Self-reported adherence to such coronavirus-curbing behaviors as physical distancing fell substantially—while mask wearing rose significantly—from spring to fall 2020, regardless of US Census region, according to a research letter published late last week in JAMA.

The study, led by scientists from Johns Hopkins University, analyzed responses to 16 waves of the national Coronavirus Tracking Survey from Apr 1 to Nov 24, 2020. The respondents were recruited from the University of Southern California’s Understanding America Study, an ongoing nationwide panel of US residents.

The researchers asked all participants to complete a survey every 14 days on 16 evidence-based nonpharmaceutical interventions (NPIs) vulnerable to COVID-19 pandemic fatigue, or apathy due to prolonged coronavirus-related isolation, uncertainty, and disruptions. Participants were provided with internet-connected tablet computers if they didn’t have a way to access the survey website.

The authors scored the responses by creating an NPI adherence index that adds the number of self-reported protective behaviors during the week before the survey, with scores ranging from 0 to 100, with higher scores indicating better compliance.

Among the 7,705 participants who completed all survey waves, the NPI index showed peak compliance at the beginning of the pandemic (70.0 in early April), a leveling off in June (high 50s), and a slight climb to 60.1—but still much lower than in the spring—at the end of the survey in November.

Midwest sees largest drop in compliance


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