Perspectives of US Youth During Initial Month of the COVID-19 Pandemic

Eric Waselewski, MD; Marika Waselewski, MPH; Chloe Harper; Sarah Dickey; Sue Anne Bell, PhD, FNP-BC; Tammy Chang, MD, MPH, MS


Ann Fam Med. 2021;19(2):141-147. 

In This Article

Abstract and Introduction


Purpose: Asymptomatic youth in the United States acting as "silent spreaders" during the coronavirus disease 2019 (COVID-19) pandemic are an ongoing public health concern, particularly given their depiction as unengaged with recommendations. Our goal was to understand the knowledge, beliefs, and experiences of US youth at the onset of the COVID-19 pandemic.

Methods: We posed 2 open-ended surveys to the national MyVoice text message cohort of youth, aged 14–24 years. On March 6, 2020, 4 questions were asked regarding knowledge and experiences during the COVID-19 pandemic with 3 questions repeated on March 20, 2020. Qualitative responses were coded using thematic analysis and summarized with descriptive statistics.

Results: Of 1,174 youth, 1,087 responded to at least 1 question (response rate of 88%). The average age of respondents was 19 (SD 2.8) years with 52% female and 56% non-Hispanic White respondents. On March 6, 2020, most (70%) respondents reported knowing about COVID-19 and primarily cited the news (46%) as their source of information. Nearly all (95%) respondents reported impact by March 20, 2020, and respondents expressing worry increased from 25% to 51%. In both surveys, worried youth primarily cited concern for others (26% and 34%). Regarding preparation, respondents primarily reported doing nothing (36%) on March 6, 2020, and practicing social distancing (50%) on March 20, 2020.

Conclusions: Many youths in our sample are engaged with the COVID-19 pandemic and most are feeling knowledgeable, are concerned about its impacts on others, and are practicing social distancing. Sustained public health efforts should focus on maintaining youth engagement with accurate public information and youth-centered messaging promoting prevention measures to protect the health and well-being of youth and their friends and family.


Adolescents and young adults have been shown to be at lower risk for coronavirus disease 2019 (COVD-19) morbidity and mortality with asymptomatic and less serious cases skewed toward younger individuals.[1,2] As a result, pandemic impacts on this age group are largely related to interruptions in education, work, and social interactions.[3–5] Evidence suggests, however, asymptomatic youth may contribute to pandemic progression as "silent spreaders," that is, individuals who transmit the disease without exhibiting symptoms.[1,2,6,7] Concerns regarding the health and well-being of youth as well as their potential role as silent spreaders make this group, nearly 13% of the US population (aged 15–24 years), important in understanding the epidemiology of this pandemic and guiding ongoing public health efforts.[8]

Youth are also commonly depicted as being unengaged in current events, unenthusiastic about political engagement, and generally disconnected.[9–13] Despite increased visibility of youth in advocacy, particularly focused on gun violence in schools, climate change, and social justice, the prevailing depiction of youth continues to be overwhelmingly, and sometimes inaccurately, apathetic and negative.[14–19] Psychologists and media have further labeled young adults as reward driven, lacking empathy, and increasingly self-absorbed.[20–26] However, many of these characteristics are part of normative neuro-biologic development and play important roles in learning, relationship development, and risk-taking behaviors essential to adolescent growth.[21,27]

During the COVID-19 pandemic, these views of adolescents and young adults have gained additional traction with reports of these age groups ignoring social distancing guidelines to pack bars, visit beaches, and convene in large groups with others.[28–30] Insight on youth behaviors and their perceptions are limited, however, as is scientific knowledge of COVID-19, resulting in a need for continued efforts to understand the many facets of the pandemic. Our study aims to assess the knowledge, beliefs, and experiences of adolescents and young adults to discern their understanding, feelings, and behaviors during the COVID-19 pandemic and how they evolved as the pandemic progressed.