‘I Didn’t Think COVID-19 Was Real’: Why 40% Misled During the Pandemic

Three in five Americans say they either misled others about their COVID-19 infection or vaccination status, or didn’t follow pandemic-related public health measures, a new study indicated.

In a survey involving over 1,700 respondents, 41.6% suggested they either misrepresented and/or did not adhere to at least one of nine survey items, most commonly 24.3% saying they were taking more precautions than they really were and 22.5% who said they broke quarantines, reported Andrea Levy, PhD, MBE, of Middlesex Community College in Middletown, Connecticut, and colleagues.

Other frequently cited examples of non-adherence included people avoiding testing when they had or thought they might have COVID (21%), and not mentioning that they had or might have COVID-19 during screening at doctors’ offices (20.4%), the group wrote in JAMA Network Open.

“COVID-19 safety measures can certainly be burdensome, but they work,” Levy said in a press release. “When people are dishonest about their COVID-19 status or what precautions they are taking, it can increase the spread of disease in their community.”

“For some people, particularly before we had COVID vaccines, that can mean death,” Levy added.

People most commonly cited a desire to feel normal or to exercise their personal freedom as reasons for their misrepresentation or non-adherence. Other reasons included:

• I didn’t think COVID-19 was real, or it was no big deal
• It’s no one else’s business
• I didn’t feel sick
• I was following the advice of a celebrity or other public figure
• I couldn’t miss work to stay home

“Some individuals may think if they fib about their COVID-19 status once or twice, it’s not a big deal,” said coauthor Angela Fagerlin, PhD, of the University of Utah in Salt Lake City, in a statement. “But if, as our study suggests, nearly half of us are doing it, that’s a significant problem that contributes to prolonging the pandemic.”

People tended to be more likely to be adherent or truthful the older they were: ages 18-29 (OR 4.87, 95% CI 3.27-7.34); ages 30-39 (OR 3.16, 95% CI 2.16-4.70), ages 40-49 (OR 2.59, 95% CI 1.73-3.92), ages 50-59 (OR 2.09, 95% CI 1.35-3.25).

Exploratory analyses suggested that misrepresentation/non-adherence was more common among those with a greater distrust for science (OR 1.14, 95% CI 1.05-1.23).

“It’s a real phenomenon; we see it all around us every day,” Dirk Sostman, MD, president of the Houston Methodist Academic Institute, told MedPage Today.

“Our country was founded on a philosophy of individual liberty, and in many spheres of life we tend to err on the side of allowing one person’s liberty to infringe on another person’s safety,” said Sostman, who was not involved in this study.

But he noted that with increasing levels of population immunity, the stakes are lower and “non-compliance has lesser potential consequences than it once did.”

“Since the risks are lower and people want to put fear and restrictions behind them, they are more likely to bend the rules,” explained Sostman.

For their study, Levy’s group sent a total of 2,260 emails from Dec. 8-23, 2021 to U.S. adults to participate in an online survey (with an 80% response rate). The final sample included 1,733 participants, of which 27.5% were confident they’d been infected with COVID-19 at some point, and 53% had received at least one dose of vaccine.

Mean participant age was 41, two-thirds were women, and two-thirds were white. About a third considered themselves democrats, and a little more than a fourth were republicans. No significant relationships were observed between misrepresentations/non-adherence and gender identity, political affiliation, vaccination attitude, race/ethnicity, education level, and mask use in stores.

In response to who people turned to for a source of COVID-19 information, 62% said their physician, 53% said the CDC, 51% their local health department, while 7% said a certain population and 5% a certain celebrity.

“People really listen to public figures about this stuff, so we need to leverage that,” said Levy. “We also need to do things like improve access to testing and make staying home from work in quarantine more financially feasible.”

The authors acknowledged limitations to the data: the sample was not fully representative of all U.S. individuals and the findings may be prone to bias and “should be interpreted with caution,” the researchers noted.