Coronavirus (COVID-19): highest risk – interviews report – August 2021

Results from qualitative Scottish Government interviews conducted in August 2021 with people at highest clinical risk from COVID-19.

'Getting back to normal' is dependent on being able to control risk

Participants felt more comfortable to do things again when they were in control of the risk. Some balanced the benefits of seeing people against the risks of transmission in certain places and at certain times, before making a decision. However, not being able to control the risk increased anxiety.

Gaining confidence takes time

Many participants were taking steps to start doing things again after long periods of being very cautious and limiting social interactions. Given the impact that shielding had on peoples' perceptions of safety and risk, readjusting to do things and seeing people again was taking time, with many understanding this as an incremental process:

I've started to move towards better integration – but slowly … at my own pace. I'm in no hurry. I'll go back to normality in my own time. I'll keep wearing a mask and keep being careful when I need to. (Participant 6)

Although participants were largely still being cautious and not doing all the things that they felt comfortable doing before the pandemic, many participants acknowledged that there was little guidance Scottish Government could offer to make them feel safer, and that instead, it was their responsibility to start doing things again when they felt ready:

I don't think there is anything more the government can do. I need time to take wee steps and be confident to get there. I am still nervous. I can only take responsibility for myself. I am fed up being in the house and need to stop existing and start living. (Participant 9)

The behaviour of others is still causing concern

Many participants were still concerned about the behaviour of others and this was often cited as something which prevented those at higher risk from being able to start doing things again. Not having control over the behaviour of others introduces risk for those at highest risk and so many were choosing to avoid places where they believed that risk to be highest:

I tend to get really anxious about the actions of other people - who are they seeing? Are they being safe? I'm particularly not keen on going to pubs because people get too close. A room full of drunk, rowdy people not physical distancing is not my idea of fun. (Participant 1)

Additionally, some participants mentioned that recently, their levels of anxiety had increased as Scotland moved 'beyond level 0' because physical distancing had been removed.

I just feel anxious now that restrictions have been eased. I feel a bit sad that I feel that I can't do things again [because of the lack of restrictions]. I think that it'll get worse again in the winter and people meeting more indoors because it's cold and rainy. (Participant 10)

Returning to the workplace removes 'choice' when trying to manage risk

Being asked to return to the workplace in the near future was a stressful time for many participants. While participants said that they had a choice about whether they did things like going to a bar or meeting friends inside, having to return to work removed this choice and forced those at highest risk into situations which they were not comfortable with:

If they made me go back I have actually thought about leaving - I know that sounds extreme. Having to go back removes that element of choice. What's going to happen with the work situation when the cases rise in the future, if I did have to go back?

Having to go back would put myself in a really difficult position of work or long term sick or giving up employment completely. This is my most urgent need. It's the reason I am doing this interview." (Participant 10)

People's feelings of anxiousness about returning to work depended on how understanding their employer is of their high risk status, the measures that have been put in place to make offices more Covid-19 secure and whether hybrid working is an available option.

There are questions about the practicalities of a 'high risk identifier'

In a recent survey, we asked those at highest risk, 'If you were offered something small to wear (such as a wristband) to indicate that you'd prefer people to keep their distance, would you use it?' This would likely be a small item, such as a wristband, lanyard or badge, which would signal to others to keep their distance and take more precautions to protect those at higher risk. In this follow-up qualitative research, questions were asked about the practicalities of such a scheme and about whether it would alter people's behaviour:

I don't know if that would be helpful or if people would even notice it if it's small. Would it make much difference? I hope a few decent people would take notice but the majority of people wouldn't make much difference. But I would wear just to make me feel I was doing everything I could to make myself safe (Participant 4)

There was a breadth of opinion on the usefulness of a high risk identifier with some saying it could be used to 'reduce stigma and embarrassment' (Participant 1) while others said they would avoid using it because 'I don't want it [my condition] tattooed on my forehead' (Participant 12).



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