Abstract

Background: The COVID-19 outbreak early 2020 was followed by an unprecedented package of measures. The relative calmness of the pandemic early 2022 provides a momentum to prepare for various scenarios.Objectives: As acceptance of COVID-19 measures is key for public support we investigated citizens' preferences towards imposing measures in four scenarios: 1) spring/summer scenario with few hospitalizations; 2) autumn/ winter scenario with many hospitalizations; 3) a new contagious variant, the impact on hospitalizations is un-clear; 4) a new contagious variant, hospitalizations will substantially increase.Methods: Study 1 comprised a Participatory Value Evaluation (PVE) in which 2011 respondents advised their government on which measures to impose in the four scenarios. Respondents received information regarding the impact of each measure on the risk that the health system would be overloaded. To triangulate the results, 2958 respondents in Study 2 evaluated the acceptability of the measures in each scenario.Results: Measures were ranked similarly by respondents in Study 1 and 2: 1) the majority of respondents thought that hygiene measures should be upheld, even in the spring/summer; 2) the majority supported booster vacci-nation, working from home, encouraging self-testing, and mandatory face masks from scenario 2 onwards; 3) even in scenario 4, lockdown measures were not supported by the majority. Young respondents were willing to accept more risks for the health system than older respondents.Conclusion: The results suggest that policies that focus on prevention (through advising low-impact hygiene measures) and early response to moderate threats (by scaling up to moderately restrictive measures and boos -tering) can count on substantial support. There is low support for lockdown measures even under high-risk conditions, which further emphasizes the importance of prevention and a timely response to new threats. Our results imply that young citizens' concerns, in particular, should be addressed when restrictive COVID-19 measures are to be implemented.