Social Distancing in America: Understanding Long-term Adherence to COVID-19 Mitigation Recommendations

In the period from May to July, the United States repealed statewide and local lockdown measures, reopened society, and became the global leader in reported infections and deaths from the coronavirus COVID-19. During this timeframe, the country saw some of the largest civil rights protests in United States history, and increasing politicization of the pandemic leading up to the Presidential elections. Throughout these events, social distancing recommendations have remained in force. However, social distancing was no longer the focus of the public health response, and was largely overshadowed by face masks – despite evidence of its effectiveness for reducing virus transmission. This study examines to what extent Americans have continued to adhere to social distancing measures across these developments, and which factors sustained adherence. Our findings, based on three waves of nationally representative and cross-sectional studies conducted in May, June, and July, show that adherence to social distancing measures declined from May to July, as did knowledge of these measures, citizens’ practical capacity to adhere to them, and the social norms for adherence. At the same time, opportunities to violate these measures have increased. However, adherence levels stabilized in July, and support for social distancing measures among Americans has remained high throughout. These findings provide important insight into what motivated Americans to adhere to social distancing measures when distancing ceased to be the focus of the public health response. It thereby identifies important directions through which public health policy could sustain or promote adherence to mitigation measures in the United States.