Over 40% of Americans reported misleading others about their Covid-19 infection or vaccination status or not adhering to safety precautions, according to a new study published in JAMA Network Open—a problem that the researchers said "contributes to prolonging the pandemic."

How well did Americans follow Covid-19 safety measures?

For the study, researchers sent out 2,260 emails between Dec. 8 and Dec. 23, 2021, to U.S. adults asking them to participant in an online survey about Covid-19 and their adherence to safety precautions during the pandemic. In total, 1,733 participants were included in the final sample.

Among the participants, the mean age was 41, two-thirds were women, and two-thirds were white. Roughly a third said they considered themselves Democrats, and a little over 25% said they were Republicans.

Overall, 27.5% of participants said they were confident they had been infected by the coronavirus at some point during the pandemic, and 53% said they had received at least one dose of a Covid-19 vaccine.

When it came to getting information about Covid-19, 62% said they turned to their physician while 53% said CDC, and 51% said their local health department. A small portion of participants said they turned to a specific population (7%) or a specific celebrity (5%) to get information.

In the survey, 41.6% of participants said they had either misrepresented their Covid-19 or vaccination status or did not adhere to certain safety precautions, such as quarantine rules or getting tested for Covid-19 when they thought they were sick.

Other examples of misrepresentation or nonadherence included:

• Not mentioning they thought or knew they had Covid-19 to someone they were with or about to be with in-person
• Not mentioning they thought or knew they had Covid-19 when being screened to enter a public place
• Telling someone they were vaccinated when they were not
• Telling someone they were not vaccinated when they were
• Telling someone they did not have to quarantine when they were supposed to

"COVID-19 safety measures can certainly be burdensome, but they work," said Andrea Levy, a professor of social sciences at Middlesex Community College in Connecticut and the study's co-lead author. "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.

In general, participants under the age of 60 and those who had a greater distrust of science were more likely to reporting misrepresentation or nonadherence. However, the researchers did not find any association between Covid-19 misrepresentation and education level, political party affiliation, attitude towards vaccines, race or ethnicity, or religion.

Participants who reported misrepresentation or nonadherence described several reasons for their behavior, including a desire for normality, not believing Covid-19 was real, and feeling that it was no one's business but their own.

"Some individuals may think if they fib about their COVID-19 status once or twice, it's not a big deal," said Angela Fagerlin, chair of the department of population health sciences at University of Utah Health and the study's senior author. "But if, as our study suggests, nearly half of us are doing it, that's a significant problem that contributes to prolonging the pandemic."

"It's a real phenomenon; we see it all around us every day," said Dirk Sostman, president of the Houston Methodist Academic Institute, who was not involved in the study. "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."

However, Sostman noted that since population immunity has increased, the risks are now lower and "non-compliance has lesser potential consequences than it once did," meaning people are "more likely to bend the rules."

The researchers also acknowledged potential limitations of the study, including that the sample was not fully representative of the U.S. population and the fact that the findings may be prone to bias and "should be interpreted with caution."

Overall, "[t]his study goes a long way toward showing us what concerns people have about the public health measures implemented in response to the pandemic and how likely they are to be honest in the face of a global crisis," said Alistair Thorpe, the study's co-author and a post-doctoral researcher in the department of population health sciences at University of Utah Health. "Knowing that will help us better prepare for the next wave of worldwide illness." (Hamza, MedPage Today, 10/10; Levy et al., JAMA Network Open, 10/10; Dollemore, University of Utah Health, 10/10)