Rapid antigen testing and public support for freedom granting in Germany during the COVID-19 pandemic

Abstract

Pandemic management can involve restricting people’s freedoms to curb the spread of infection, as done with introducing large-scale rapid antigen testing for SARS-CoV-2 in 2021. But do people understand what a test result means? Because testing has both benefits (e.g., societal) and risks (e.g., classification errors), we investigated whether understanding test performance and perception of societal benefits are associated with the acceptance of test-based granting of individual freedoms and personal testing intentions. We conducted a longitudinal study with a representative online panel of German citizens (N = 4991) during the Corona pandemic between 5 March and 26 May 2021. We assessed support for granting freedoms for various activities (e.g., visiting restaurants) based on health status indicators (negative rapid antigen test, vaccination status, COVID-19 recovery, or none of these), as well as comprehension of rapid antigen test performance. An experiment within the panel (N = 1660) examined how information from a national health authority about the societal benefits of regular testing and test performance related to citizens' comprehension of tests and willingness to grant freedoms. Initially, substantial freedoms were only granted to individuals with negative test results and those who were vaccinated, based on perceived infectivity. By May 2021, recovered individuals were also included. Restrictions on activities for other citizens were widely accepted. Providing evidence-based information improved comprehension of test performance and reduced willingness to grant freedoms to test-negative groups, unless additional societal benefit information was provided. Citizens expressed uncertainty about both infectivity risks and test properties. However, presenting performance information improved understanding and reduced freedom granting to test-negative groups. Evidence-based information has the potential to foster critical acceptance of targeted ‘freedom granting’ as a measure for pandemic management.