Changes in public health-seeking behaviours for respiratory tract infections during the COVID-19 pandemic.

Background: COVID-19 exerted significant strain on national healthcare services across England. To explore changes in public health-seeking behaviours for respiratory tract infections (RTIs), and knowledge of, and attitudes towards antibiotics, a national survey was conducted in March 2021 with findings compared to a baseline survey from before UK lockdown restrictions in March 2020. 

Methods: Comparing responses to a telephone survey of 1,676 adults (2021) and a face-to-face survey of 2,022 adults (2020) across England. Key demographics were representative of the population. The 2021 survey included additional COVID-19 relevant questions. 

Findings: Compared to 2020, fewer respondents self-reported RTIs in the last 12-months (51% vs. 70%; p<0.05), however, there was no change in reported consultation with GPs (25% vs. 23%; ns). Expectation for antibiotics increased in 2021 (56% vs. 38%, p<.05), but self-reported antibiotic prescriptions were similar (54% vs. 52%; ns). Respondents reported more proactive symptom management, with greater reports of seeking over-the-counter remedies (55% vs. 35%; p<.05), alongside continuation of usual activities (56% vs. 30%; p<.05).

In 2021, 71% of respondents understood antibiotics are not effective against COVID-19 and did not differ according to their COVID-19 infection status. Compared to 2020, there was increased belief (62% vs. 57%, p<.05) that individuals can personally help reduce antibiotic resistance.

Interpretation: Public health bodies should consider how changes brought about by the pandemic may have facilitated increased self-care, and how to support continued self-care post-pandemic. Conjunctively, campaigns should capitalise on increased public empowerment to tackle antimicrobial resistance.