New Quest Diagnostics Health Trends™ Survey Reveals COVID-19 Testing Hesitancy Among Americans, With 3 of 4 Avoiding a Test When They Believed They Needed One

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12/09/2020 - 08:03 AM

SECAUCUS, N.J., Dec. 9, 2020 /PRNewswire/ -- A new Quest Diagnostics Health Trends™ study finds that three in four Americans who believed they needed a COVID-19 test (74%) chose not to get one, or delayed getting one, primarily due to concerns about exposure to the SARS-CoV-2 virus (30%).

The nationally representative survey was conducted online by The Harris Poll on behalf of Quest Diagnostics (NYSE: DGX) between November 10-12, 2020, among 2,050 U.S. adults. This survey is believed to be the first to evaluate attitudes about COVID-19's impact on medical care and testing since the recent fall-winter wave of COVID-19 cases began to sweep across the United States.

The findings suggest large numbers of Americans are putting off medical care they may need – including COVID-19 diagnostic lab tests as well as preventative and chronic care – due to fears and other barriers, with likely long-term consequences for patients and the U.S. healthcare system.

Among the key findings:

Of those Americans who believed they needed a COVID-19 test, 74% chose not to get or delayed getting one. The primary reason was concern about exposure to the virus (30%); with others citing that they thought it was very unlikely they had COVID-19 (21%); concerns over having to quarantine while waiting for results or if they were positive (15%); and cost (15%). Lab testing for COVID-19 is an important tool in preventing COVID-19 disease spread, given that as many as 40% of infected individuals may lack symptoms and not know they are infected and able to pass the infection to othersⁱ
A larger proportion of Hispanic/Latinx adults (83%) vs. Whites (non-Hispanic) (72%) and Blacks (72%) chose to avoid or delayed getting a diagnostic COVID-19 test when they believed they needed one.
Black Americans, who are overrepresented among America's essential workforce, who have been disproportionately affected by the pandemic and are more likely to be in essential jobs that put them at exposure risk, found greater access to testing even more important: specifically, 73% of Blacks compared to 55% of Whites feel greater access is "absolutely essential" or "very important" to slow the pandemic.

"Our Health Trends data show that while most Americans understand the vital role testing plays in helping to control the COVID-19 pandemic, people are scared of exposure to the virus. This fear keeps them from getting tested when they believe they needed it, and out of the doctor's office for routine care and treatment," said Harvey W. Kaufman, M.D., Senior Medical Director, Head of the Health Trends Research Program for Quest Diagnostics. "Those who are concerned about exposure should discuss their concerns with their healthcare provider or local health department, so that they can access a test, if appropriate, and other important health care services."

Delayed Health Care during Pandemic Could Lead to Surge of Chronic Disease and Non-COVID-19 Health Conditions and Emergencies

In the meantime, while they await a vaccine, Americans revealed deep concerns about undiagnosed and worsening chronic health conditions during the pandemic. Worries about exposure to the virus are at the top of the list of reasons why U.S. adults have avoided or delayed in-person health care (53%), but many of them also recognize that forgoing this care has now led to other health problems, like greater stress about a health condition (31%), delayed treatment (23%) or diagnosis (18%) and worsening symptoms (17%).

At the same time, Americans' reluctance to maintain routine or preventive medical visits due to the pandemic could lead to a wave of non-COVID-19 health conditions once the pandemic abates or a vaccine is distributed.

According to the findings:

The majority of U.S. adults (60%) have skipped or delayed some in-person medical treatments or appointments during the COVID-19 pandemic, in particular, Hispanic/Latinx adults (67%) (compared to 59% White and 58% Black). About one in five Americans (22%) skipped or delayed blood work or lab testing specifically.
Over a third of Americans do not plan to resume attending in-person medical treatments and appointments until the pandemic is under better control (39%) or until a vaccine is available (33%).
One in two Americans (51%) said that only a severe illness or injury would motivate them to seek in-person medical care during the COVID-19 pandemic.
Nearly one in three Americans who have a chronic health condition (31%) said their condition had gotten worse since the pandemic began and two in five Americans (41%) are somewhat/very concerned that they may currently have an undiagnosed health condition.
Current attitudes toward delaying care are also supported by Quest Diagnostics lab data. According to other Health Trends™ research, the rate of cancer diagnoses across six common cancer types decreased by 46% between March 1 and April 18, 2020, during the COVID-19 pandemic.ⁱⁱ And the rate of diabetes (hemoglobin A1c) testing declined by as much as 66% during approximately the first two months of the pandemic, compared with the previous year.ⁱⁱⁱ

Women and Parents Have Borne the Brunt of the Pandemic's Impact

More women than men say COVID-19 has negatively impacted their mental (49% of women vs. 36% of men), financial (42% vs. 37%) and physical health (33% vs. 26%).

