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04 November 2020

People who thought they'd had COVID-19 were less likely to follow April lockdown rules

New research from King’s College London reveals an individual’s beliefs about whether or not they’d had COVID-19 influenced how likely they were to follow lockdown rules early in the pandemic.

Digital sign on the side of an empty road reading 'stay home, essential travel only'

The study, led by researchers at King’s Institute of Psychiatry, Psychology & Neuroscience (IoPPN), found that nearly a quarter of people surveyed thought they had had COVID-19, and subsequently were less likely to report that they had followed early pandemic lockdown measures and were less worried about COVID-19. They were also less likely to identify two key symptoms of COVID-19: coughing and a high temperature.

The researchers say these findings suggest that beliefs about having had COVID-19 are an important influence on people’s behaviour and engagement with lockdown rules. These findings have been published today in PLOS ONE.

A representative sample of 6,149 people aged over 18 were surveyed online between the 20th and 22nd April 2020, at the height of lockdown restrictions in the UK. At this time, COVID-19 antigen testing (which identifies whether someone is currently infected with COVID-19) was only available to frontline workers such as healthcare staff.

Participants were asked whether they thought they had had COVID-19, and how often in the last 7 days they had left their home for various reasons, including whether they had visited family and friends not in their household. The lockdown rules then stated that people must stay at home except to shop for essentials, exercise once a day, care for a vulnerable person, or go into work if they couldn’t work from home. Participants were also asked whether they thought they were immune to COVID-19, how worried they were about COVID-19, to what extent they thought COVID-19 posed a risk to themselves and other people, and what the common symptoms of COVID-19 were.

24% of participants thought they had had COVID-19, which is significantly higher than official estimates of infection rates in the population in April. Only 9% of participants reported having an antigen test for the virus. A significant percentage (57%) of those who received a negative test nonetheless believed that they had had COVID-19.

Of people who thought they had COVID-19, 42% believed they had immunity against the virus, and 28% reported recently meeting up with family and friends against lockdown rules. Comparatively, only 9% of people who didn’t think they had had COVID-19 met up with family and friends.

There were significant differences in behaviour between people who thought they had had coronavirus and those who thought they had not had coronavirus. People who thought they had had coronavirus reported going out more for shopping and to meet friends and family who they did not live with, which was not allowed at that point in the pandemic.

Study first author Dr Louise Smith, senior research associate in the NIHR Health Protection Research Unit for Emergency Preparedness and Response (HPRU EPR) at King’s College London

Dr Smith added ‘As we still don’t know if you are immune to coronavirus or if you can spread it after having caught it, it is especially important to make sure that everyone adheres to measures put in place to prevent the spread of the virus, regardless of whether you think you’ve already had coronavirus’.

Despite believing they had had COVID-19, only 47% of this group correctly identified COVID-19 symptoms, compared to 64% of people who didn’t think they had had the virus. This suggests that people may have been misdiagnosing themselves with COVID-19.

The authors highlight that this survey was carried out relatively early in the pandemic, and may not reflect people’s behaviour in the current situation.

Almost a quarter of people surveyed thought they had had coronavirus. This is much higher than the estimate for that time from the Office for National Statistics and is especially high given the early stage of the pandemic.

Senior author Dr James Rubin, assistant director of the HPRU EPR at King’s College London

He continued, ‘I suspect a lot of people were remembering flu or common colds that they had had earlier in the year and were assuming that must have been COVID. As we go through the winter, this confusion may pick up again. People shouldn’t assume they are immune – the official guidance is that any time you have a new continuous cough, a fever or lose your sense of taste or smell you should self-isolate and get a test.’

The paper is available online here.

Contact: For interviews or any further media information please contact Louise Pratt, Head of Communications, IoPPN: / +44 7850 919020

In this story

James Rubin

Professor of Psychology & Emerging Health Risks