17 February 2021.

There are many moving parts in a government’s response to a highly infectious disease such as COVID-19. In the acute phase, the focus is rightly on medical research and public health strategies to contain the pandemic. But over the longer term, it is critically important for policymakers to understand the impact that the pandemic – and the measures to control it – is having on the general population.

The Sax Institute is helping to answer some of these questions, thanks to a COVID-19 research grant from the NSW government. Our flagship 45 and Up Study, which has tracked the health of over 260,000 NSW people over the age of 45 for the past 14 years, is rolling out a series of rapid COVID surveys to 60,000 of its participants, to gain a real-time snapshot of health and wellbeing during the COVID-19 pandemic. These fast turnaround COVID surveys cover a range of topics, including the pandemic’s impact on health, loneliness, lifestyle, physical activity, diet, sleep, alcohol use, access to health services, experiences with telehealth and more – providing data and insights that will help guide policy and health services in the coming months and years.

Interim results from the first of these surveys – sent out in November 2020 – are now in. They yield some fascinating insights into the concerns and behaviours of people in this time of pandemic and will no doubt give policymakers plenty to chew on.

One key public health concern is how the pandemic and associated measures have affected people’s mental health. The first COVID survey from the 45 and Up Study found that in fact, a smaller percentage of people in this age bracket experienced psychological stress in 2020, compared with the previous two years. However, one in four still said their psychological health was worse and the same proportion reported some degree of psychological distress. Men were less likely to suffer from high distress levels, while people between 45 and 65 were more likely to experience high or very high levels of stress (8%) compared with older groups. 

Loneliness due to lockdowns and restrictions, particularly among older people, has been another topic attracting media attention. In this survey, almost one in ten people were intensely lonely in 2020, with 56% missing having other people around. Loneliness is associated with a number of poor health outcomes, including higher mortality and hospitalisation rates. Ninety-two percent of respondents reported reduced personal contact outside their own household in 2020, with the reasons given centring more on concern for others and following recommendations, rather than government restrictions per se.

Despite Australia’s low rates of infection and deaths from the COVID pandemic compared with other countries, 11% of respondents said they were very or extremely concerned they would get sick from COVID, while 20% were similarly concerned about family and friends getting the disease. Those who were not at all concerned about getting infected tended to be older (over 85) and from more disadvantaged areas of the state. Twice as many men than women were unconcerned about family and friends getting COVID (7% vs 14%).

The pandemic has had an impact on healthcare provision well beyond the care of people infected with COVID-19. Seventy percent of people in the 45 and Up Study survey reported missed or delayed access to healthcare services, including missed appointments with a dentist (25%), GP (16%) and medical specialist (12%). On the flipside, respondents were largely positive about telehealth, which really took off in 2020. Nearly half of participants said they had received telehealth services, mostly by telephone. And the experience was mostly good, with 56% of people of the opinion that it was just as good or better than a face-to-face visit, compared with only 27% who said it was worse.

During the lockdown, Australians made the most out of their parks and bushlands for exercise and there was a boom in cycling. But were people really doing more exercise? The survey suggests otherwise: participants reported spending less time on all forms of physical activity compared with the previous year, while 24% reported spending more time watching TV. 

Are Australians getting the information they need on COVID, and where do they get it? Three in five respondents reported being confused about the COVID information they read or heard, with people from more disadvantaged areas more likely to feel this confusion. The most frequently accessed sources of information about COVID prevention in this cohort of people over the age of 45 was public TV and radio (71%), followed by commercial TV/radio (45%) and newspapers (34%). Fifty-two percent reported never having used social media. Healthcare providers were the most trusted source of information – and yet the least accessed.

As Australia prepares for the rollout of COVID vaccines, the next survey in this series will provide vital information on attitudes to immunisation. In all, five surveys are planned in this series, and the Sax Institute welcomes any suggestions on survey questions and topics. For more information, please contact Dr Kerrin Bleicher at kerrin.bleicher@saxinstitute.org.au .