The coronavirus disease 2019 (COVID-19) pandemic has led to major changes in people’s lives. Governments around the world had to impose restrictions as a means to slow down the spread. In many countries, this response has led to people being dependent on the government for information. ^{Reference Nutbeam1} However, the level of trust in government differs across countries. ^{Reference Han, Zheng and Cristea2} Trust in institutions is crucial for legitimizing the decisions made by authorities ^{Reference Luhmann3} and achieving the cooperation of the citizens. ^{Reference Harring, Jagers and Löfgren4}

People’s lack of cooperation with the restrictions imposed in controlling the pandemic has likely caused the problem to be exacerbated. Some of the people who were willing to comply with the requirements might have not properly understood. The countries that controlled best the situations were those that responded quickly to health advice. Even in the current situation, some people believe it is all a big conspiracy theory with misinformation rapidly spreading through social media. ^{Reference Zarocostas5} This could be a consequence of low health literacy.

For people who do not respect social distancing rules, isolation or lockdown coercive measures were put in place. This approach is a top-down approach that is likely to be encountered with resistance. It is also with a reactive response to an existing problem that has been highlighted by the pandemic, that is, the poor health literacy that exists within the population. ^{Reference Paakkari and Okan6} Poor health literacy is not a new problem and has been highlighted in the past. For example, studies have shown that, in the United States, 26% of people have a general low literacy, ^{Reference Paasche-Orlow, Parker and Gazmararian7} and in Australia, 59% have inadequate health literacy. ⁸

The severity of the current situation has asked people to rapidly acquire information and change their behavior. ^{Reference Zarocostas5} As a result, educational materials that are easily understandable were developed ^{Reference Paakkari and Okan6} and were made available for different segments of the population. In a pandemic, when an immediate response is required, improving the health literacy of the population at the same time adds a further layer of complexity ^{Reference Paakkari and Okan6} to addressing imminent issues. Having some prior knowledge and being able to determine the rationale of a decision could make it easier for people to be intrinsically motivated, ^{Reference Salvi, Frost and Couillard9} learn more, and help in controlling the spread. A cross-sectional community survey in Australia has shown that people with low health literacy had more difficulty understanding prevention behavior and finding and understanding COVID-19 information provided by the government. ^{Reference McCaffery, Dodd and Cvejic10} They were also more likely to spread misinformation about COVID-19. ^{Reference McCaffery, Dodd and Cvejic10}

This asks for a better approach to future pandemics: the need for a preventive rather than a reactive solution for these situations. We need to empower people to understand the risks that occur in this situation and ideally have a bottom-up response in the future. This raises the questions on health literacy and how it could be improved: 1 way to do this is through education, and this has to be done early in life ^{Reference Nutbeam1} especially because health literacy could further increase existing health disparities. ^{Reference Stormacq, Van den Broucke and Wosinski11,Reference Van Der Heide, Wang and Droomers12}