Citizens’ Perceptions of Ethical Issues in COVID-19 Containment: A Quantitative Cross-Country and Cross-Cultural Study

COVID-19 has forced policy-makers to impose measures affecting citizens' fundamental rights without public consultation. This study examines citizens’ perceptions of such measures in four countries, focusing on how moral foundations and socio-demographic factors shape differing views. A survey was conducted in April-October 2021 in The Netherlands (NL), Italy (IT), Indonesia (ID) and Kenya (KE), with questions on citizens’ agreement with containment measures, plus the Moral Foundation Theory questionnaire. Univariable and multivariable multinomial logistic regression analysis was performed to examine associations between agreement levels and moral foundations/socio-demographic factors. Agreement with the government approach was at 47% in NL, 21% in IT, 58% in ID and 26% in KE. Most participants agreed with a full lockdown in NL (61·3%), IT (58·8%) and ID (82·5%) but not in KE (36·1%). Being religious increased the probability of agreeing with most containment measures. The moral foundations of care, fairness, and sanctity-purity were positively associated with the likelihood of agreeing with all measures but restricting hospital visits. Containment measures were perceived differently based on country, morals, and background. More focus is needed on the potential influence of socio-cultural contexts and overlooked dynamics when designing and communicating these measures.