In early April, just weeks after COVID-19 changed life as we know it, only about two-thirds of the people responding to our CommunityWisdom survey on coping with COVID-19 challenges reported that they and any others living in their household were being ‘very careful’ when it comes to following public-health guidelines. Now, with 1,060 responses to the survey in the US, the percentage of people reporting that they are being very careful stands at 60%. In other words, 4 of 10 are not. And being ‘pretty careful’ is not good enough, a point reinforced by looking at rates in different states and grieving the loss of more than 200,000 Americans.

Listening to the real-world perspectives and experiences of community members can help guide communication strategies and support efforts in communities across the US. There is a tremendous opportunity for health organizations, elected leaders, and community advocates to reinforce relevant messages and point people to relevant resources that meet their needs. But the only way to know what is relevant is to listen. This fundamental notion may be even more essential now.

What else are people telling us? Here are 5 key findings and recommendations for addressing each:

  1. Types of Stress. Not surprisingly, the vast majority (76%) of respondents are feeling more stress than usual, primarily stemming from concern about family health and safety: 97% highlight fear and worry about the health of their loved ones. In fact, 61% report ‘a lot’ of fear and worry about their loved ones, but only 23% have the same degree of concern about themselves. Other major stressors for respondents: concern about money and finances, concern about their job or business, concern about getting the groceries and supplies they need.

    • Since people are more worried about their loved ones than themselves, we can all reinforce the importance of being ‘very careful’ as a way to optimize the health and safety of family and friends: You’ve got to stay safe for the sake of the people you care about. Wear a mask. Avoid crowds. Wash your hands.
  2. Signs of Stress. More than 70% of people report difficulty sleeping, lack of energy, and/or strong emotions or mood swings. Nearly as many (65%) report poor appetite or over-eating. And 37% report increased use of alcohol – ‘a lot’ more for 9% of respondents. All of these take their toll. And people are asking for help. The three most frequently requested education or support programs: getting enough exercise / activity; having the motivation and energy needed; managing stress and understanding feelings.

    • Given that most people are reporting significant signs of stress and asking for help, organizations can either develop or partner with programs that explicitly address the priority needs, offering a coherent set of online resources focusing on safe activities, exercise for people with different interests and abilities, motivational messages, meditation and mindfulness strategies, techniques for managing stress and understanding feelings, and healthy options for better sleep.
  3. Challenges. The big challenge for respondents is not being able to do the day-to-day things they like to do (79%). These may be mundane things, but mundane things matter. They factor into our sense of self and connection to the world. When respondents leave their living space, it tends to be for getting food (86%) or getting some fresh air / exercise (79%). People are trying to connect – 83% reported reaching out to friends, family, and co-workers as a way to cope with the COVID-19 situation. Despite these contacts, our survey found that 53% of all respondents are feeling lonely. Interestingly, only 13% live alone, and not all of them report feeling lonely.

    • If people are feeling lonely in this age of social media despite living with and/or reaching out to others, there is much to be gained if we all encourage active listening (i.e., being in the moment, curious, and respectful) to more authentically connect with people. At an even more basic level, the simple act of safely acknowledging – and being acknowledged by – someone who passes by can help us feel less isolated.
  4. Healthcare Venues. In late May, we augmented the survey with timely items on re-opening and healthcare. Preliminary results suggest that most people would be comfortable with a virtual visit (80%) or talking to a healthcare provider via phone (73%) if they needed help in dealing with a health problem. People are less sanguine about in-person care, whether going for an office visit (63%), going to the office or hospital for a test, procedure, or surgery (51%), or going to the emergency room (47%).

    • For telehealth to sustain the rapid gains made over the past few months, healthcare organizations will need to improve the user experience for both clinicians and patients by paying as much attention to the relationship as the transaction.
  5. Safe Care. We also asked what would make people feel safe if they did have to go in for care. Four essential elements emerged: masks (91%), plenty of hand sanitizer (87%), space between people (87%), and cleanliness of all areas (87%). While temperature checks, testing for COVID-19, no waiting, no paperwork to touch, and gloves were all seen as less important, none were endorsed by less than 50% of respondents.

    • Wherever in-person care is available, emphasize safety in deeds not just words: ensure the correct use of masks, offer plenty of hand sanitizer (and remember that dispensers are useless if they are empty), use simple design principles to enforce space between people, and make every effort to keep both waiting and clinical areas clean.

Participation amplifies the power of listening. Our online survey was initially released in Connecticut as a public service to the local community and gained broader distribution, particularly in Massachusetts, New York, and Ohio. Respondents were invited to take the survey via email and media outreach. This is a non-probability sample and results should be considered representative only of the respondents -- not all people in all communities:

  • Nearly 66% are female and, while the biggest age group is 55-64 years old, the range encompasses teens and octogenarians.
  • When asked how the COVID-19 situation has affected work or school, 54% say they are working or learning from home and 10% report that their vocation is shut down for now.
  • 74% of respondents identify as White, 8% as Asian, 7% as Black, and 6% as Hispanic or Latino.

Results are publicly available on our website. Bottom lines: The stress related to COVID-19 is real. People have actionable requests for help. Solutions need to be realistic. And being ‘pretty careful’ is not good enough.