Meanwhile, parents of children under 18 years of age are more likely to have delayed in-person medical treatment or appointments during the pandemic: 71% have delayed an appointment, compared to 54% of those who don't have children under age 18. Specifically, parents are more likely than those without children under age 18 to have delayed or skipped:

An annual physical exam (31% vs. 22%)
Blood work/lab testing (30% vs. 18%)
Preventative vaccinations or screenings (24% vs. 12%)

Dr. Kaufman continued, "With a vaccine likely not making its way to the general public until spring at the earliest, the healthcare community needs to do a better job of helping Americans get back to routine care now. Early diagnosis can save lives and putting off preventative care and chronic disease treatment could make the difference between life and death. Chronic diseases take a toll on the body each day. Delays in diagnosis and treatment will cause, for many people, irreversible damage, require more aggressive and less effective treatments, and contribute to a higher death rate. As Benjamin Franklin advised, 'An ounce of prevention is worth a pound of cure.'"

Methodology

On behalf of Quest, The Harris Poll conducted an online survey of 2,050 adults 18 years and older across the United States from November 10-12, 2020. The survey sample included 337 Hispanic/Latinx, 265 Black and 1,278 White adults. Harris weighted figures for age by sex, region, education, household size, marital status and household income by race/ethnicity where necessary to make them representative of their actual proportions in the population. The Harris Poll is one of the longest running surveys in the U.S. tracking public opinion, motivations and social sentiment since 1963 that is now part of Harris Insights & Analytics, a global consulting and market research firm that delivers social intelligence for transformational times.

About Quest Diagnostics Health Trends™

Quest Diagnostics Health Trends™ is a series of scientific reports that provide insights into health topics, based on analysis of objective clinical laboratory data, to empower better patient care, population health management and public health policy. The reports are based on the Quest Diagnostics database of 48 billion de-identified laboratory test results, believed to be the largest of its kind in healthcare. Health Trends has yielded novel insights to aid the management of allergies and asthma, prescription drug monitoring, diabetes, Lyme disease, heart disease, influenza and workplace wellness. Quest Diagnostics also produces the Drug Testing Index (DTI)™, a series of reports on national workplace drug positivity trends based on the company's employer workplace drug testing data.
www.QuestDiagnostics.com/HealthTrends

About COVID-19 testing at Quest Diagnostics

Quest Diagnostics is at the forefront of the response to the COVID-19 pandemic, working to broaden access to laboratory insights to help us all lead healthier lives. We provide both molecular diagnostic and antibody serology tests to aid in the diagnosis of COVID-19 and immune response.  Through our team of dedicated phlebotomists, air fleet team, couriers and laboratory professionals, Quest Diagnostics works hard every day to help patients and communities across the United States access quality COVID-19 testing. 

For more information about the latest developments with our COVID-19 testing, visit: newsroom.questdiagnostics.com/COVIDTestingUpdates

About Quest Diagnostics

Quest Diagnostics empowers people to take action to improve health outcomes. Derived from the world's largest database of clinical lab results, our diagnostic insights reveal new avenues to identify and treat disease, inspire healthy behaviors and improve health care management. Quest annually serves one in three adult Americans and half the physicians and hospitals in the United States, and our 47,000 employees understand that, in the right hands and with the right context, our diagnostic insights can inspire actions that transform lives. www.QuestDiagnostics.com


ⁱ Centers for Disease Control. COVID-19 Pandemic Planning Scenarios. https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html. Accessed December 2020.
ⁱⁱKaufman HW, Chen Z, Niles J, Fesko Y. Changes in the Number of US Patients With Newly Identified Cancer Before and During the Coronavirus Disease 2019 (COVID-19) Pandemic. JAMA Netw Open. 2020;3(8):e2017267. doi:10.1001/jamanetworkopen.2020.17267
ⁱⁱⁱ Fragala MS, Kaufman HW, Meigs JB, Niles JK, McPhaul MJ. Consequences of the COVID-19 pandemic: reduced hemoglobin A1c diabetes monitoring [published online ahead of print June 29, 2020]. Popul Health Manag. doi:10.1089/pop.2020.0134