INSTITUTE FOR POLICY RESEARCH

Surveys Reveal New Insights on Masks, At-Home Test Kits, and Misinformation

N95 masks are seen as better, but most still wear cloth; at-home test kits are likely causing case undercounts

• More than a quarter of those surveyed remain unsure if N95s offer more protection than cloth masks.
• Up to 6% of adult COVID-19 cases are not being counted due to the use of at-home test kits.
• Of the healthcare workers surveyed, 73% point to social media, and Facebook in particular, as a leading source of COVID-19 misinformation for patients. 

As the Biden administration moves to contain the latest ravaging wave of COVID-19 by providing Americans with 1 billion COVID-19 self-test kits and 400 million N95 masks for free, new survey data reveal how many are wearing masks, including which types, and how at-home COVID tests are likely leading to undercounts of those contracting the virus.

These data could shed light on how Americans might—or might not—use these forthcoming masks and tests in the fight to stop COVID-19. They also underscore how doctors and nurses see the misinformation spread via social media as the No. 1 source undermining decisions to get vaccines.

Most See N95 Masks as More Protective, But Only 1 in 5 Wears One

Data collected between December 22 and January 10 from a total of more than 17,000 Americans on mask use finds that two-thirds (66%) have correctly understood that N95 masks provide more protection than cloth masks, yet only 1 in 5 reports wearing one.

Startlingly, more than one-quarter (26%) of the more than 2,000 surveyed on recommended masks remain unsure if N95s offer more protection than cloth masks. Overall, 64% of all respondents say they still wear cloth masks as well as gaiters, bandanas, and scarves. (Respondents could pick more than one type of mask.) Nine percent say they never wore a mask.

“This lack of accurate information likely reflects a mix of poor communication, confusion on what masks are called, and exhaustion from having to process additional protective measures,” said IPR political scientist James Druckman, who co-led the survey conducted between December 22 and January 10. IPR graduate research assistants Jennifer Lin and Caroline Pippert, who are getting their PhDs in political science, also worked on the surveys. 

The researchers from Northwestern, Harvard, Northeastern, and Rutgers show the numbers of Americans wearing masks plunged from a high of 80% in winter 2020–21 to a low of 50% over summer 2021 after the Centers for Disease Control and Prevention (CDC) declared that wearing a mask was no longer necessary. The rate has nudged up following each wave of a new variant, rising to 56% in December 2021 as omicron became dominant.

The data also highlight that many remain confused by the CDC’s messaging on masks.

Of the individuals surveyed on CDC recommendations, most (54%) think the CDC recommends N95 masks for all Americans, but the survey was taken before the CDC changed its guidance for wearing N95s, KN95s, and other more protective masks to a “preferred choice” instead of a “recommendation” on January 14. Cloth masks remain recommended by the CDC.

Those who incorrectly believe that the CDC has recommended N95s are more likely to be Democrats (60%), high earners (65%), vaccinated (59%), college educated (58%), and White (55%). But between 71% and 75% of these groups and Americans over the age of 65 recognize that N95s offer more protection than cloth masks.

“It will be interesting to see if confusion declines as the administration distributes more masks and works on more consistent messaging,” Druckman said.

Read the report.

Up to 6% of Adult Cases Not Counted Due to Use of At-Home Test Kits

In another survey of nearly 11,000 respondents conducted between December 27 and January 15, the researchers asked about COVID-19 testing and the use of at-home test kits. Of those surveyed,

• 63% report they had been tested for COVID-19 either in a testing facility or using an at-home test;
• 18% confirm they tested positive for COVID at least once; and
• 4% say they tested positive using a rapid antigen test at home. 

Of the 4% who tested positive with rapid at-home test kits, more than one-third disclosed they did not go in for a follow-up test at either their doctor’s office or a testing facility. The researchers estimate that around 6% of such cases are missing from official government counts, and that number could continue to grow as at-home testing increases.

“This is a meaningful result insofar as it suggests an undercount of official COVID-19 numbers, which also could mean inaccurate planning that uses projected case counts,” Druckman said.

The demographics of these undercounted adults skew towards those who use at-home tests more—respondents who are younger, richer, college-educated, and Democrats. 

Read the report.

Healthcare Workers Pinpoint Facebook as a Key Source of Vaccine Misinformation

Beyond understanding what Americans believe about masks and tests in the COVID era, the data also point to how misinformation continues to fuel the virus’ spread as people take decisions about whether to get vaccinated or to seek care for it.

“It is well understood that COVID-19 misinformation is present in social media,” Druckman said. “Our data suggest this has clear consequences for public health.”

From November 3 to December 3, the researchers surveyed 545 healthcare workers to understand the role they believe misinformation plays in patients’ healthcare decisions.

A sizable majority say misinformation is a negative influence on patients’ decisions either to get vaccinated (72%) or to seek care (71%) once they fall ill with COVID. And one-third called such misinformation an “urgent” problem and the single most important factor influencing decisions to not get vaccinated.

When asked about the sources of misinformation, healthcare workers point to social media (73%) as the No. 1 source of misinformation, followed by family and friends (64%). Only about a third of them identified cable news (33%) or local and network news (32%) as sources.

Diving into the responses of the 405 who identified social media or apps as sources of misinformation, 84% of them overwhelmingly point to Facebook first, with Instagram (48%), YouTube (46%), Twitter (45%), and TikTok (42%) rounding out the top five.

“The identification of Facebook as the top source is consistent with other work that suggests Facebook is a platform that correlates with lower vaccine rates,” Druckman said. “All the platforms are aware of the misinformation problem, but it is a difficult issue to address given financial incentives and free speech considerations.”

Read the report.

James Druckman is the Payson S. Wild Professor of Political Science and IPR associate director and fellow. Jennifer Lin and Caroline Pippert are IPR graduate research assistants and PhD students in political science.

Photo credit: Pexels, CDC

Published: January 21, 2022.