Understand how we got here — and how to move forward.


December 7, 2020

Map: Are your state's residents social distancing?

Daily Briefing

    Surveys show that rates of social distancing among Americans dropped significantly leading up to this fall, when the country started seeing another surge in new coronavirus cases, hospitalizations, and deaths, Rob Stein reports for NPR's "Shots."

    How Covid-19 is changing the future of the health care industry

    How adherence to coronavirus countermeasures has changed throughout the year

    According to Stein, researchers at Northeastern University, Harvard University, and Rutgers University in April began conducting monthly surveys about the novel coronavirus pandemic, with each survey including about 20,000 U.S. adults.

    For a new report, the researchers analyzed the responses from 139,230 of survey participants across all 50 states and Washington, D.C., looking in particular at how respondents' reported adherence to mask wearing and social distancing—two measures intended to curb the novel coronavirus's spread—have changed over the past several months.

    The researchers wrote that respondents' adherence to the mitigation measures "decreased dramatically" leading up to the fall.

    Findings on social distancing measures

    For example, the researchers found that the percentage of respondents who reported being in a room with people who didn't live in their household within the previous 24 hours increased from 25% in April to 45% in October. In addition, the percentage of respondents who reported that they went to a café, bar, or restaurant increased from 5% in April to 15.9% in November, the researchers found.

    Further, the researchers discovered that reported adherence to four behaviors CDC recommends to stop the novel coronavirus's spread—avoiding contact with others, avoiding crowded or public places, washing your hands frequently, and disinfecting surfaces—all hit their lowest points in October.

    The researchers provided each state with an overall score based on a "social distancing index" (SDI), which they created to gauge adherence by averaging standardized values of eight social distancing variables for each state. States' SDI scores largely decreased—meaning respondents less likely to report adhering to social distancing measures—as the year progressed.

    Based on states' SDI rankings, the researchers determined that Vermont had the highest adherence to social distancing this fall, while Wyoming had the lowest.

    The researchers identified some disparities among different groups' reported adherence to coronavirus mitigation measures. For example, the researchers found that women were more likely to report adhering to social distancing than men, and Asian Americans and African Americans were more likely to report adhering to social distancing than white respondents. In addition, respondents who were older and more educated were more likely to report social distancing than those who were younger and less-educated.

    Still, in the researchers' latest survey—which included responds from 19,766 adults throughout the United States—the researchers found that, generally, respondents were "supportive of taking stronger measures to prevent the spread of Covid-19," David Lazer, a professor of political science at Northeastern and one of the survey's co-authors, told Stein.

    Findings on mask wearing

    Unlike reported adherence to social distancing measures, the researchers found that reported mask wearing increased from the spring to the fall and has held steady, with about 77% of respondents saying they very closely adhered to mask recommendations in November.

    The researchers provided state-level break downs based on percentages of respondents who reported adhering to mask wearing throughout the spring, summer, and fall, and they found that those percentages largely increased as the year progressed.

    The researchers determined that Hawaii had the highest percentage of people wearing masks in the fall, while Wyoming had the least.


    According to Lazer, the findings shows that Americans "let our guard down" while the novel coronavirus "was still lurking."

    "It was still there, right. And Covid-19 came roaring back" in the fall, he said.

    However, Lazer added, "[t]he good news here is, there is a collective desire to do what's necessary to keep the disease at bay."

    Similarly, Jeffrey Shaman, an infectious disease researcher at Columbia University, said, "Overall it is encouraging to see how many people want to take this seriously." But Shaman said he believes the United States "need[s] to have both leadership about what we're doing and how we are going to be confronting this going forward" (Stein, "Shots," NPR, 12/2; Lazer et al., "Report #26: Trajectory of Covid-19-Related Behaviors," The Covid States Project, November 2020).

    How Covid-19 is changing the future of the health care industry


    Read on to get Advisory Board's take on how Covid-19 will reshape demand, purchaser strategies, the competitive landscape, and delivery models.

    Get our Take

    Have a Question?


    Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.