Public Health Attitudes Toward Prevention Measures Drastically Change As Awareness Shifts To Long-Term Presence Of COVID

As public health professionals consider how best to educate the public about the shift from COVID as a pandemic to an endemic.

EmblemHealth, one of the nation’s largest nonprofit health insurers, released results today from its national Living With COVID-19 Research.

The study examined the public’s interpretation of a pandemic vs. endemic and associated behaviors and public perceptions of other COVID-care terms.

Findings will inform the medical community of the population’s general understanding of these concepts and help improve communications around public health guidance and progression.

“Facing a growing sentiment of ‘COVID exhaustion,’ EmblemHealth drilled down into whether the public was ready to move from a global health crisis stance; to accepting COVID as the new long term normal,” said Dr. Richard Dal Col, MD, and Chief Medical Officer of EmblemHealth. “Our research revealed that the public will practice fewer preventive behaviors in an endemic, at the same time the public primarily looks to and trusts clinical experts for direction, and words like “booster” [alone] do not incite public proactivity.”

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While the COVID-19 vaccines have effectively helped reduce hospitalizations and death rates, the country has also seen adult vaccination rates stall — 76% of adults are fully vaccinated, and only 49% have received a COVID booster, according to the US Centers for Disease Control and Prevention’s April 2022 COVID Data Tracker.

The data, plus what is being seen on the ground, prompted EmblemHealth to explore what the healthcare industry should consider in the next phase of the disease.

Its resulting study–conducted in February 2022–found that people have a positive but mixed perception of “boosters.” They see the term synonymous with extra protection and maintenance but less preventive than an “immunization” and “vaccination.”

Moreover, when asked to describe what an endemic is to a friend or family member, the study found that the lack of understanding of the term “endemic” varied among respondents.

Based on a general misunderstanding of the word, a majority expressed that they are more likely to reduce participation in preventative behaviors in an endemic, particularly the likelihood of getting a booster.

Meanwhile, respondents also stated they were more likely to keep up and follow additional preventive measures when faced with a pandemic verses an endemic.

The study polled nearly 1,000 respondents nationwide, focusing on the New York Tri-State Area, where EmblemHealth primarily operates.

Among key findings from the survey:

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  • Consumers’ adherence to public health behaviors – such as wearing a mask, testing, quarantining and more are slated to be much lower in an endemic vs. in a pandemic classification.
  • The term “pandemic” is very well understood. When asked to define “endemic,” around 1 in 4 persons expressed they are unfamiliar with the term. The remaining themes described it as when the pandemic/disease is contained to a particular geographical area, allowing people to live more commonly, like with the flu.
  • Slightly more than half of the respondents plan to wear a mask in an endemic, which is a 30% decline compared to in a pandemic. In a pandemic, 1 in 2 people plan to get a booster, while only 37% plan to get a booster in an endemic.
  • Consumers understand the term “booster,” but it is associated more with “extra” or “maintenance.” “Immunization” is associated more as “preventive,” “effective,” and “safe,” even by more hesitant groups.
  • Key behaviors that suppress the spread of disease — including quarantining and avoidance of others if tested positive — see drastic declines in an endemic compared to in a pandemic, with only 2 in 5 saying they will avoid seeing others if they test positive or quarantining if they experience symptoms.
  • Most respondents believe COVID-19 will become a seasonal disease like the flu and would be more receptive to getting an annual booster associated with a seasonal/yearly immunization rather than getting one, if at all, if COVID-19 becomes endemic.

“EmblemHealth’s findings serve as a great snapshot of where public opinion stands and how we in healthcare can best meet people where they are,” said Beth Leonard, EmblemHealth Chief Corporate Affairs Officer. “As we move forward, we will need to work in tandem and speak the same language across health systems and policies to ensure we do not lose any ground on our progress in beating back the virus.”

With a fourth COVID vaccine dose approved by the FDA, and now top infectious-disease experts stating the US is out of the pandemic phase, Leonard whose team oversees communications for EmblemHealth and its medical practice, AdvantageCare Physicians, suggests medical experts and communicators support vaccine rollouts by connecting the importance of “boosters” to keeping up with one’s COVID-19 vaccinations.

Also, heath care insiders should consider increasing the use of terms like “immunizations and vaccinations” as opposed to only relaying to the public “boosters,” “shots,” or “jabs in the arm” — terms found to cause feelings of fear, pain, and potential side effects–especially among hesitant populations.

In addition, stakeholders in health care should be cautious when using the word “endemic” to promote public safety behaviors in the current and future phases of COVID-19.

For more results from EmblemHealth’s study, view the Research White Paper.

Detailed infographic highlighting the Living With COVID-19 Research findings. View a PDF copy of the infographic here.


EmblemHealth is one of the nation’s largest nonprofit health insurers, with 3.2 million members and an 80-year legacy of serving New York’s communities.

The company offers a full range of commercial and government-sponsored health plans to employers, individuals, and families, as well as convenient community resources.

As a market leader in value-based care, EmblemHealth partners with top doctors and hospitals to deliver quality, affordable care. For more information, visit

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