COVID-19 Policy Compliance among Aging Adults in Pakistan

ABSTRACT

Background: The Government of Pakistan implemented an age-specific policy to protect the aging adults from COVID-19, in addition to lockdown in the year 2020. This policy disallowed people above 50 years of age from going to mosques to offer prayer during the holy Islamic month of Ramadan. In this paper, we study policy compliance among aging adults. Methods: We conducted a telephonic, population-based repeated crosssectional study with a panel component in 24 districts of Pakistan via a preformed questionnaire between April and July 2020. The primary objective was to assess compliance with the age-specific COVID-19 policy among people above 60 years of age, using difference-indifferences design (comparison group 50 years or below). We further conducted a descriptive analysis to estimate the proportion of our study population who regularly followed the three main coronavirus preventive measures, i.e. regular hand washing, wearing masks and physical distancing. Results: In about 62.1% of our observations, people above 60 years of age went out daily during the lockdown as opposed to the spirit of lockdown. The difference-in-differences regression analysis revealed that individuals above the age of 60 years did not significantly reduce going to the mosque for prayer after the onset of Ramadan as compared to those aged 50 years or younger (p>0.05). Apart from that, our analysis also showed no significant difference between people above 60 years and younger study participants (aged 60 years or less) in terms of going out daily during the lockdown (p>0.05). Furthermore, about 54% of people above 60 years of age washed hands regularly, while about 66.4% of the aging adults practiced physical distancing and 55.9% reported that they wore a mask while going out. The regression analysis revealed no significant difference among the three age groups in terms of regularly following the three main COVID-19 preventive measures (p>0.05). Conclusion: These findings indicate that policy compliance among aging adults remained limited in our setting. Moreover, aging adults in our study population did not behave more cautiously during the pandemic, despite being at a higher risk of developing a severe COVID-19 illness.