As SARS-CoV-2 variant strains emerge and vaccine supplies remain uncertain, the need to mask, social distance, and use other nonpharmaceutical interventions (NPIs) is critical.

“Reports describe an increasing attitude of apathy or resistance toward adherence to NPIs, termed pandemic fatigue,” the authors of a recent research letter noted. “To better describe this phenomenon in the U.S., we used national surveillance data to analyze reporting of adherence to protective behaviors identified as NPIs.”1

More People Are Masking

The researchers analyzed U.S. household survey responses to the University of Southern California’s Understanding America Study. In the USC study, 8,000 participants were asked twice monthly if they were practicing NPIs, including physical distancing, frequent handwashing, and wearing a mask. The data were collected and analyzed from April 1 to Nov. 24, 2020.2

The biggest increase was in mask-wearing, which rose from 39% to 89% over the period. However, some of that could be surveillance artifact, as the survey asked the respondents whether they had worn a mask in the last week. That means a person may have worn a mask as required to enter a business but was noncompliant in voluntary situations.

Combat Pandemic Fatigue

“This study found a decrease in reported adherence to NPIs overall and to most individual NPIs during the pandemic, irrespective of geography,” the authors concluded. “The increase in reported mask-wearing aligns with other national surveys of self-reported mask use, and may reflect improved public health messaging. Strategic approaches to combating pandemic fatigue have been proposed, such as precision in government mandates and consistent communication from authorities.”


  1. Crane MA, Shermock KM, Omer SB, et al. Research letter: Change in reported adherence to nonpharmaceutical interventions during the COVID-19 pandemic, April-November 2020. JAMA 2021. doi:10.1001/jama.2021.0286. [Online ahead of print].
  2. University of Southern California. Understanding America Study.