In the COVID-19 pandemic, who did we trust? An eight-country cross-sectional study.

Background: Trust is a key determinant of health, but has been undermined by the COVID-19 pandemic and the associated infodemic. Using data from eight countries, we aimed to epidemiologically describe levels of trust in health, governments, news media organisations, and experts, and measure the impact of political orientation and COVID-19 information sources on participant's levels of trust.

Methods: We simultaneously conducted a stratified randomised online cross-sectional study across eight countries on adults aged ≥18 years between 6 and 18 November 2020. We employed crude and adjusted weighted regression analyses.

Results: We included 9027 adults with a mean age of 47 years (range = 18-99), of whom 4667 (51.7%) were female. Trust in health experts ranked highest across all countries (mean (x̄) = 7.83; 95% confidence interval (CI) = 7.79-7.88), while trust in politicians ranked lowest (x̄ = 5.34; 95% CI = 5.28, 5.40). In adjusted analyses, political orientation and utilised information sources were significantly associated with trust. Individuals using higher levels of health information sources trusted health authorities more than those using lower levels (mean difference = 1.12; 95% CI = 1.02, 1.14). Similarly, individuals using higher levels of government information sources (mean difference = 1.55; 95% CI = 1.43, 1.64) and those using higher levels of new media information sources (mean difference = 1.17; 95% CI = 1.06, 1.28) had highest trust in governments/politicians and news media, respectively. However, there was little difference in trust in health, government, or news media between individuals using higher or lower levels of social media information sources.

Conclusions: Trust is a key determinant of health, but has been politically fragile during this infodemic. High compliance with public health measures is key to combatting infectious diseases. In terms of people's trust, our findings suggest that politicians and governments worldwide should coordinate their response with health experts and authorities to maximise the success of public health measures.