(Mis)information and Anxiety: Experimental Evidence from a COVID-19 Information Campaign

In this experiment, we ask whether information on COVID-19 can be delivered without negative consequences to mental health.

Between June and August of 2020, we recruited internal migrants employed in the Indian garment industry to participate in the study. Internal migrants are an important population because they could be at a higher risk of contracting COVID-19 during return migration, and could infect their families.

We selected individuals from an administrative dataset of 23 factories in Karnataka. Since some individuals declined to participate, we were left with 914 individuals at baseline, 57 percent of whom were female. The sample was young with an average age of 24 years.

We first measured their knowledge of COVID-19 and screened them for depression and anxiety. We then randomly assigned them to receive information pertaining to COVID-19 via one of three modes:

1. Text messages
2. A pre-recorded audio message, or
3. Phone calls.

About 20 percent of participants were assigned to receive text messages, and the rest were split between pre-recorded audio and phone calls. The content of the message remained unchanged for all three modes.

We had two outcomes of interest— knowledge and mental health.

Baseline data confirmed that there was substantial misinformation among participants.

1. About a third did not mention cough to be a symptom of COVID-19, and about half did not mention fever.
2. Fewer than half were certain that non-symptomatic individuals can spread the disease.
3. Participants also seemed to hold inconsistent beliefs.
   • Only eight percent were certain that COVID-19 had remedies
   • 26 percent participants said they would recommend symptomatic individuals to take antibiotics*
   • 13 percent said they would recommend drinking cow’s urine**
   • A third felt that consuming turmeric regularly protects from COVID-19 infections, and**
   • 21 percent said that people of certain religions are more likely to spread the disease.

About 18 percent of the sample was attrited between baseline and endline.

1. Phone calls were the most effective at engaging individuals compared to text messages or pre-recorded audio messages.
2. Two thirds (about 66%) of the participants assigned to phone calls were delivered the entire message in contrast to 40 percent of those assigned to pre-recorded audio.
3. Calling improved COVID-19 knowledge among those without smartphones, but not among those with smartphones.
4. Calling reduced anxiety and depression by 16% overall.

Given the rise in stress, anxiety and depression during the COVID-19 pandemic, the mental health consequences of risk communication demand attention. We demonstrate that, for under $0.25 per message, phone calls can broadcast information at least as effectively as conventional methods, yet with better consequences for mental health.

*WHO warned against antibiotics and how they should not be used for treatment. **Such beliefs could lead to risk substitution.