key: cord-0959342-hjavbyei authors: Krishna, Puvvada Rahul; Undela, Krishna; Gupta, Balaji Sathyanarayana; Palaksha, Shilpa title: Knowledge and Beliefs of General Public of India on COVID-19: A Web-based Cross-sectional Survey date: 2020-04-25 journal: nan DOI: 10.1101/2020.04.22.20075267 sha: e88330eb6d3009c0786db6e041ea84d928df1164 doc_id: 959342 cord_uid: hjavbyei Context: Despite many awareness programs conducted by the governments and other agencies, there are certain false beliefs among the general public of India towards the transmission, prevention, and treatment of COVID-19. Aims: To assess the knowledge and beliefs of the general public of India on COVID-19. Materials and Methods: A web-based cross-sectional survey was conducted between 20th March and 15th April 2020. A 17-item questionnaire was developed, validated, and used for the study. The questionnaire was randomly distributed among the public using Google forms through social media networks. Descriptive analysis was performed to represent the study characteristics, Chi-square test for assessing the associations among the study variables, and logistic regression analysis for identifying the factors influencing the beliefs. Results: A total of 462 participants with a mean (SD) age of 30.66 (11.31) years were responded to the questionnaire. Study participants are having fairly good knowledge of the basic aspects of COVID-19. However, a considerable fraction of participants were having false beliefs towards the transmission of new coronavirus, and prevention & treatment of COVID-19. It was observed that the participants who were aged 31-60 years and >60 years, education level of intermediate or diploma and high school certificate, and occupation as the unskilled workers had more of false beliefs towards COVID-19 compared to their counterparts. Conclusion: Though the overall knowledge on COVID-19 was good enough among the general public of India, still there is a need for education to avoid false beliefs especially among the people who are elderly, having a low level of education, and non-professional workers. Coronaviruses are large family of viruses that are known to cause mild to moderate respiratory symptoms. However, the epidemics of two beta coronaviruses namely MERS (Middle East Respiratory Syndrome), SARS (Severe Acute Respiratory Syndrome) has caused over 10,000 deaths over the past two decades. [1, 2] In December 2019, scientists had found series of cases with symptoms resemble to pneumonia in Wuhan, China and identified that it was caused by a novel strain of coronavirus called SARS-CoV-2. Later, on 11 th February 2020, World Health Organization (WHO) has announced COVID-19 (Coronavirus Disease 2019) as new name of the disease. [3] The WHO has announced COIVD-19 as pandemic on 11 th March 2020. [4] As of 19 th April 2020, 185 countries/regions were affected with SARS-Cov-2 with a total of 2,329,651 confirmed cases and 160,721 deaths. [5] Of these countries, highest number of cases are seen in United States (735,086 cases), followed by Spain (194,416 cases), Italy (175,925), France (152,978), Germany (143,724) and United Kingdom (115, 314) . COVID-19 cases in India increasing gradually, and the number of cases as of 19 th April 2020 are 16,365 including 521 deaths. [6] Despite general awareness programs conducted by the state and central governments, there are many false beliefs among the general public of India due to circulation of various misconceptions in social media and internet about the spread of novel coronavirus, and prevention & treatment of COVID-19. False beliefs not only misrepresent the situation but may increase the effects of disasters by compromising the public's collective effort. [7] An advocacy group of BBC said around 46% of adults have been seeing fake news or misleading information about the COVID-19 pandemic and suggested that there is a need to stop the false posts. [8] In Iran, thinking that alcohol can kill the coronavirus, around 600 people died and 3000 were hospitalised after drinking methanol, [9] which is a type of alcohol used in marine, automotive and electricity industries as a renewable energy resource. [10] In a study All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. India, with 1.39 billion population, is the second largest internet user in the world with over 560 million internet users, and has over 400 million WhatsApp users as of July 2019. [12, 13] According to the article published in India Today, the Maharashtra cyber cell department has registered 115 cases over spread of fake news since lockdown during COVID-19. [14] Hence, it is essential to assess the knowledge and beliefs of general public of India towards COVID-19 for taking preventive measures in spreading misconceptions and increase awareness. To the best of our knowledge, this is the first Indian study conducted to assess the knowledge and beliefs of general public of India on COVID-19. A cross-sectional web-based online survey was conducted between 20 th March and 15 th April 2020. A 17-item questionnaire was developed based on WHO myth busters. [15] The developed questionnaire was validated for relevance, clarity, simplicity and ambiguity by using four point content validity index. [16] A pilot study was conducted among 15 individuals to identify further barriers in understanding the questionnaire before disseminating the questionnaire. Cronbach's alpha was used to measure the internal consistency of the questionnaire. [17] The questionnaire consists of three sections. The first section consists of demographics of participants such as age, gender, occupation, education and monthly income. The socioeconomic status of participants were grouped according to modified kuppuswamy scale. [18] The second section has six knowledge based questions focus on knowledge of general public of India on COVID-19. Initial five questions were provided with multiple options with only one correct answer and the last question is about sources of information for All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted April 25, 2020. . | P a g e which the respondent can choose multiple options. The scoring was given to first five questions. Each correct answer was given score "1" and incorrect answer was given "0". participants were asked to give consent before taking part in the survey. Mean with standard deviation was calculated for continuous variables and number with percentage was calculated for categorical variables. Chi-square test was used to find the association between demographic details of people and their beliefs on COVID-19, and the factors influencing beliefs were identified by using odds ratio with 95% CI. The results were considered statistically significant with p 0.05. All statistical analyses were performed All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted April 25, 2020. . | P a g e or gargling warm water or saltwater (41.55%) can't kill the new coronavirus. Also, majority of participants (88.09%) were aware that the COVID-19 is not the disease of only elderly ( This study presented the information on knowledge and beliefs of general public of India on COVID-19. To the best of our knowledge this is the first Indian on this hypothesis. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted April 25, 2020. [20] Bleach is easily available at low costs. It is effective against bacteria, fungi and viruses including influenza virus. But it easily reacts with other All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted April 25, 2020. . 1 0 | P a g e chemicals and decomposes in presence of heat and light. Contacting with bleach or spraying it over the body would irritate the skin and mucous membrane. [20] This study identified that the people who are aged, having low level of education and non- https://www.indiatoday.in/india/story/coronavirus-maharashtra-registers-115-casesover-fake-news-since-lockdown-1664318-2020-04-07. All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted April 25, 2020. . (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted April 25, 2020. . Middle East respiratory syndrome coronavirus (MERS-CoV): announcement of the Coronavirus Study Group Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia Naming the coronavirus disease (COVID-19) and the virus that causes it, c2020 WHO Director-General's opening remarks at the media briefing on COVID-19 -11 Coronavirus disease (COVID-19) Pandemic, c2020 COVID-19) advice for the public: Myth busters, c2020 Content validity and its estimation Making sense of Cronbach's alpha Socioeconomic status scales-modified Kuppuswamy and Udai Pareekh's scale updated for 2019 The Effects of Temperature and Relative Humidity on the Viability of the SARS Coronavirus None of the authors have any conflicts of interest that are directly relevant to the content of this article.