Abstract
BACKGROUND: Protecting public health from infectious diseases often relies on the cooperation of citizens, especially when self-care interventions are the only viable tools for disease mitigation. Accordingly, social aspects related to public opinion have been studied in the context of the recent COVID-19 pandemic. However, a comprehensive understanding of the effects of opinion-related factors on disease spread still requires further exploration. METHODS: We propose an agent-based simulation framework incorporating opinion dynamics within an epidemic model based on the assumption that mass media channels play a leading role in opinion dynamics. The model simulates how opinions about preventive interventions change over time and how these changes affect the cumulative number of cases. We calibrated our simulation model using YouGov survey data and WHO COVID-19 new cases data from 15 different countries. Based on the calibrated models, we examine how different opinion-related factors change the consequences of the epidemic. We track the number of total new infections for analysis. RESULTS: Our results reveal that the initial level of public opinion on preventive interventions has the greatest impact on the cumulative number of cases. Its normalized permutation importance varies between 69.67% and 96.65% in 15 models. The patterns shown in the partial dependence plots indicate that other factors, such as the usage of the pro-intervention channel and the response time of media channels, can also bring about substantial changes in disease dynamics, but only within specific ranges of the dominant factor. CONCLUSIONS: Our results reveal the importance of public opinion on intervention during the early stage of the pandemic in protecting public health. The findings suggest that persuading the public to take actions they may be hesitant about in the early stages of epidemics is very costly because taking early action is critical for mitigating infectious diseases. Other opinion-related factors can also lead to significant changes in epidemics, depending on the average level of public opinion in the initial stage. These findings underscore the importance of media channels and authorities in delivering accurate information and persuading community members to cooperate with public health policies.