COVID testing programmes have potential to increase risky behaviour: Study

Some jurisdictions employed frequent, forced surveillance testing to try to regulate COVID-19, but current research reveals that such testing may have the unintended result of boosting riskier behaviour in individuals who participate.

According to the results of surveys performed by economists at the University of Wyoming, students who participated in frequent COVID-19 testing at two campuses engaged in more behaviour known to raise the risk of transmitting the virus than they could have otherwise.

“Recent research provides some evidence that people increase risky behavior in response to facemask wearing and vaccines, but this is the first study to examine the behavioral responses to mandatory testing,” wrote researchers Chian Jones Ritten, Linda Thunstrom and Todd Cherry, of UW, and J.D. Wulfhorst, of the University of Idaho. “Overall, (our) results suggest that students perceived that the mandatory testing policy decreased their risk of contracting COVID-19, and that this perception led to higher participation in COVID-risky events.”

The findings were published in PNAS Nexus, an open access sister publication of the renowned Proceedings of the National Academy of Sciences, on Friday.

During the fall 2020 semester, all on-campus undergraduate students were obliged to be tested for COVID twice weekly, whereas the University of Idaho tested a small random sample of students weekly. Masks were mandatory for all indoor activities at both campuses.

The researchers polled students at both campuses and discovered that those who were tested more regularly believed they were less likely to get the virus. These people also went to more “risky” activities, such as big and small interior parties, and visited restaurants and bars.

From a public health standpoint, such behavior is problematic because inaccurate and delayed test results can result in people who believe they’re not infected carrying the virus and infecting others. Although perhaps unlikely, it is possible that the benefits of testing programs could be entirely offset by increased viral transmission, the researchers say.

While other research shows that, in other contexts, this type of risk compensation behavior is generally small in magnitude, small behavioral changes may lead to meaningful increases in disease spread.

“These unintended consequences may pose a particularly large threat to public health when incubation times are short, the virus is highly transmissible and the risk of false negatives is high, such as with the Omicron variant of the coronavirus,” the researchers wrote.

Interestingly, the surveys found that women, more than men, perceive that increased testing reduces the risk of contracting the virus — and are, thus, more likely to increase risky behavior than men.

Overall, the research shows that mandatory testing programs should be accompanied by mitigation measures to reduce the unintended consequence of people engaging in riskier behavior, the researchers say.

“Our findings suggest that programs with frequent testing may unintentionally increase behavior known to contribute to virus spread — the potential consequences of which are amplified by the exponential nature of viral spread,” the researchers concluded. “Thus, when implementing mandatory testing programs to manage a pathogen, it is important to communicate the programs’ limitations in protecting against infection and highlight the potential for unintended behavioral responses.”