Just over 40 percent of 1,733 adult respondents admitted to breaking quarantine rules or misrepresenting the preventative measures they were taking to reduce viral spread.
A quarter of respondents told someone they were with – or intended to be with – that they were taking more precautions to avoid contracting SARS-CoV-2 than they were in reality.
Meanwhile, 22.5 percent confessed to breaking quarantine rules, and 21 percent avoided testing for COVID-19 even when they suspected they might have it.
When entering a doctor's office, 20 percent of those who completed the survey said they omitted mentioning if they thought they had, or knew they had the virus.
There are multiple reasons respondents gave for their dishonesty and non-compliance.
Some wanted their lives to feel 'normal'. Others wanted to exercise their freedom, or they believed personal information on their state of health was private.
Many said they were following guidance from a public figure they trusted, whether that be a politician, scientist, news presenter, or celebrity.
When vaccine requirements were later enstated in numerous states and businesses, many respondents admitted to lying about their vaccination status.
Reasons included: "I didn't think COVID-19 was real", "I didn't think COVID-19 was a big deal", "I didn't want someone to judge or think badly of me", and "I needed to be able to attend college classes".
"Some individuals may think if they fib about their COVID-19 status once or twice, it's not a big deal," says population health scientist Angela Fagerlin from the University of Utah.
"But if, as our study suggests, nearly half of us are doing it, that's a significant problem that contributes to prolonging the pandemic."
The goal of the survey was to figure out where the US might have gone wrong when it came to handling COVID-19, and one of the authors, Alistair Thorpe, recognizes in a video accompanying the study that there are systemic factors that influence dishonesty and noncompliance among the public.
The COVID-19 pandemic has shown the world how important it is to create clear, consistent and achievable public health measures. It's also essential to ensure the public understands the consequences if these measures are not followed.
In New Zealand, for instance, an online survey published last year found that the nation's super-strict lockdown gave many people a greater sense of positive mental health.
The community spirit and cohesion exhibited during these trying times tended to relieve people of stress. Taking actionable measures to reduce the spread of COVID-19 also appeared to give the public a greater sense of control.
"This reasoning highlights the crucial role of clear government messaging," researchers of the New Zealand survey wrote.
"The New Zealand government provided daily updates on case numbers, recoveries, and testing; the high transparency received international recognition."
The US government handled the coronavirus outbreak in a very different way. On 3 February 2020, the Trump administration declared a public health emergency. By March 13, the spread of a novel coronavirus was deemed a national emergency and a travel ban was put into place for non-residents flying from Europe.
For two months, from late April to late June, the White House Coronavirus Task Force did not hold a press briefing.
During this time, testing and quarantining requirements were left up to individual states, and in many cases, stay-at-home orders were suggestions, not mandatory.
One of the biggest problems was a lack of financial relief for those who couldn't work from home. Employers in the US are also not federally required to provide sick leave, forcing many with the virus to leave home to receive a paycheck.
Under these conditions, not disclosing a positive COVID-19 test is not necessarily due to a lack of care, or a preference for personal freedom over the health of others.
For instance, 38 percent of respondents said they couldn't miss a work engagement to stay at home. Meanwhile, 33 percent of respondents said they broke quarantine because they were confused about the rules for meeting face-to-face.
The fact that many respondents didn't think of COVID-19 as a big deal also suggests a communication breakdown between experts and the public that needs to be remedied in the future.
The online sample is not fully representative of the entire US, but it is one of the largest sample sizes on the topic to date. Obviously, it's hard to fully trust survey respondents when they are already admitting to lying in the past, but the findings do suggest that honesty is a serious public health challenge that needs to be addressed in the US, and likely elsewhere, too.
The findings have researchers calling for more studies on what strategies can best educate the public on the importance of honesty and adherence to public health measures.
"It also underscores the importance of public health officials, policymakers, and media personalities fostering trust and engagement in these public health measures to reduce the occurrence and therefore the impact of misrepresentation and non-adherence," the team concludes.
The study was published in JAMA Network Open.