Researcher wants to know if New Brunswickers are slipping back into pre-COVID ways
Emergency room visits a good indication of adherence to warnings
Daniel Dutton wonders how long it took New Brunswickers to slip back into their pre-COVID habits.
The researcher with Dalhousie University's faculty of medicine in Saint John is looking at emergency room visits as an indicator of how closely people were following public health warnings.
Dutton says his findings could help governments tweak their future warnings for maximum effectiveness. He says there's a sweet spot between instilling too much and too little fear in people.
"The idea is that in the presence of another pandemic or an additional wave of this pandemic, that we would know how to manage messaging to decrease infection rates in our province," said Dutton, an associate professor in the department of community health and epidemiology.
Dutton is one of several New Brunswick researchers to receive money for COVID-19-related projects.
In March, the New Brunswick Innovation Foundation, in partnership with the New Brunswick Health Research Foundation (NBHRF), launched a COVID-19 Research Fund and invited researchers to apply — which they did in droves.
They received 60 applications and requests for $2.3 million in funding, which was more money than they had available.
That's when the Atlantic Canada Opportunities Agency stepped in to provide more money. In total, 27 projects across the province have been approved — to the tune of $846,707.
Dutton's project, entitled "The half-life of public health messages on infection control behaviour in the general public" was one of the successful candidates.
"I want to know how long people stay focused on what we, as public health practitioners, wish they would do with respect to stopping the spread of COVID-19," he said.
"You see these stories of people having large gatherings and whenever that happens somebody from public health, or the premier, will say, 'Please don't do that. That's not what we're supposed to be doing.' And we don't really have a way to judge how well people are sticking to the rules."
Dutton said the polarized minorities have been vocal about whether they're willing to wear masks.
"But that doesn't really help us because we want to know whether or not we should change our public health messaging to make it stronger or perhaps more effective or perhaps we should mix it up and do some research into what it is about masks that are stopping people from wearing them."
Dutton said the best way is through a survey, but surveys are expensive and rely on accurate self-reporting. He said there are other ways of predicting how well people are adhering to the warnings, including emergency department visits.
"The idea is that if people are avoiding the emergency room for what we would call low-acuity problems … maybe we would consider that to be successful public health messaging."
Dutton said there was a "large drop" in emergency room visits at the beginning of the pandemic — at least anecdotally.
He said there were reported cases of people staying home with serious medical conditions when they really should have gone to the emergency room.
Fast forward a couple of months and Premier Blaine Higgs was publicly chastising party-goers who were gathering in large groups, contrary to public health warnings that were still in place.
Dutton said those examples "underline exactly what it is we're trying to measure. We don't want to wait for those things to happen and then scold people, because it's not going to work. They've already gone to the party."
He plans to collect emergency room statistics from Horizon Health Network. When patients arrive at the ER, they're given a triage score based on the severity of their symptoms.
Dutton suspects the stats will show a quick drop in acuity early on and a slow return to normal levels as the number of cases in the province dropped off.
He will compare the fluctuations in acuity with the messages that were being delivered by health officials at the time. He hopes that will help determine what messages were being delivered effectively and which ones may have led to an over-reaction by patients.
One interesting example, said Dutton, would be to look at what officials were saying that led people with serious health problems to stay away from the ER.
Knowing the effect that certain messages had on people's behaviours can help improve future messaging, he said.
Dutton suspects that New Brunswickers — thanks to relatively few cases in the province — slipped quite quickly back into their old ways.
"We've seen it from previous research on other infectious diseases, things like AIDS, is that if there's too much catastrophic messaging, people sort of give up, you know. They say, 'Oh well, it's going to happen to me anyway. I'm going to get COVID-19 anyway, so who cares?'
"So we need to figure out the sweet spot in between causing people to be on vigilant behaviour for their own health, and not giving up in the face of overwhelming negative messaging."