During the height of the COVID-19 pandemic, 4 of 10 Americans didn't follow public health measures or lied about being compliant, mostly because they wanted life to feel normal and exercise their personal freedoms, reveals a survey published yesterday in JAMA Network Open.
A team led by researchers from Middlesex Community College in Connecticut and the University of Utah analyzed the responses of 1,733 adult Americans to an online survey fielded from Dec 8 to 23, 2021.
Questions assessed rates of nine different kinds of misrepresentation and lack of adherence to COVID-prevention measures, virus-related beliefs, and demographic factors. Screening questions allowed an even distribution of participants who had been infected with COVID-19, were not infected but were at least partially vaccinated, and were not infected and were unvaccinated.
Average participant age was 41 years, 66.0% were women, 66.4% were White, and 27.1% had at least a bachelor's degree.
Youth, greater distrust of science as factors
A total of 41.6% of respondents said they misrepresented or didn't following at least one public health measure, while 24.3% told someone they were with or about to be with that they were taking more COVID-19 precautions than they were, 22.5% broke quarantine rules, 21.5% avoided getting tested when they thought they might be infected, and 20.4% didn't disclose suspected or confirmed infection when entering a doctor's office.
The most common reasons for ignoring guidelines were wanting life to feel normal and desiring to exercise personal freedom. Other reasons cited include thinking COVID-19 was a hoax or not a major issue, believing that their behavior was no one else's concern, not having symptoms, following the advice of a celebrity or other public figure, not wanting to miss work to quarantine, and not wanting someone to judge or think badly of them.
Significantly higher odds of misrepresentation or nonadherence to at least one measure were seen in people younger than 60 years (eg, odds ratio [OR] for 18- to 29-year-olds, 4.87) and those with greater distrust of science (OR, 1.14).
"Greater disbelief in science has been an important factor associated with nonadherence to health behaviors during the pandemic (eg, masking, vaccination uptake) and beyond," the researchers wrote. "These groups may represent an important focus for efforts to address misrepresentation and nonadherence."
Roughly 60% of participants reported seeking advice from a doctor on COVID-19 prevention or treatment. There was no link between COVID-19 untruthfulness and political beliefs or affiliation or religion.
Consequences of dishonesty
The authors noted that while public health measures can dramatically quell the spread and impact of disease, they can have substantial psychological, social, financial, and physical costs that can threaten adherence.
"Future work is needed to examine strategies for communicating the consequences of misrepresentation and nonadherence and to address contributing factors," they wrote.
In a University of Utah news release, co-first author Andrea Gurmankin Levy, PhD, of Middlesex Community College, said that COVID-19 dishonesty can lead to greater transmission of the virus in communities. "For some people, particularly before we had COVID vaccines, that can mean death," she said.
Senior author Angela Fagerlin, PhD, of the University of Utah, said that some people may think dodging the truth about COVID-19 once or twice is no big deal. "But if, as our study suggests, nearly half of us are doing it, that's a significant problem that contributes to prolonging the pandemic," she said in the release.
Co-first author Alistair Thorpe, PhD, of the University of Utah, said the study shows the likelihood of public honesty in the face of a global crisis. "Knowing that will help us better prepare for the next wave of worldwide illness," he said.