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The Office for National Statistics (ONS) have released the latest data looking at the behaviour of individuals required to self-isolate after testing positive for COVID-19.
Dr Simon Williams, Lecturer in Psychology, Swansea University, said:
“The ONS results on self-isolation are quite reassuring, however there are a few issues to bear in mind.
“Although adherence to self-isolation in this report was very high, at 80%, data were collected when it was still a legal requirement. We can expect that the proportion of people with COVID-19 voluntarily self-isolating will drop now that the legal requirement to do so has been removed.
“On the plus side, the ONS data show how willing people have been to self-isolate when required to do so, even after nearly two years of the pandemic. The 80% adherence figure is similar to the figure reported in previous ONS surveys and to figures reported in other research, including, for example our Swansea University research and research from Public Health Wales, which also found that adherence was around 80% earlier in the pandemic. This suggests that when asked to self-isolate most people have been willing to do so – a remarkable effort by the public.
“The intention to self-isolate in future is also encouraging. 70% suggest they will still self-isolate if they are infected with COVID-19 even though it is not now legally required in England. This shows most people still want to do what they can to help limit transmission of the virus.
“However, we cannot take this at face value. In psychology we have good evidence for what is called the ‘intention-action gap’. This is where, although people often have good intentions around behaviours – like eating more healthily, quitting smoking, or indeed self-isolating – they do not always follow through, or rather, are not always able to follow through. As far as self-isolation is concerned, there are a number of threats to future adherence.
“For example, the removal of rules sends a signal or message that the behaviour is not as important as it once was. As such we might expect future adherence to decline. We have seen, and are again seeing, this with mask-wearing in England – as soon as mask rules are removed, overall adherence quickly drops.
“Also, other research over the pandemic has shown that one of the big challenges with self-isolation has not so much been getting people to self-isolate once they have been officially instructed to by contact tracers, but rather with the bigger, overall picture of getting people to identify Covid symptoms, take a test and then self-isolate. Going forward encouraging and supporting people to recognise Covid symptoms, and isolate from symptom-onset until they test negative, will be an important challenge.
“It is also encouraging to see that many people, roughly two-thirds, intend to carry on buying tests, including those who are living in the most deprived areas. However, we may also see an intention-action gap here. How many people will actually buy tests when they experience symptoms? Firstly, continuing free testing for a little while longer would likely see higher proportion of people testing overall. Also, it is arguably unfair to expect those on the lowest incomes – many of whom have higher occupational exposure to COVID-19 – to be able to afford tests compared to those on higher incomes. Free or subsidised tests for those on the lowest incomes would likely increase the number of people testing in the more deprived communities and help to reduce the intention-action gap.
“The ONS data also shows that mental health and wellbeing are a priority going forward. Although for some the pandemic, including the experience of self-isolation, will have temporary or even short-lived negative effects on mental health for others this maybe longer lasting and support resources will need to help people recover from the stress and isolation of the pandemic.
“On the methods used in the research: It is also worth bearing in mind that, as the researchers note, the survey has a relatively small sample size. This means that we should not necessarily assume it is reflective of the population as a whole. One of the issues noted was that the overall response rate was 18%. In other words, we don’t know for sure what the other 82% were doing or feeling, and whether adherence would be as high in a different or larger sample. One concern with this, like a lot of research on COVID-19 behaviours, is that those who choose to respond to interviews or surveys are perhaps more likely to either be compliant, or are more likely to say they have been compliant – that is, self-selection bias and social desirability bias. In other words, it’s hard to know whether there are people out there who are less compliant but who also don’t want to fill in a survey or respond to an interview to say they broke the rules.
“In short, the results of this are overall encouraging and show how motivated people have been to self-isolate to reduce the spread of COVID-19 even after nearly two years of the pandemic. Going forward we need government to provide enough support to enable people to follow through with their good intentions.”
Prof Robert Dingwall, Professor of Sociology, Nottingham Trent University, said:
“I would be cautious about some of these findings. ONS surveys are greatly respected but they are not immune from problems of interpretation and social desirability bias.
1. When people report that they would ‘self-isolate’, do they literally mean that they would minimize contact with other household members or simply ‘stay at home if symptomatic’, which now seems to be the dominant message. Ordinary people are not specialists in infection control and do not necessarily understand professional terminology in the same way.
2. Would people test, and test even if they had to pay for it? We have to think of the counterfactual answer here. To what extent are people going to admit to intending to do something that might not seem to be socially desirable. How easy is it to say no to these questions, even if the survey is anonymous? Social scientists are always concerned about the likely gap between words and deeds, especially when the deeds involve finding your way to a test supplier when you feel unwell and handing over money.
3. Will people self-isolate without a legal requirement? The same issues as 2 above. When asked about intentions, social desirability is always a factor to take into consideration when assessing the responses.
4. It is not surprising that self-isolation has mental health effects. There are good reasons why prison systems employ solitary confinement as an exceptional punishment and why its use is carefully regulated in countries with humane values. Self-isolation at home may involve less sensory deprivation but it is still a limitation on things that seem to be important to the mental health of humans, especially if strictly understood – see 1 above. The well-documented high level of transmission within households suggests that it has rarely ever been interpreted as narrowly as infection control might have intended. If so, a shift to ‘stay home if symptomatic’ may not make much practical difference. However, the mental health impact should be explicitly weighed in the balance when considering to what extent we should actively seek to control a generally mild respiratory infection with measures beyond those that have been historically thought justified.”
All our previous output on this subject can be seen at this weblink:
www.sciencemediacentre.org/tag/covid-19
Declared interests
None received.