These are positive developments. In the last measurement, however, we do see a change: the perceived threat of the virus is no longer decreasing. Also, more people indicate that they see a COVID-19 infection as serious or very serious, and consider a second wave to be likely or very likely. In other words, it would seem that concern is no longer diminishing, and may even be increasing somewhat. Note: These survey results were collected before an increase in infections was reported by the Netherlands Municipal Public Health Services and Medical Assistance in Accidents and Disasters (GGD-GHOR) and the National Institute for Public Health and the Environment (RIVM).

In the meantime, people are continuing to comply with the hygiene measures. The rules regarding social life are not being followed quite as strictly. Fewer and fewer people are staying 1.5 metres apart in many places, and fewer people are avoiding busy places. In locations where new infections are now occurring more frequently – at work, at home, in interaction with family, and in cafés and restaurants – people are increasingly not staying 1.5 metres apart. Meanwhile, many people who have symptoms that could indicate a COVID-19 infection are still going to work, visiting the supermarket, going out to cafés and restaurants, or visiting friends and family. And four out of every five people who have symptoms are not getting tested, although there has been an increase in the number of tests in recent weeks.

This combination of factors, in which people have more social contact, are more likely to be in groups, and are less likely to stay 1.5 metres apart, offers more opportunities for the coronavirus to spread. Last week’s infection figures have shown that infections are in fact now increasing. At this time, there has been a very limited spread of infections to people in more vulnerable health. However, the behavioural study shows increasingly frequent contact between people in vulnerable health and the age groups (20 – 60 years) in which more infections are now being diagnosed. As a result, the virus could also have more opportunities to spread to people in vulnerable health. 

The causes of the decrease in compliance with the 1.5 metre measure and other social measures (working from home, avoiding crowds) do not primarily seem to be prompted by a decrease in motivation: the perceived threat of the virus seems stable, and so does the extent to which people find the measures useful and the extent to which they support them. However, people do seem to find it increasingly difficult to follow these behavioural rules. It is growing busier in all locations, after all, and people are seeing others in their area following the measures less strictly.

These results suggest that it may be useful to inform people about the possible risks and about how well the measures are protecting us against those risks (how many infections or hospital admissions are prevented by the measures). But above all, it seems that people would primarily benefit from tangible operational perspectives (what should I do in which situation and why?), resources and information (e.g. where is it busy right now and where is it quiet?), social support (helping each other to comply with the rules as much as possible), and a physical environment that is structured in smart ways (e.g. setting it up so the easiest option is to stay 1.5 metres apart, or regulating the influx of people to reduce crowds). Health promotion expertise (both scientific theory and hands-on application) will be required to design and implement such complex behavioural interventions.

These are the results from the five survey rounds in the Corona Behavioural Study conducted by the National Institute for Public Health and the Environment (RIVM), the Netherlands Municipal Public Health Services and Medical Assistance in Accidents and Disasters (GGD-GHOR) and the regional public health services (GGDs), as commissioned by the Ministry of Health, Welfare and Sport (VWS) and funded by the Netherlands Organisation for Scientific Research (NWO) and the Netherlands Organisation for Health Research and Development (ZonMw). Between April and July 2020, between 50,000 and 90,000 people took part in each survey round of the study.