The Ontario government plans to find out whether people are following COVID-19 prevention measures such as physical distancing and wearing a mask — and if not, why not.
It’s called “health behaviour surveillance,” and while that term might sound like it involves the province spying on you, that’s not what will be happening.
In this case, surveillance means doing surveys. Premier Doug Ford’s government will ask questions about people’s compliance with public health guidelines to try to better understand some of the behaviours driving Ontario’s upsurge in COVID-19 cases.
Experts in the field say health behaviour surveillance is crucial work that can help rein in the spread of infections, provided the government does it right. However, they question why the province has waited until the pandemic’s second wave has already hit to commence the research.
The government plans to start the work this month by surveying representative samples of the population across the province.
Good data could help the province understand what actually influences people’s behaviours around preventing the spread of COVID-19, said Scott Leatherdale, a professor at the University of Waterloo’s School of Public Health and Public Health Systems.
“It would be incredibly important to know what’s working and how we can learn from that,” said Leatherdale, whose specialty is researching the health behaviours of youth.
“You can collect high-level insight on what people are doing, why they may be doing it or why they may not be doing it, and some of the knowledge and beliefs that may underpin those decisions,” Leatherdale said in an interview with CBC News.
People under age 40 have accounted for a disproportionate number of new cases of COVID-19 reported in Ontario since the second wave started building at the end of August.
While Ford repeatedly condemned young people for “wild parties” as a source of infections, health officials have suggested lack of fear of the virus, fatigue with pandemic restrictions and a growing number of less-than-wild social gatherings contributed to the spread of cases among that age group.
The survey work could shed more light on the factors at play, albeit not quickly enough to halt Ontario’s expected trajectory toward an average of 1,000 new cases a day in mid-October.
“The health behaviour surveillance initiative would involve conducting research on Ontarians’ attitudes towards, barriers associated with, and compliance with public health measures,” said a Ministry of Health spokesperson in an email to CBC News.
The goal of the research is “obtaining a better understanding of people’s adherence” to guidelines on physical distancing, face coverings, social circles and rules on gatherings, said the spokesperson.
The ministry said it would obtain “third-party support” to conduct the surveys, but did not indicate what methods would be used for gathering responses.
The results would inform the advice that public health experts give the government on adjusting pandemic restrictions, targeting prevention measures to certain groups or locations, or strengthening its messaging to improve compliance.
Some of Ontario’s public health units already participate in what’s called the Rapid Risk Factor Surveillance System (RRFSS), a mechanism for collecting and analyzing data on health-related attitudes and behaviours. It has developed 100 survey questions related to COVID-19, including on compliance with prevention measures.
“If you have sufficient resources, both human and financial, to ask the questions and process the data quickly, these surveys can be done in a number of days,” said Michael King, chair of the provincial steering group for RRFSS.
“We have been hearing from public health and governmental leaders for months that the only way that we’re going to flatten the curve of COVID-19 is to change our behaviours,” said King, who works as an epidemiologist with Public Health Sudbury and District.
“It’s really important that we are monitoring the degree to which our communities are undertaking this behaviour change.”
Adherence to COVID-19 guidelines has been the subject of some national surveys conducted by the Angus Reid Institute.
The polling firm reported in August that the younger Canadians are, the less likely they are to follow recommended protocols. Its survey also found some correlation between how people voted in the last federal election and their adherence to public health measures.
The experts say getting valid, reliable data requires care, as the pitfalls of surveying health behaviours can be similar to those in political polling, such as loaded questions that would torque the results.
“It’s quite difficult to get young males to pick up the phone and answer a survey,” said King..
“If you’re trying to get a representative population sample, that can be incredibly challenging because getting people to get engaged in survey research is hard enough to begin with,” added Leatherdale.
He said the precise wording of survey questions is important, adding that the surveys should be repeated as time passes to find out whether behaviours are changing.
“That would be really important if you really want to understand what’s happening, and too often that side of things is overlooked,” said Leatherdale.
“There are teams in Ontario who have the capacity to run with this nationally right now, where data could be collected in real-time rather quickly.”