Many people still unwilling to comply with COVID-19 prevention behaviors

In a new study, researchers found that several U.S. cities may be at increased risk of surges in COVID-19 cases as they reopen their economies because their residents are unwilling to follow practices that reduce the spread of the disease.

They developed a survey to determine whether people were willing to follow key recommendations from the Centers for Disease Control and Prevention (CDC) in preventing the spread of COVID-19.

They found that there is a public lack of intent to comply with certain CDC recommendations in several parts of the United States.

As a result, these areas might be at increased risk for a surge in COVID-19 cases as quarantine restrictions ease.

The preliminary findings may cause concern for public health experts and government officials in certain regions.

The research was conducted by Penn State scientists.

In the study, people reported demographic information as well as their knowledge of and intent to comply with the CDC’s five recommendations for preventing COVID-19.

The recommendations are:

Wash your hands often (for 20 seconds or more);

Maintain social distancing/social isolation even if you have no symptoms;

Avoid touching your eyes, nose, and mouth (avoid touching your face);

Cough or sneeze into your elbow; and

Stay at home if you feel unwell. If you have a fever, cough and difficulty breathing seek medical attention and call in advance.

The global survey, available online in more than 23 languages, assesses public perceptions and compliance with COVID-19 health safety recommendations.

The team analyzed responses from more than 5,000 U.S. adults who completed the survey between April 9 and 15. They used three-digit zip code prefix areas to determine where the participants lived.

Respondents showed substantial, big differences in their intent to comply with CDC recommendations across different cities.

As compliance falls below 80%, the behaviors are less likely to be effective.

The team found a particularly low intent to comply with the recommendation they said is the most important—avoid touching your face.

Half or fewer of respondents from Atlanta, Minneapolis, Philadelphia, and Seattle said they intend to comply with that one measure.

While respondents indicated fairly high intent to comply with other recommendations, all of the cities surveyed had compliance near 80% for at least some of the other behaviors.

The team cautions that the actions of even one individual might undo the work of the majority of people who are following recommendations carefully.

For example, a person leaving home when they are experiencing COVID-19 symptoms may put others at risk for exposure.

The anonymous survey, which has been completed in every state in the U.S. and 70 countries, will remain open until July 9.

It takes about five minutes to complete and is available here.

The data may be used to help get people appropriate information from sources they trust to prevent the spread of COVID-19.

One author of the study is Dr. Robert Lennon, an associate professor of family and community medicine at Penn State College of Medicine.

The study will be published in HLRP: Health, Literacy, Research, and Practice.

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