Fever? Sore Throat? They Just Check ‘No’

Every morning, Ashley, a mother of two on Long Island, has to navigate an ethical minefield: Her children’s schools send out a health questionnaire for Covid-19.

The “daily attestation,” as it is known, asks people to volunteer information about their health: “Fever of 100 or above?” “Sore Throat?” “In the past 14 days have you knowingly been in close contact with anyone who has tested positive for Covid-19?”

Answer in the negative and entry is granted. Answer in a way that suggests you or a family member may be sick, and you’re banned. And, herein lies the problem: The forms are on the honor system.

“My kids have a runny nose the entire year,” said Ashley, who like many people interviewed for this story asked that she be identified only by her first name because she feared reprisal. “If I was to say, ‘Yes, they have one of these symptoms,’ they can’t go to school.”

So Ashley does what she feels she must. She fibs.

“It makes me uncomfortable when I do it,” she said, but added, “you kind of have to survive.”

Some attestation forms seem impractical, requiring parents to interview their pre-school-age children about their health, when some that age can’t distinguish between a boo-boo and a sore throat.

Other forms are easily bypassed, rendering them ineffectual.

In 2020, the University of Southern California created a Trojan Check system that students quickly discovered could be bypassed by registering as a guest. One student even created an auto-fill shortcut and posted it to Reddit.

Lying on these questionnaires, which are also used by employers, airlines and day care centers, has become so widespread that the humor publication McSweeney’s ran a recent spoof: “Fill out a daily health attestation by 5 a.m. We understand that you will lie.”

Ethicists say that a system in which people routinely answer falsely can undermine public confidence. “It sows the seeds of distrust,” said Keith G. Meador, the director of the Center for Biomedical Ethics and Society at Vanderbilt University in Nashville, Tenn. “We all have a common commitment to protecting one another.”

Abbie, who works in marketing and lives in Midtown Manhattan, often finds herself bending the truth, even though she has a toddler daughter too young to qualify for the vaccine and a husband who is immunocompromised.

“She’s a day care kid — she’s had a cough since she started going. Sometimes I say ‘no’ because this is just her normal cough,” Abbie said. “But technically, she has a cough, so yeah, I’m fibbing. I say ‘yes’ when it’s a different cough.”

Part of the problem is that the binary yes/no format allows no room for nuance, encouraging users to err on the side of healthy. This is especially true with schools and workplaces that have a zero-symptom policy: Fess up to a headache, no matter if it’s sinus, and it can result in a 10-day home quarantine.

So people fudge to avoid all the stress and hassle.

“Think about the implications,” Ashley said. “You have working parents who have to completely rearrange their day, figure out how to parent and excel at their jobs. Because of that ripple effect, it’s causing people to be dishonest.”

So what purpose do these questionnaires serve? “It creates an accountability,” said Pamela Herd, a professor at the McCourt School of Public Policy at Georgetown University who studies surveys.

Dr. Herd added that people are more likely to disclose information if they are asked to do so, and more likely to answer honestly if asked via computer rather than face-to-face because they don’t feel judged.

Dr. Herd also fills out a daily screener for her middle-school-age daughter, and has noticed that the questionnaire hasn’t changed in more than a year. Answering it has become rote, an exercise in checking boxes with eyes half closed. “You’re not reading it anymore,” she said, “which may weaken the effect.”

The Covid attestations first appeared in the summer of 2020, when workplaces, schools and day camps were figuring how to safely return to in-person attendance. Instead of collecting and analyzing all that data themselves, many schools and employers turned to vendors like Medcor, a health care firm in Illinois, and Pikmykid, a tech firm in Tampa, Fla., that makes an app that helps schools track students’ whereabouts.

New York University adopted the screeners, in part because it’s required under the New York State Health and Essential Rights Act, but also, “allowing or cutting off access to our buildings is an important part of enforcing our health protocols,” said John Beckman, a spokesman for the university.

Although “people don’t love filling it out every day,” to visit campus, Mr. Beckman added, “we continue to find it an effective tool.”

But the daily attestation may be falling out of favor, as a relic from the early days of the pandemic before there were vaccinations or readily available Covid tests.

“As we evolved and learned more, many companies replaced day-to-day screenings with a vaccine or testing mandate,” said Carol Goodman, an employment lawyer at the law firm Herrick Feinstein.

But many companies still use the forms, inadvertently encouraging parents and employees to become fibbers.

The other day, Abbie forgot to fill out her daughter’s Covid attestation, but her daughter was allowed to attend day care anyway. The experience shook her confidence in the system. “The school clearly isn’t following up with parents who forgot to do it,” she said. “I wonder if other parents are taking it seriously.”