At the peak of the pandemic, many people did not tell the whole truth about their health status and behavior. Nearly half surveyed admitted that they had cheated on COVID-19 preventive behaviors or misled others about their status.
The Whole Truth About the Survey:
Investigators conducted an online survey of 1,733 Americans in December 2021 (JAMA Network Open, Oct. 10, 2022). At that time, both the pandemic and the associated polarization continued. The researchers included roughly equal numbers of people in three groups. People who had had COVID made up the first group. The second was comprised of those who had not had COVID and were vaccinated. Finally, the third group contained those who had experienced neither vaccinations nor COVID infections.
What Did People Fib About?
The authors write in JAMA Network Open that public health measures designed to flatten the curve rely on people following them. Nevertheless, some people in the survey said they did not disclose a recent or active COVID infection prior to an in-person visit. Others failed to tell a physician’s office or clinic that they had symptoms of COVID or thought they might have the infection. Withholding the whole truth about a possible infection allows the virus to spread from person to person more readily.
Vaccination and Quarantine Behaviors:
Unvaccinated people sometimes claimed to have been vaccinated, while others who were supposed to quarantine represented that they were exempt from quarantine. The investigators also asked whether people sometimes broke quarantine rules. In general, survey respondents often suggested to others that they were taking more precautions than was the case.
How People Justify Not Telling the Whole Truth:
Respondents justified their actions on the basis that they wanted to exercise personal freedom in some cases. In others, they stated that they didn’t think COVID-19 was real, and therefore didn’t warrant taking inconvenient precautions. Another reason that most people can relate to is that respondents who withheld the whole truth wanted life to feel more normal. People who did not feel “sick” rationalized interacting with others on the grounds that the infection was no big deal. They may not have realized that some of those in their circle of contacts might suffer a severe infection.
According to the investigators, younger people and those who professed less belief in science were more likely to have misrepresented themselves. Many other factors were not relevant, including gender identity, educational attainment and political party affiliation.
Unfortunately, failing to follow precautions and not informing others accurately can aid the spread of the virus and may speed transmission of future variants or viruses. Public health measures work only when most people observe them.
As the investigators conclude,
“The results of this survey study reveal a serious public health challenge for the COVID-19 pandemic and any future infectious disease outbreaks. With misrepresentation and nonadherence regarding public health measures being fairly common, the effectiveness of these measures in preventing disease spread may be undermined.”
A Question of Definitions:
These survey results are quite separate from another question that has relevance for public health. We have noted that most of our family and friends define themselves as being careful about precautions. They are telling the whole truth, and yet their behavior may differ in some details. For some people, masking is the epitome of caution, while for others it is vaccination. Still others never venture into a public space indoors. Exactly how we define “careful” may have important consequences, too, but we are not always explicit about those definitions.
