A team of scientists from the University of California, Los Angeles, USA, recently conducted a survey investigating the association between availability of testing facilities and coronavirus disease 2019 (COVID-19)-related behavioral aspects. Their findings reveal that testing unavailability independently influences certain COVID-19-related behaviors that may increase the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. The study is currently available on the medRxiv* preprint server.
Since its emergence in December 2019, the highly transmissible SARS-CoV-2 has infected 125.6 million individuals and claimed 2.7 million lives globally. Despite implementing strict control measures, such as wearing face masks, washing hands, maintaining social distancing, and restricting movement, an exponential rise in COVID-19 trajectory has been observed in many countries, especially the USA. The main reasons for such non-stoppable viral transmission are testing unavailability and inadequate self-isolation.
Several studies conducted during the COVID-19 pandemic and other viral outbreaks have revealed that the self-isolation behavior of the general population can be influenced by certain factors, including demographics, vulnerability, fear, and political beliefs. Moreover, evidence suggests that COVID-19 testing unavailability can directly modulate certain behaviors, which eventually increase the risk of viral spread.
In the current study, the scientists have conducted an online survey to investigate the relationship between COVID-19 testing availability and behavioral intents to self-isolate.
The scientists used an online survey platform to select and enroll participants. Only adult US residents were eligible for the survey. During the survey, the participants were asked to imagine being present in one of the three hypothetical situations: 1) no testing facility is available for COVID-19 confirmation; 2) participants test positive for COVID-19; and 3) participants test negative for COVID-19.
One feature was common in all three hypothetical situations, i.e., at the beginning of the survey, all participants were asked to imagine that they are experiencing COVID-19-related symptoms; they are clinically diagnosed with COVID-19 by physicians; and physicians have advised them to self-isolate.
Using an 11-item risky behavior score, the scientists assessed the intentions of participants to engage in COVID-19 inappropriate behaviors.
A total of 1,194 participants completed the survey. Specifically, there were 401, 390, and 403 participants in the testing unavailable group, positive test result group, and negative test result group, respectively.
Regarding the association between COVID-19 test results and behavioral intentions, the survey findings revealed that the unavailability of testing facilities significantly influenced the participants to engage in COVID-19 inappropriate high-risk behaviors compared to those with a positive diagnosis. According to the behavioral scores, this negative influence was associated with an 11% increase in high-risk behaviors facilitating the viral spread. Similarly, a 39% increase in high-risk behavior was observed for participants with a negative test result compared to those with a positive test result.
In the survey, the scientists also explored other factors, including gender, ethnicity, political affiliation, educational level, and residence type, that may influence behavioral intentions. The statistical analyses performed to investigate these factors revealed that male participants were more likely to engage in high-risk behaviors than female participants. Similarly, participants with a “poor” health status were found to be less likely to engage in high-risk behaviors than those with an “excellent” health status.
Regarding political affiliation, a 27% increase in high-risk behavior was observed for Republicans compared to Democrats. Regarding intentions to vote or participate in large-scale political gatherings, participants with a positive test result showed lower intention to vote in-person; whereas, participants with a negative test result showed higher intention to engage in political rally/protest.
The study highlights the potential influence of testing unavailability on the behavioral intentions of individuals to engage in high-risk activities that can significantly increase the viral spread. Interestingly, the findings reveal that having a negative confirmatory test result significantly increases risky behavioral intentions even for those who are experiencing COVID-19-related symptoms and clinically diagnosed with COVID-19 by physicians. Such changes in intentions could be detrimental for others owing to the possibility of a false-negative test report.
Based on the survey findings, the scientists believe that risky behavioral intentions can be reduced by improving public perception about the disease severity and the importance of protective measures.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.