Support and confidence

Public support for the behavioural measures and recommendations was very high in the early days of the COVID-19 pandemic. In the first survey round in April 2020, all the behavioural measures and recommendations were supported by over 90% of the survey participants. Over time, support for the behavioural measures decreased to some extent. In autumn 2021, during widespread uncertainty about the Omicron variant, there was a temporary resurgence in support for all behavioural measures. Some behavioural measures saw almost no decline in public support throughout the pandemic, such as the hygiene recommendations to cough and sneeze into your elbow (from 94% to 86%) and to use paper tissues (from 90% to 83%). Support for other behavioural measures decreased more significantly and fluctuated more over time. For example, support for working from home and for self-quarantining in case of symptoms both decreased by about 30 percentage points. 

A sharper decrease was observed in confidence in the government approach to COVID-19. Where a significant majority of the survey participants expressed confidence in the Dutch approach or expressed positive sentiments about it at the start of the pandemic, by November 2021 (round 17) this had dropped to 16%. Confidence has increased slightly since then: during the last survey round in September 2022, 25% of the participants expressed significant or very significant confidence in the government approach.

Compliance with behavioural measures and recommendations

The extent to which participants complied depended on the behavioural measure. There were some measures that nearly all participants complied with for as long as they remained in effect, such as not shaking hands or wearing a face mask in public transport. The hygiene recommendations were also followed by relatively high numbers of participants, and compliance remained stable throughout the pandemic. 

The participants complied much less consistently with other measures, and compliance varied more over time; examples include testing in case of symptoms. The percentage of participants who tested in case of symptoms ranged between 30% and 88%. When the testing recommendation was introduced in summer 2020, more than 40% of participants got tested for COVID-19 if they had symptoms. This percentage rose to 66% in the following autumn and winter, when tests were more widely available and the number of infections increased. During the period of uncertainty surrounding the new Omicron variant, there was a fresh increase in compliance with the testing recommendation. Updated policy also played a role here: starting in December 2021, it was considered sufficient to use a self-test in case of symptoms, rather than getting tested by the Municipal Public Health Services (GGDs). Once self-testing was introduced in early May 2021, the use of self-tests increased steadily. In 2021, self-test use was highest among people aged 16-24 years, rising above 60%. Over the course of 2022, age-based differences in self-test use grew smaller. 

The policy context also had a visible impact on compliance with other behavioural measures. For example, almost all participants complied with the recommendation to receive a maximum number of visitors in the home when the limit was set at 3 or 4 visitors, but far fewer complied when it was reduced to 1 or 2 visitors in early 2021.

Reasons explaining behaviour

Compliance with a behavioural measure was strongly dependent on public support for a specific measure, and how easy or difficult it was for participants to comply. Most participants found it easy to cough/sneeze into their elbow, avoid shaking hands, and wear a face mask in public transport. Staying 1.5 metres apart and working from home were perceived as less easy. Participants had an easier time complying with the social distancing measure at the start of the pandemic and during the lockdowns, compared to periods with less stringent measures.

The in-depth analyses showed that compliance with the behavioural measures was less affected by opinions about the COVID-19 approach adopted by the Dutch government, confidence in the government approach, and the extent to which participants saw others around them complying with a behavioural measure.

Slight rise in confidence, accompanied by continued demand for more communication

Compared to the previous survey round, confidence in the government’s approach has increased slightly, rising by 4 percentage points. A quarter of participants are now positive or very positive about the approach (25% positive; 51% neutral; 24% negative). The majority of participants felt that there were sufficient measures now (62% sufficient; 10% too many; 27% too few). Despite the fact that concerns about a possible surge in the virus have decreased slightly in this round (-7%), only 1 in 4 participants are still confident that the government will be well prepared for another surge. Three-quarters of participants indicated that the government should communicate more about its plans to deal with a possible surge. 

These findings and more were clear from the twenty-first round (which is the final round for the time being) of the survey-based study conducted by the RIVM Corona Behavioural Unit in cooperation with GGD GHOR Nederland and the 25 Municipal Public Health Services (GGDs), conducted between 7 and 11 September 2022 among 34,283 participants.

Well-being

During the COVID-19 pandemic, participants rated their own lives as from 6.9 to 7.6, on a scale from 1 to 10. This figure was somewhat lower during periods when stringent measures were in effect, and somewhat higher during periods when measures were relaxed. A similar trend can be observed in mental health and perceived loneliness. During periods with more stringent measures, fewer participants felt mentally healthy and more participants felt lonely. Poor mental health and loneliness were more common among people aged 16–24 and 25–39 than among older participants.  

Willingness to vaccinate

Vaccines against the coronavirus SARS-CoV-2 became available in January 2021. From then on, willingness to vaccinate was high among participants in all age groups (77–94%). Over the course of 2021, this percentage rose in all age groups, reaching 90–98% in June 2021. In September 2022, 95% of the participants had completed the series of basic vaccinations and 4% were unwilling or unable to be vaccinated. Willingness to vaccinate was higher among older people than among younger people, and was lower in later vaccination rounds (for the booster vaccination and the repeat vaccination against COVID-19). Vaccination coverage among the people who participated in this survey-based study deviated from the recorded vaccination coverage in the Netherlands overall. Among participants in this study, vaccination coverage for the basic series (95%) was higher than the national vaccination coverage (83%).

Participants who were willing to get vaccinated were generally more positive about vaccinations against COVID-19. Compared to participants who were unwilling to be vaccinated or were still uncertain, they were more likely to hold the opinion that the vaccine would protect them and others from the coronavirus SARS-CoV-2, that the vaccine is safe, and that vaccination contributes to a way out of the COVID-19 crisis. Conversely, they were less afraid of side effects and any unknown long-term consequences.