Pandemic Fatigue and Preferences for COVID-19 Public Health and Social Measures in China: Nationwide Discrete Choice Experiment

Background: Information on the public's preferences for current public health and social measures (PHSMs) and people'smental health under PHSMs is insufficient. Objective: This study aimed to quantify the public's preferences for varied PHSMs and measure the level of pandemic fatiguein the COVID-19 normalization stage in China. Methods: A nationwide cross-sectional study with a discrete choice experiment and psychometric scales was conducted toassess public preferences for and attitudes toward PHSMs, using the quota sampling method. The COVID-19 Pandemic FatigueScale (CPFS) was used to screen fatigue levels among respondents. The multinomial logit model, latent class model, andMann-Whitney test were used for statistical analysis. We also conducted subgroup analysis based on sex, age, monthly income,mental health status, and pandemic fatigue status. Results: A total of 689 respondents across China completed the survey. The discrete choice experiment revealed that respondentsattached the greatest importance to the risk of COVID-19 infection within 3 months (45.53%), followed by loss of income within3 months (30.69%). Vulnerable populations (low-income populations and elderly people) were more sensitive to the risk ofinfection, while younger respondents were more sensitive to income loss and preferred nonsuspension of social places andtransportation. Migrants and those with pandemic fatigue had less acceptance of the mandatory booster vaccination and suspensionof transportation. Additionally, a higher pandemic fatigue level was observed in female respondents, younger respondents,migrants, and relatively lower-income respondents (CPFS correlation with age: r=-0.274, P<.001; correlation with monthlyincome: r=-0.25, P<.001). Mandatory booster COVID-19 vaccination was also not preferred by respondents with a higher levelof pandemic fatigue, while universal COVID-19 booster vaccination was preferred by respondents with a lower level of pandemicfatigue. Conclusions: Pandemic fatigue is widely prevalent in respondents across China, and respondents desired the resumption ofnormal social life while being confronted with the fear of COVID-19 infection in the normalization stage of COVID-19 in China.During future pandemics, the mental burden and adherence of residents should be considered for the proper implementation ofPHSMs