Compared to others of same age & gender, they believed they were unlikely to experience a range of controllable (eg accidentally infect/ be infected) & uncontrollable (eg need hospitalization/ intensive care treatment) COVID‐19‐related risks in the short term

Comparative optimism about infection and recovery from COVID‐19; Implications for adherence with lockdown advice. Koula Asimakopoulou  et al. Health Expectations, September 27 2020. https://doi.org/10.1111/hex.13134

Rolf Degen's take: https://twitter.com/DegenRolf/status/1310560848943906820

Abstract

Background: Comparative optimism, the belief that negative events are more likely to happen to others rather than to oneself, is well established in health risk research. It is unknown, however, whether comparative optimism also permeates people’s health expectations and potentially behaviour during the COVID‐19 pandemic.

Objectives: Data were collected through an international survey (N = 6485) exploring people’s thoughts and psychosocial behaviours relating to COVID‐19. This paper reports UK data on comparative optimism. In particular, we examine the belief that negative events surrounding risk and recovery from COVID‐19 are perceived as more likely to happen to others rather than to oneself.

Methods: Using online snowball sampling through social media, anonymous UK survey data were collected from N = 645 adults during weeks 5‐8 of the UK COVID‐19 lockdown. The sample was normally distributed in terms of age and reflected the UK ethnic and disability profile.

Findings: Respondents demonstrated comparative optimism where they believed that as compared to others of the same age and gender, they were unlikely to experience a range of controllable (eg accidentally infect/ be infected) and uncontrollable (eg need hospitalization/ intensive care treatment if infected) COVID‐19‐related risks in the short term (P < .001). They were comparatively pessimistic (ie thinking they were more at risk than others for developing COVID‐19‐related infection or symptoms) when thinking about the next year.

Discussion: This is the first ever study to report compelling comparative biases in UK adults’ thinking about COVID‐19 We discuss ways in which such thinking may influence adherence with lockdown regimes as these are being relaxed in the UK.

4 DISCUSSION

On the basis of these data, we suggest that UK adults who meet the demographic characteristics of our sample display comparative optimism concerning many aspects of COVID‐19. Where participants showed comparative optimism its pattern was consistent with earlier findings showing that comparative optimism is stronger for controllable than for uncontrollable events.6, 7 Our participants overwhelmingly believed that as compared to people of their age and gender, they were somewhat or extremely unlikely to have accidentally infected people with COVID‐19 in the past and to infect others or get infected themselves in the next month. They were also comparatively optimistic, but to a lesser extent, about their likelihood of getting hospitalized due to COVID‐19, finding themselves in an ICU, being ventilated, and making a full recovery.

In contrast, participants showed comparative pessimism about COVID‐19 infections in the more distant future. As compared to the average person of their age and gender they felt likely to get infected by COVID‐19 in the next year and to develop COVID‐19‐related symptoms. This pattern is inconsistent with earlier findings showing greater comparative optimism for events that are further in the future than for nearer events.21, 22 However, such a finding supports earlier research that shows that people who have experienced some ill health tend to unduly exaggerate their future risk of experiencing further ill health.23 One important difference between COVID‐19 and other risks is that controlling the pandemic was very much placed in the hands of individuals restricting their lives in the UK—as seen in the slogan urging people to ‘Stay at home’. It is reasonable that participants would reason that in the long term, staying at home would be less possible, plausible or practical.11 Feeling that compliance with social distancing rules cannot be maintained indefinitely may thus explain these perceptions, in line with research showing that high prevalence negative events may engender comparative pessimism.24

We have thus established the presence of comparative optimism in relation to both controllable and uncontrollable aspects of COVID‐19. We have also found comparative pessimism concerning future infection and symptom development. Both comparative optimism and comparative pessimism may have important consequences for people’s psychological well‐being and their likelihood of engaging in risk behaviours or responding to further lockdown measures.

If people believe COVID‐19 ‘will not happen to me any time now’ or that they are unlikely to have infected others in the past or to do so in future, they may be more relaxed about lockdown advice. In an effort to make people look beyond their own risk (which for some age and gender groups may be lower than for other groups), most governments, including the UK government, have focused their communication about social distancing rules on how much these protect against infecting others. Unfortunately, having infected others and infecting others in the future are precisely the aspects of COVID‐19 on which we found the strongest comparative optimism—people think it is unlikely these will happen to them.

Equally, for people reporting comparative optimism for present and past COVID‐19 infection, these beliefs could fuel resistance to give up on lockdown—because to do so will place them amongst the very same ‘average others’ who—like them—have been unsuccessful in controlling the pandemic. Given that we have now established comparative optimism in relation to COVID‐19, future work should systematically explore how this thinking may influence behavioural outcomes such as returning to school, work and normal life.

There are limitations of this study which, although do not detract from the generalizability of the findings, should be noted. Firstly, the sample was predominantly White. Although this pattern is typical of wider online survey taking behaviour,20 it may well not represent the views of other ethnic groups. Our sample was also predominantly female, although that may be less of a limitation; our findings showed no gender differences in two subscales, entirely in line with previously reported work.3 The sole difference we observed involved men showing less comparative pessimism and thus being relatively more optimistic than women concerning their long term risk. If anything, then, our study may have underestimated comparative optimism by sampling fewer men. A further limitation of our study is that our participants have self‐selected to participate and that we have no means of estimating the participation rate. This is a methodological issue in all surveys conducted on‐line that use a sampling approach similar to ours. We are therefore confident that our results are no less robust and valid than other appropriately powered surveys in the field; the pattern of comparative optimism and pessimism that we have found is very much in line with patterns reported in previous work in the field of comparative optimism, and which used a range of recruitment strategies, response rates and methods of inquiry.2, 3

On the basis of the above, we conclude that UK adults may be comparatively optimistic about the chances of coming to harm due to COVID‐19 at the moment or having caused harm themselves previously. Future research is needed on the implications of comparatively optimistic thinking for future compliance with government guidelines on managing COVID‐19.