Public perceptions of non-adherence to pandemic protection measures by self and others: A study of COVID-19 in the United Kingdom

PLoS One. 2021 Oct 28;16(10):e0258781. doi: 10.1371/journal.pone.0258781. eCollection 2021.


Background: Novel viral pandemics present significant challenges to global public health. Non-pharmaceutical interventions (e.g. social distancing) are an important means through which to control the transmission of such viruses. One of the key factors determining the effectiveness of such measures is the level of public adherence to them. Research to date has focused on quantitative exploration of adherence and non-adherence, with a relative lack of qualitative exploration of the reasons for non-adherence.

Objective: To explore participants' perceptions of non-adherence to COVID-19 policy measures by self and others in the UK, focusing on perceived reasons for non-adherence.

Methods: Qualitative study comprising 12 focus groups conducted via video-conferencing between 25th September and 13th November 2020. Participants were 51 UK residents aged 18 and above, reflecting a range of ages, genders and race/ethnicities. Data were analysed using a thematic approach.

Results: Participants reported seeing an increase in non-adherence in others over the course of the pandemic. Reports of non-adherence in self were lower than reports of non-adherence in others. Analysis revealed six main themes related to participants' reported reasons for non-adherence in self and others: (1) 'Alert fatigue' (where people find it difficult to follow, or switch off from, information about frequently changing rules or advice) (2) Inconsistent rules (3) Lack of trust in government (4) Learned Helplessness (5) Resistance and rebelliousness (6)The impact of vaccines on risk perception. Participants perceived a number of systemic failures (e.g. unclear policy, untrustworthy policymakers) to strongly contribute to two forms non-adherence-violations and errors.

Conclusion: Findings suggest that latent and systemic failures-in the form of policy decisions that are commonly experienced as too changeable, inconsistent and confusing, and policy makers that are commonly perceived as untrustworthy-may play a significant role in creating the conditions that enable or encourage non-adherence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / prevention & control
  • COVID-19 / psychology*
  • Female
  • Focus Groups
  • Humans
  • Male
  • Middle Aged
  • Pandemics / prevention & control
  • Patient Compliance / psychology*
  • Physical Distancing
  • Public Health / methods
  • Public Health / trends*
  • Public Opinion
  • SARS-CoV-2 / pathogenicity
  • Surveys and Questionnaires
  • United Kingdom

Grant support

This research was supported by the Manchester Centre for Health Psychology based at the University of Manchester (£2000) and Swansea University’s ‘Greatest Need Fund’ (£3000). The funders played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.