3.6 Correlation of demographics with medication recommendation, influenza and COVID-19 vaccination
The vaccination status against COVID-19 vaccination was significantly correlated with Education (r = -0.067, p<0.05). The details can be seen in Table 6 .

Discussion

Understanding the public perception of COVID-19 is crucial for effective public health management, policymaking, communication, and addressing the social and economic impacts of the pandemic. It can influence public health outcomes by affecting peoples’ adherence to preventive measures, such as wearing masks, social distancing, and vaccination. It can also impact policymaking decisions and help policymakers develop appropriate responses to address the social and economic impacts of the pandemic. Furthermore, understanding the public’s concerns and beliefs can enable health officials and policymakers to communicate effectively and address misinformation and rumors that could lead to further confusion and fear .
Since the beginning of the COVID-19 pandemic, several studies have examined the public’s perception of the outbreak in Pakistan from various perspectives. For instance, Khyzar Hayat et al. conducted a rapid online survey within two weeks of the outbreak to assess the public’s general knowledge about it in different areas of Pakistan . Ot her studies by Taaha Muddassir Mirza et al. , Muhammad Arslan Iqbal et al. , Narendar KUMAR et al. , Saadullah Khattak et al. , Sammina Mahmood et al. , and Zoya Fatima Rizwan Ladiwala et al. have examined the Pakistani public’s knowledge, perception, and preventive measures regarding COVID-19. Muhammad Junaid Tahir et al. have investigated the attitudes of the Pakistani population toward COVID-19 vaccination. This rеsеarch aimеd to providе a comprеhеnsivе undеrstanding of thе Pakistani public’s perception of COVID-19 and thе impact of еducation on thеir pеrcеption of thе pandеmic.
Concerning sample distribution in this study, age is a critical factor, as it may influence participant’s level of knowledge and cognitive abilities; therefore, our findings confirmed the intimate link between age and knowledge, corroborating with previous studies’ findings . Furthermore, the large proportion of educated participants in this study suggests a potential correlation between higher levels of education, and improved perception and knowledge of COVID-19. Educated individuals are likely to have higher critical thinking and access to information resources, resulting in greater awareness, comprehension of health hazards and preventive measures . Additionally, the fact that the overwhelming majority of the participants resided in urban areas suggests that their experience and perception may differ from those living in rural areas. Moreover, individuals with a higher socioeconomic status were found to possess greater knowledge about the diseases, display optimistic attitudes, and engage in reasonable practices to prevent their spread . Interestingly, no significant association was observed between gender and perception, susceptibility to complications, and relationship with influenza, which is opposite to what was mentioned by Hayat et al. , and Mahmood et al. . These findings suggest that gender may not significantly determine an individual’s knowledge and attitudes about COVID-19. However, further research is needed to explore other potential factors that may influence individuals’ perceptions and behaviors related to the disease, especially in cities where females have no right to pursue their high education unless under special circumstances.
Since the onset of the COVID-19 pandemic, numerous hypotheses have emerged regarding its origin. Of particular intеrеst is thе contеntion that SARS-CoV-2 virus was laboratory еnginееrеd as part of an еffort to producе an AIDS vaccinе. Another hypothesis suggested that the virus may have been inadvertently released by a trainee at the Wuhan Institute of Virology in China. These conjectures have contributed to the notion that COVID-19 is a laboratory-manufactured bioweapon . In contrast, the belief that COVID-19 has a bacterial origin, despite its acronym indicating a viral origin, suggests that a substantial portion of the population still lacks awareness about the COVID-19 acronym and its corresponding meaning. The COVID-19 pandemic has also been approached through a religious lens . Since Pakistan has a predominantly Muslim population, participants were queried about their perspective on whether COVID-19 represents a divine punishment. Half of the participants (50%) affirmed that they believed COVID-19 to be a punishment from God. This outcome highlights the importance of spirituality in Pakistan.
Furthermore, half the participants (50.2%) believed the virus may have been transmitted to humans from an animal host. This perspective is supported by scientific evidence indicating that bats serve as the primary reservoir hosts of SARS-CoV-2 . However, it does not necessarily suggest that COVID-19 can directly transmit to humans from animals, particularly bats. Similarly, a significant proportion (56.7%) maintained that COVID-19 is nothing more than a toxic gas that solely affects the respiratory system rather than a microbial organism. These findings imply that a lack of adequate medical knowledge may impair the public’s capacity to comprehend scientific news or that the scientific reports presented on social media may not be sufficiently comprehensible for general publicity.
Regarding the prevalence of the COVID-19 pandemic, it is noteworthy that as of 12:37 am CEST, 26 April 2023, the World Health Organization has reported 764,474,387 confirmed cases of COVID-19, with 6,915,286 recorded deaths globally . Despite this, a significant majority of the participants (75.7%) believed COVID-19 could be fatal. Nevertheless, a minority (33.8%) believed it was not an excessively severe life-threatening affliction. These outcomes suggest that despite the high global mortality rate, many individuals may lack awareness of the fatal effect of COVID-19 or express skepticism regarding the reliability of global health authorities and statistical data. Taking it all together suggests that knowledge promotion could contribute to the relative success of future public health measures enforced in Pakistan.
This research also assessed participants’ knowledge of COVID-19 disease susceptibility. Based on the results, it is suggested that participants have linked the severity and life-threatening consequences of COVID-19 with elderly individuals, possibly due to their perception of the higher vulnerability of this population group. This perception is consistent with previous studies that have reported higher susceptibility to COVID-19 in older adults , pregnant women , , or those with chronic co-morbidities , including cancer and transplantation patients . However, it is important to note that COVID-19 can affect individuals of all ages , and younger individuals can also experience severe symptoms and complications, in particular, mentally and financially . This highlights the need for continued public health efforts to promote accurate information about COVID-19 susceptibility, effective prevention measures, and treatments, particularly among those who may be less informed or have limited access to information. By raising awareness about the potential risks of COVID-19 for all age groups and providing accurate information about prevention and treatment, public health officials can help to mitigate the spread of the disease and reduce the incidence of severe complications.
Regarding prophylaxis and preventive measures against COVID-19, most participants showed an acceptable understanding with high adherence to preventive measures, including using masks and hand sanitizers to minimize the risk of infection. In contrast, exceeding half of the participants have used or recommended specific medications such as antibiotics and chloroquine or suggested self-protection, despite the lack of evidence to support these claims, indicating a potential lack of awareness about the risk and benefits of medications. The findings obviously indicated the participants have mixed up the use of drugs for prophylaxis or treatment purposes. This delusion led the participants to recommend some prescription-required medications, such as antibiotics, antiviral, anticoagulants, and steroids. Such drugs are intended for prophylactic use and require specialized medical supervision. The misuse of such medications can result in severe or even lethal consequences that could be more harmful than the pandemic itself. These findings emphasize the critical need to increase participants’ health education and improve their health knowledge, especially regarding over-the-counter (OTC) medications and their appropriate use. People must be educated that non-specialized individuals should not recommend specific medications to others, and the general public should be aware of the potential risks and benefits of medications and consult medical professionals for guidance.
The results suggest that people have a good understanding of the similarities between COVID-19 and seasonal influenza. They also showed acceptable knowledge regarding the vaccine priorities. These findings underscore the importance of targeted health education campaigns to address vaccine hesitancy and improve public knowledge about the benefits of COVID-19 vaccination.

