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Epidemiol Infect. 2009 Jul;137(7):988-93. doi: 10.1017/S0950268809002726. Epub 2009 May 11.

Reported changes in health-related behaviours in Chinese urban residents in response to an influenza pandemic.

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  • 1Chinese Field Epidemiology Training Program, Beijing, China.


Strategies to lessen the impact of pandemic influenza include behavioural modifications of the general public regarding medical care, personal hygiene and protection, and social distancing. We conducted a telephone survey of Beijing residents to evaluate potential behavioural changes in the general public in the event of an influenza pandemic occurring. We used a two-stage Mitofsky-Waksberg telephone survey of Beijing residents aged 15 years. The sample was weighted to reflect the 2000 census. We asked the respondents about their current healthcare-seeking behaviours for influenza-like illness (ILI), protective measures (personal hygiene, social distancing), and compliance with health authorities. We then asked what they would do during a hypothetical pandemic. We interviewed 256 Beijing participants in our study (response rate 56%). The percent of participants consulting a doctor for ILI rose from the current 41% [95% confidence interval (CI) 35-47] to 74% (95% CI 68-79) during a pandemic. Fifty-five percent (95% CI 48-62) of the participants would seek care from a more specialized hospital during a pandemic than currently. More than 90% of the participants reported already practising hand-washing or covering their coughs or sneezes during a non-pandemic period; this percentage changed little under a pandemic scenario. Compared to the current social distancing practices, more people would avoid crowded places (77% vs. 92%, P<0.01), use a mask outside the home (10% vs. 58%, P<0.01), and take time off from work or school (17% vs. 38%, P<0.01) during a pandemic. Moreover, 26% of the participants (95% CI 21-32) would stockpile food or water, and 55% (95% CI 49-61) would stockpile medicines. Some of the behavioural changes reported by Beijing participants might help to alleviate the damage caused by a potential pandemic. However, increased use of medical care at referral hospitals will further strain the healthcare system during a pandemic.

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