Identifying and Mitigating the Public Health Consequences of Meta-Ignorance about "Long COVID" Risks

Many efforts have been made to study both the prevalence of and public concern about "Long COVID". Fewer, however, have asked what the public knows and/or purports to know about Long COVID. This is an important oversight, as low knowledge and/or "meta-ignorance" (the Dunning Kruger Effect or DKE) concerning Long COVID might undermine public willingness to take action to protect themselves and others from endemic COVID-19. In a nationally representative survey of US adults, we find that objective levels of public knowledge about Long COVID are quite low. We also detect a prevalent DKE, such that greater than one fifth of respondents express high confidence in their perceived Long COVID knowledge, despite exhibiting lower than average objective knowledge. Unfortunately, we find that the expression of DKE -- irrespective of partisan identity -- is associated with a series of deleterious public health and health policy outcomes, including: opposition to workplace COVID-19 vaccine mandates, annual COVID-19 vaccine hesitancy, and an increased likelihood of being sick with Long COVID. We conclude by offering a data-driven discussion of both the promises and potential limitations of health communication efforts to provide the public with basic facts about the causes and consequences of Long COVID.