Know your epidemic, know your response: Early perceptions of COVID-19 and self-reported social distancing in the United States.

As COVID-19 is rapidly unfolding in the United States, it is important to understand how individuals perceive the health and economic risks of the pandemic. In the absence of a readily available medical treatment, any strategy to contain the virus in the US will depend on the behavioral response of US residents. In this paper, we study individual's perceptions on COVID-19 and social distancing during the week of March 10-16, 2020, a week when COVID-19 was officially declared to be a pandemic by WHO and when new infections in the US were more than doubling every three days. Using a nationally representative sample of 5,414 respondents 18+ years of age from the Understanding America Study (UAS), we find that perceptions about COVID-19 health risks and economic consequences in the US population were largely pessimistic and highly variable by age and education. US residents who are young and do not have a college degree perceived a lower risk of getting infected but a higher probability of running out of money than others. Most individuals reported taking some steps to distance themselves from others but important differences emerge by gender and by source of information on COVID-19. Using state and day fixed-effect regressions, we show that perceptions of the health risks closely followed the number of COVID-19 cases in the country, and perceptions of the economic consequences and the prevalence of social distancing were driven upwards by both national and state-level cases. Unless addressed by effective health communication that reaches individuals across all social strata, variations in perceptions about COVID-19 epidemic raise concerns about the ability of the US to implement and sustain the widespread and restrictive policies that are required to curtail the pandemic.