4.1 Knowledge of Respondents on COVID–19
In the fight against the Coronavirus Pandemic, one key measure several Governments, the WHO, and other stakeholders have adopted is the periodic sharing of information about updates on preventive protocols, new cases, new deaths and new recoveries. The study results demonstrate that 66.4% of the respondents depended on social media for most of the information they got about COVID–19 in Ghana. Like the results obtained by an earlier study by Abdelhafiz et al. (2020), and another, that was conducted among South Africans, Kenyans and Nigerians, and published online, the use of social media was a predominant channel over more traditional channels like TV, Radio, Newspapers, Family and Friends (Abdelhafiz, 2020; GeoPoll, 2020). Quite expectedly, the use of Newspapers was not recorded by any respondent as their most used channel of information. This may be due to the restrictions imposed by the Government on the operations of businesses and movement of people. This is because, in Ghana, people usually buy their newspapers while they are out of the houses, as it is uncommon to have individual newspaper subscriptions where these papers are regularly delivered at home. The rest who would usually benefit from their employers’ subscription will also miss out due to the restrictions. Again, in spite of the fact that the virus is transmissible through the touching of surfaces, people might have been conscious about touching objects in trying to prevent potential contamination of their hands and onwards touching of their face as part of improvement in the knowledge of the infection prevention protocols.
One thing that became of great concern in this period of the pandemic was the dissemination of inaccurate and fake news about the virus. With the growing access to, and use of internet and social media, health professionals and scientists are able to have direct interactions with peoples by sharing accurate information on awareness, safety measures, and emerging researches (Alejandro, 2020). On the other hand, several people spread sensational rumor, misinformation, and disinformation, making the fight against the pandemic a difficult one (Jayaseelan, Brindha, & Waran, 2020). While it is encouraging that up to 77.9% of the respondents involved in this survey got most of the information they had about the disease from Health Professionals, it is worrying that others may not be receiving the accurate information, needed for the effective fight against the pandemic. To control the spread of an infectious disease like COVID–19, epidemiologists must have an understanding of the epidemiological triad of the disease, which is the interplay between the agent, host and environment (Johnson-Walker & Kaneene, 2018). This provides further information on preventive measures, risk factors, and treatment methods, nature of the virus, and its mode of transmission. From the study results, there appears to be much focus on preventive measures of the virus by providers of information as 60% of the respondents established it as the most common information they had received. This, the researchers believe to be appropriate for public health and safety, as regards COVID–19 prevention and control among the general population.
As a measure to control the spread of the disease, the World Health Organization on12th March, 2020, outlined the following protocols to be observed; washing hands frequently with running water and soap or using alcohol based hand-sanitizing gel; maintaining social distancing (keeping a distance of 1 meter (3 feet) between oneself and anyone who is coughing or sneezing); avoiding touching eyes, nose and mouth; observing and following respiratory hygiene etiquette (covering your mouth and nose with your bent elbow or tissue when you cough or sneeze, then disposing of the used tissue immediately); seeking medical care early when one has a fever, cough and difficulty breathing; and staying informed and following advice given by health-care providers, national and local public health authorities, or employers on how to protect yourself and others from COVID–19 (WHO, 2020b). Subsequently, a series of public education on the pandemic have focused on educating the people about these safety measures in Ghana (Agyeman-Manu, 2020). This information appears to have been circulated well in Ghana. This is because, from the study results, except for the avoidance of touching of eyes, nose, and mouth, all the other preventive protocols as outlined by the WHO, were very often and often read or heard about by over 70.0% of the respondents in each case. The most commonly circulated public education was about the frequent use of alcohol-based hand sanitizing gel, followed by the frequent washing of hands with soap under running water.
4.2 Attitudes of Respondents towards COVID–19
The respondents had varying views about what concerns them most about the impact of the pandemic. For the top three concerns, 70.6% of respondents were more concerned about personal infections, global infections, and local infections. While there have been widespread outcries about the impact of COVID–19 on economies, only 7.0% of the respondents considered that to be of more concern. A similar study conducted among South African, Kenyans and Nigerians, and published online also found Global and personal infections as among the first three commonest impacts people were concerned with (GeoPoll, 2020). However, unlike in this current study, Economic Impact was part of the first three concerns in that earlier study. One thing that has been of great concern is the stigmatization against people with COVID–19 and their families, even after they have been declared treated by health officials. There have been several such reports of discrimination in Ghana (Awuni, 2020; Citi Newsroom, 2020a, 2020b; Noi, 2020). Contrary to such reports, results from this study show that a total of 84.1% of the respondents indicated they were highly willing or willing to accept the integration of COVID–19 treated patients into their communities. In fact, about half (49.4%) of the respondents specifically indicated that they were highly willing to do that. Nonetheless, even though none of the respondents showed sharp tendencies to stigmatise patients by not indicating unwillingness to accept reintegration of treated patients, a significant (15.9%) proportion of them were less willing. This was an indication that there is a real and potential threat of stigmatizing attitude among the study population. It is however assumption that if our study participants who had some level of formal education and were more inclined to be more informed were exhibiting unfavorable attitudes towards patients, the situation could be worse among the general Ghanaian population.
