What factors influence symptom reporting during an emerging infectious disease outbreak? A rapid review of the evidence

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Abstract
Introduction: During any emerging infectious disease outbreak, people with symptoms of the illness are often asked to report their symptoms to the health service in a timely manner, to facilitate contact tracing. Numerous factors may influence an individual’s willingness to report these symptoms. Understanding these factors has become urgent during the COVID-19 pandemic. Objective: To determine which factors influence symptom reporting during an emerging infectious disease outbreak. Methods: We conducted a rapid review of the evidence. We included papers based on primary research; published in a peer-reviewed journal; written in English; included factors associated with symptom reporting or accessing healthcare; and related to a major public health incident involving an infectious disease outbreak. Main results: Five themes were identified as facilitators of symptom reporting or accessing healthcare: accurate and informative communication; symptom severity; concern about exposure; ease of access; and relationship with the healthcare provider. Seven themes were identified as barriers of symptom reporting or accessing healthcare: lack of knowledge; fear; stigmatization; invasion of privacy; low concern about symptoms; economics; and practicalities of attending a healthcare facility. Discussion & Conclusion: If contract tracing services are to be effective, members of the public need to have the capability, opportunity and motivation to use them. The themes identified should be used to evaluate the information provided to the public about such a service, the routes of access, and the underlying policies relating to the service, in order to ensure that as many people as possible with relevant symptoms will make contact.
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