trust in institutions and expertise, and perceptions of the necessity, effectiveness and fairness of interventions. Rather than assuming public acquiescence, defiance or disinterest, in preparing for the next pandemic it is important to devote resources to understanding the public acceptability and perceived legitimacy of implementing any or all these measures.