From the study results, the majority of respondents demonstrated an overall impressive attitude towards the observation of the preventive measures as outlined by the WHO. In fact, some 84.3% of respondents reported frequently washing of hands with soap under running water, 77.1% frequently used alcohol-based hand-sanitizing gels and so on. However, quiet not surprisingly, more than half of the study participants could not as often as possible, avoid touching their eyes, nose, and mouth.
4.3 Perceptions of respondents on COVID–19
People perceive differently their susceptibility to getting a particular disease, how severe the disease is, and how efficacious treatments given to people with the disease are. This was true in this study, as results show that different respondents expressed that they were highly susceptible, moderately susceptible, less susceptible, or not susceptible at all. It is impressive to recognise that only 3.8% of the study participants indicated that they were not susceptible at all. Evidence exists that people who perceive that they are susceptible to a particular disease are more likely to take preventive actions than those who do not feel susceptible (Jones, Jensen, Scherr, Brown, Christy, & Weaver, 2015; Joseph, Burke, Tuason, Barker, & Pasick, 2009). Indeed, according to the WHO the virus infects people of all ages, although older people and people with underlying medical conditions are at higher risks of the disease severity. WHO advises that all must protect themselves from COVID–19 to protect others (WHO, 2020e).
Similarly, respondents expressed different views about how they perceive the severity of the disease. While almost all the study participants perceived some degree of severity of the disease, just 0.8% felt that the disease is not severe. This shows a positive perception as people who perceive that a particular disease is severe are more likely to adopt preventive measures against the disease (Jones, Jensen, Scherr, Brown, Christy, & Weaver, 2015; Joseph, Burke, Tuason, Barker, & Pasick, 2009). The efficacy of medical care given to people with COVID–19 was also expressed in different terms by the study respondents. Again, just 1% of them believe that these medical attentions are not efficacious.
The ability of people to perform the various preventive measures against COVID–19, as presented by the WHO is an important part of our collective fight. The study results show that an impressive 82.9% of the respondents expressed that they were either highly able or able to frequently wash their hands with soap under running water. However, results on the ability of participants to frequently use alcohol-based hand-sanitizing gel; ability to observe social distancing, ability to seek medical care early, when fever, cough and difficulty breathing show; and ability to stay informed and following advice on COVID–19 were not satisfactory. What was more disturbing, although not very surprising, was that only 55.5% of study participants were highly able, or simply able to frequently observe respiratory hygiene, and, less than half (45.3%) reported that they were highly able or only able to avoid touching their eyes, nose, and mouth frequently.
Because this was an online survey in design, the study faced a limitation where people who were less formally educated and could not complete the self-administered questionnaire and/or were not online at the time of data collection might have been excluded, but whose inclusion could have influenced the results in this study. This requires cautious interpretation and limits generalizability. It is also reasonable to suspect that because this was a self-administered questionnaire it might have led to some response bias. However, due to the large sample size, design of the questionnaire, and the adherence to ethical procedures including the assurance of anonymity and confidentiality of data, the researchers believe that the results in this study have not been biased.
This article concludes that it has made a significant contribution to the body of science that can be depended on for evidence based policy formulation for COVID–19 in Ghana. It also resolves that the use of social media platforms by the government and other stakeholders for COVID–19 information, education, and communication is commendable and must be continued especially for the benefit of the youth and social media active population in Ghana. There is an impressive level of positive attitudes towards the practice of the various preventive measures as outlined by the WHO among the study participants. Although the majority of Ghanaians do not deny their susceptibility to getting the disease, a significant proportion perceives COVID–19 not to be severe. However, because majority of respondents indicated that they were unable to avoid touching their faces, we recommend that Ghanaians should develop the habit of using face shields, to help prevent how often they would have directly touch their faces and possibly pass on an infection. Finally, there is urgent need for anti-stigma communications to mitigate its negative effects in Ghana.