Conclusion and limitation

In conclusion, the present study provides valuable insights into the perception of the Pakistani public regarding various aspects of COVID-19; the findings highlight the importance of continued public health efforts to promote and ensure access to effective prevention measures, particularly in vulnerable populations who may face barriers to obtaining protective equipment. The study also highlights the critical demand for sustained public education initiatives that advocate accurate knowledge about COVID-19 susceptibility, effective prevention measures, and treatments, especially for less informed people or those with limited information access.
Furthermore, participants’ knowledge of the disease’s nature, the causative organism, and the risk of complications showed the experience accumulated from previous outbreaks, such as SARS and H1N1. These outcomes will significantly implicate policy development and health interventions that aim to improve the efficiency of COVID-19 prevention measures in public.
Nevertheless, some limitations have been claimed to this study, including the use of an online survey and self-reported data, in which individuals with no internet access or have discomfort using online platforms may be excluded, resulting in biased samples, as they might hold opinions that differ than those who participated. The study also relied on self-reported data subject to social desirability or recall bias. Some individuals may provide inaccurate responses based on socially acceptable behaviors rather than their own beliefs, which may influence the study’s ultimate conclusion.
Moreover, further research is required to investigate other potential factors that may influence public perceptions and behaviors toward the pandemic, especially in regions where females may encounter challenges to pursue higher education, unless under special circumstances. Less educated individuals may have implications for the generalizability of the study findings, as they may have different perceptions and behaviors toward the COVID-19 pandemic than educated individuals. Therefore, to ensure the applicability of the findings across various demographic groups and geographic regions, future studies should consider incorporating a broader range of populations from different ages, levels of education, and geographic locations.

DATA AVAILABILITY STATEMENT

Data sharing is not applicable to this article as no new data were created or analysed in this study.

ETHIC STATEMENT

Not applicable.

References