This research innovatively investigated the roles of the government and individuals in curbing recurrence, based on which we proposed an AGIB model in response to the resurgence of COVID-19. Specifically, current government interventions are essential to improving individual perceived efficacy and positive emotions for combating repeated outbreaks, which, in turn, stimulate a positive mental state – PTG – and promote protective behavior compliance. These results revealed a sound mechanism to curtail the resurgence of COVID-19 and verified the proposed AGIB model. Practically, we are also enlightened that under unavoidable and repeated disasters, the government is expected to reinforce active guidance and inspire individual potential so that society can cope to the best of its ability.
First, subgroups tend to differ in their engagement in protective behaviors. Compared to groups of male, younger and unmarried, being female, older and married was associated with a higher chance of complying with behaviors during repeated outbreaks, which is consistent with previous research2,23,24. This could be ascribed to the higher risks that older females perceive25, which drives them to engage in more protective behaviors. Married people shoulder heavier family responsibilities than unmarried people and therefore may adopt more behaviors to keep themselves and other family members from being infected. Moreover, those with a bachelor’s degree and with an income ranging from 4000 to 10,000 reported more frequent engagement in protective behaviors than subgroups with a higher school or lower education level and an income below 4000 RMB, as previous studies found26,27. One possibility is that people with higher education and higher income levels may be more concerned about the potential health and life risks of the epidemic, leading them to engage in more protective behavior. These results suggest that the government ought to intensify measures and formulate specific actions targeting those people in defending the pandemic. Supervising their behaviors closely will facilitate the mitigation of COVID-19.
Second, government intervention can promote protective behaviors in the context of pandemic recurrence. In the current study, we observed that when the government refutes rumors in a timely manner, discloses information on the suspected and infected individuals, conveys positive messages and provides sufficient supplies, protective behaviors are engaged in more frequently by the public, including behaviors such as avoiding trips, washing hands, and gathering medical knowledge. Our result is consistent with previous research, in which government prevention and control and government rescue increased the likelihood of the public adopting recommended actions9. Furthermore, another study, which was conducted in eight countries, including the U.S., revealed that government measures were not predictors of behavioral adherence by the public28. The reason may partly lie in the optimistic bias of the public, which could undermine individuals’ motivation to engage in protective behaviors by decreasing both perceived risk and subsequent affective responses29.
As the AGIB model suggested, we recommend that the government maintain an active coping position in defending the recurrence of COVID-19. For example, from the very beginning of the pandemic recurrence at Xinfadi Market in Beijing, the government has constantly announced the number of confirmed cases and carried out contact tracing30, which may increase the government’s credibility and make people more willing to adopt protective behaviors31. When a false message was spread that nearly 3,000 positive results were linked to Xinfadi Market, the creator and spreader was detained by the police in Beijing to refute the rumor32. Actions such as this help the government foster a righteous image, promote confidence in the public, and motivate them to comply with protective behaviors33. Additionally, after the suspension of operations at Xinfadi Market, which provides large amounts of food products, six other large wholesale markets across the city moved quickly to increase their vegetable supply, and some cities in Hebei Province have taken steps to increase supplies of agricultural products to Beijing34,35. Such measures of ensuring sufficient governmental supplies and engaging in positive communications can encourage members of the public to actively improve their behavior adoption by eliciting positive emotions36,37, reducing the sense of insecurity and reinforcing public cohesion38.
Afterwards, in early March and May 2021, a devastating second wave of COVID-19 broke out in Bangladesh and India, respectively, which were overwhelmed by a number of daily confirmed cases twenty times than the previous average39,40. The Bangladesh government implemented a nationwide intervention to fight against the second wave and closed public transport, educational institutions and other gathering sites41. India received timely support from the WHO and other countries42. At present, the situations have improved in these two countries, with the number of new cases gradually decreasing. Under such circumstances, it is advised that the government continue to engage in active interventions, identify and quiet rumors, keep information transparent, keep the public informed of positive messages and offer supplies. In this way, the government can establish a sound image and increase trustworthiness to encourage frequent adherence to protective behaviors so that the resurgence can be contained effectively.
Third, government intervention could predict the adoption of protective behaviors by enhancing perceived efficacy and positive emotions in subsequent waves of the pandemic. According to the stimulus-organism-response model (SOR)43, external environmental factors and conditions affect emotions and perceptions that drive individuals’ behavioral responses. It is indicated that not only governmental factors but also individual factors play an important role in the control of repeated outbreaks.
First, as far as emotions are concerned, people become panicked, anxious and depressive when confronting disasters such as COVID-1944–46. As subjects scored higher in these negative emotions, their mental health proved to be seriously damaged. Notwithstanding, active government interventions can mobilize the public’s positive emotions, such as hope, gratitude and confidence, which drive them to adopt more protective behaviors. In addition, both self-efficacy and response efficacy facilitate engagement in more adaptive coping47. Believing that one can perform protective behaviors (self-efficacy) can reduce feelings of hopelessness. Believing that the coping response will be effective in protecting them from infection (response efficacy) will strengthen people’s intentions to engage in behaviors47.
Taking the repeated outbreaks in Beijing as an example, under the government measure of imposing a partial lockdown in the vicinity of the infected market, the public demonstrated strong belief in the government and displayed a sense of responsibility toward the collective good. They strengthened the management in residential communities regarding getting people in and out, suspended the operation of gathering places for entertainment and stayed decisively at home in this city48. Many residents volunteered to provide assistance to the locked-down communities to help maintain normalcy49. Therefore, it is recommended that the public place more emphasis on positive emotions and cultivate their efficacy to the fullest, which is beneficial to both enhancing their mental health and slowing the spread of the pandemic.
Last, government intervention can promote individuals’ perceived efficacy and positive emotions to achieve greater PTG, which, in turn, is associated with more behavior adoption in response to the resurgence of COVID-19. This result is consistent with the conceptualization theory of PTG as the outcome of traumas and as a coping strategy. First, as the outcome of struggling with a crisis, PTG is predicted by self-efficacy and positive emotions. Such personal resources can exert their influence on cognitive appraisal and coping responses. Active cognitive-coping processes help people concentrate on the beneficial aspects of the resurgence of COVID-19 by employing strategies such as cognitive redefinition and positive comparisons to emphasize adaptive and favorable values. Especially in situations like this one that are not easily resolved, the cognitive process can not only minimize the traumatic aspects of the pandemic but also bolster individuals’ mood and self-esteem and confer PTG8. In addition, PTG can serve as a coping strategy influencing individuals’ protective behaviors in the recurrent pandemic. With the meaning-making process being completed after the traumatic event, people’s behavior is likely to be motivated by perceived positive outcomes in direct relation to damaged and reconstituted beliefs8. Since PTG is central to promoting behavioral adherence and fighting the pandemic, it is recommended that individuals promote their posttraumatic growth as they face repeated outbreaks of COVID-19.
Although the research yielded significant progress theoretically and practically, there are still several limitations. First, considering the cross-sectional nature of the study, we are not in a position to empirically establish causal relationships between government intervention and protective behaviors. Thus, a cross-lagged model may be further employed to reveal a clear cause-and-effect conclusion. Second, since the results were obtained at a fixed time point, whether the relationships in the model are still effective in the long run remains questionable. Future research should retest the model and examine its robustness. Third, the results were reached on the basis of a limited sample of subjects living in Beijing. However, given that the COVID-19 pandemic is resurging worldwide, further research is required to ascertain whether the conclusions can help to contain the global pandemic on a wide scale. Accordingly, an international investigation may be needed.