Abstract
Risk perception and consequently engagement in behaviors to avoid illness often do not match actual risk of infection, morbidity, and mortality. Unrealistic optimism occurs when individuals falsely believe that their personal outcomes will be more favorable than others' in the same risk category. Natural selection could favor overconfidence if its benefits, such as psychological resilience, outweigh its costs. However, just because optimism biases may have offered fitness advantages in our evolutionary past does not mean that they are always optimal. The current project examined relationships among personal risk for severe COVID-19, risk perceptions, and preventative behaviors. We predicted that those with higher risk of severe COVID-19 would exhibit unrealistic optimism and behave in ways inconsistent with their elevated risk of morbidity and mortality. Clinical risk scores for severe COVID-19 were calculated and compared with COVID-19 threat appraisal, compliance with shelter-in-place orders (March 13–May 22, 2020) and travel restrictions, compliance with public health recommendations, and potential covariates like self-rated knowledge about COVID-19 in a robust dataset including 492 participants from McLennan County, TX, USA. While those with high clinical risk acknowledged their greater likelihood of experiencing severe illness if infected, they actually reported lower perceived likelihood of becoming infected in the first place. While it is possible that those with higher clinical risk scores truly are less likely to become infected, the pattern and significance of these results held after controlling for possible occupational exposure, household size, and other factors related to infection probability. Higher clinical risk also predicted more recent travel within Texas and lower distress during the pandemic (i.e., feeling less stressed, depressed, and helpless). Additional behavioral data suggested that those with higher clinical risk scores did not generally behave differently than those with lower scores during the shelter-in-place order. While unrealistic optimism may provide some short-term psychological benefits, it could be dangerous due to improper assessment of hazardous situations; inferring that optimism bias has evolutionary origins does not mean that unrealistic optimism is “optimal” in every situation. This may be especially true when individuals face novel sources (or scales) of risk, such as a global pandemic.
Highlights
The spread of the SARS CoV-2 virus since late 2019 has generated a public health crisis, creating economic uncertainties (Pak et al, 2020), interrupting well-established food supply chains (Rizou et al, 2020), and resulting in large scale hospitalizations and deaths (Meyerowitz-Katz and Merone, 2020; Reese et al, 2020; Weinberger et al, 2020)
This project was based on a repeated sampling protocol of targeted clusters of individuals that varied by exposure risk: those working in healthcare, essential service employees, employees in businesses and other organizations that reopened in May, and those who had claimed to strictly follow shelter-in-place and all public health recommendations
While individuals with a high clinical risk score seemed to acknowledge their elevated likelihood of experiencing severe COVID-19 if infected, they reported lower perceived risk of becoming infected in the first place
Summary
The spread of the SARS CoV-2 virus since late 2019 has generated a public health crisis, creating economic uncertainties (Pak et al, 2020), interrupting well-established food supply chains (Rizou et al, 2020), and resulting in large scale hospitalizations and deaths (Meyerowitz-Katz and Merone, 2020; Reese et al, 2020; Weinberger et al, 2020). The SARSCoV-2 virus transmitted rapidly around the globe, resulting in millions of cases of COVID-19 disease. This serious and persistent threat remains, individuals’ perceptions of risk and, their engagements in behaviors to avoid illness (e.g., wearing face coverings, social distancing, hygiene) have often not matched their own actual degree of risk of infection, morbidity, and mortality. We sought to build on these findings by examining relationships among individuals’ personal risk for severe COVID-19 disease, risk perceptions, and preventative behaviors in a large community cohort. We calculated clinical risk scores for severe COVID-19 disease and compared them to individuals’ own perceptions of their risk. Combining insights from the evolutionary and cognitive sciences, we predicted that those with a high clinical risk for severe COVID-19 disease would exhibit unrealistic optimism, characterized by an underestimation of their personal vulnerability and behaving in a manner inconsistent with their elevated risk of morbidity and mortality
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