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To wear or not to wear? Adherence to face mask use during the COVID-19 and Spanish influenza pandemics
Abstract
During the COVID-19 pandemic, face masks have been employed as a public and personal health control measure against the spread of SARS-CoV-2. Their use is intended as personal protection to prevent infection and as source control to limit transmission of the virus in a community or healthcare setting. Yet the wearing of masks has become a catalyst for political conflict, an arena where scientific evidence is often viewed through a partisan lens. The way that anti-maskers chafe at the mask requirement evokes a time when people were advised to wear a mask during the 1918 pandemic. As the Spanish flu swept through the world causing global devastation in 1918 and 1919, face masks became ubiquitous to help in preventing the spread of disease. A century apart, medical authorities urged and urge the wearing of masks to help slow the spread of disease. Nonetheless, people were and remain resistant to this simple and common sense advice. The purpose of this article is twofold: to provide a brief literature review on the unequivocal scientific evidence that masks reduce community transmission in view of the current pandemic, review mask use in children and to compare and contrast attitudes to mask wearing during the Spanish flu and the COVID-19 pandemic, and analyse where these attitudes stem from.
... Throughout the pandemic, mandating actions has been contentious as it relates to individual freedoms and decision-making. Collegiate recreation staff were ultimately dependent on patrons adhering to mask mandates, social distancing, and hygiene protocols, and this compliance was driven by individual beliefs about the efficacy of certain restrictions (Scerri & Grech, 2020). This was most obvious in sections that detailed mask mandates which were quite brief and often vague. ...
... Presumably, this reflects the politicization of masks and how they are symbolic of constitutional rights and freedom of choice (Al-Ramahi et al., 2021). Mask wearing was not a previously established social norm in North America and has received a mixed public reception due to evolving guidelines and the political landscape (Scerri & Grech, 2020). Thus, the language for some reopening policies framed actions, such as wearing masks, as guidelines rather than mandates. ...
... Finally, practitioners should review their strategies for navigating the enforcement of policies with staff and patrons. From the beginning of the COVID-19 outbreak there were public opinion differences on appropriate protocolssuch as mask wearing and social distancing -to reduce the spread of the virus (Scerri & Grech, 2020). University officials should provide consistent and clear messages to patrons about why their policies are important, or where their policies are aligned to policy guidance, legislation, or executive orders, such as state-wide mask mandates. ...
The COVID-19 pandemic caused most collegiate recreation facilities and programs to shut down to slow the spread of the virus. Public health guidelines from the state/province, federal, and global level have inundated recreation professionals with messaging to inform reopening strategies. Rasmussen’s risk management framework served as a guide to explore the stakeholders, decisions, and environmental conditions influencing COVID-19 reopening plans and policies in collegiate recreation. A case study of four collegiate recreation departments was conducted, with document analysis employed to examine and interpret reopening plans. The findings highlight campus offices and leadership as major stakeholders in reopening guidelines; risk management decisions utilizing a phased reopening approach that emphasized screening, mask mandates, social distancing and touch points, equipment and floor plans, and cleaning; and communication as a critical environmental condition. Implications for collegiate recreation practitioners include strategies for decision making, dissemination of information, staff training, risk mitigation, and policy enforcement.
... Although physical distancing has been mostly accepted and practiced, the use of face coverings has not been fully embraced and it remains a highly debated issue [15][16][17]. The controversy about the use of face coverings during the COVID-19 pandemic originated from ideological differences, perception of risk, uncertainty, and lack of understanding of its effectiveness [15,[18][19][20]. ...
... Although physical distancing has been mostly accepted and practiced, the use of face coverings has not been fully embraced and it remains a highly debated issue [15][16][17]. The controversy about the use of face coverings during the COVID-19 pandemic originated from ideological differences, perception of risk, uncertainty, and lack of understanding of its effectiveness [15,[18][19][20]. The prevailing view presupposes the variation in experimental results [19,21] and limited available evidence so far on how community use of face coverings would affect the spread of COVID-19 [22]. ...
... The prevailing view presupposes the variation in experimental results [19,21] and limited available evidence so far on how community use of face coverings would affect the spread of COVID-19 [22]. Moreover, debate also occurred among the research communities [19], political entities, and decision-makers [15]. The implementation of face covering measures varies greatly from one state to another [23] and there is an increasing divide between those who wear and who do not wear masks [15]. ...
The COVID-19 pandemic has been one of the biggest public health challenges of the 21st century. Many prevalent measures have been taken to prevent its spread and protect the public. However, the use of face coverings as an effective preventive measure remains contentious. The goal of the current study is to evaluate the effectiveness of face coverings as a protective measure. We examined the effectiveness of face coverings between 1 April and 31 December 2020. This was accomplished by analyzing trends of daily new COVID-19 cases, cumulative confirmed cases, and cases per 100,000 people in different U.S. states, including the District of Columbia. The results indicated a sharp change in trends after face covering mandates. For the 32 states with face covering mandates, 63% and 66% exhibited a downward trend in confirmed cases within 21 and 28 days of implementation, respectively. We estimated that face covering mandates in the 32 states prevented approximately 78,571 and 109,703 cases within 21- and 28-day periods post face covering mandate, respectively. A statistically significant (p = 0.001) negative correlation (−0.54) was observed between the rate of cases and days since the adoption of a face covering mandate. We concluded that the use of face coverings can provide necessary protection if they are properly used.
... Как показывают данные зарубежных опросов, даже при учете национальной специфики, доля людей, выражающих неприятие этой ограничительной меры в истории пандемии COVID-19, является сравнительно небольшой, но стабильной -порядка 15-20% (Taylor, Asmundson, 2021). Поляризация мнений ведет к росту психологической напряженности, что находит отражение в острых социальных и политизированных дискуссиях в СМИ, интернет-пространстве и на бытовом уровне (Scerri, Grech, 2020). При этом опыт моделирования динамики эпидемии COVID-19 свидетельствует о том, что отказ почти пятой части населения следовать данной ограничительной мере оказывает существенный негативный эффект на темп распространения инфекции (Eikenberry et al., 2020). ...
... Феномен подобного сопротивления ущемлению гражданских свобод наблюдался и при пандемии испанского гриппа 1918-1920 гг. (Scerri, Grech, 2020). Вместе с тем люди различаются по выраженности сопротивления внешним ограничениям. ...
The paper presents an empirical study of adherence attitudes to wearing face masks during the second wave of the COVID-19 pandemic in Russia (October 2020, N=884). The new questionnaire on adherence attitudes to wearing face masks is presented. It consists of 7 scales of attitudes, which determine adherence to mask-wearing regulations. The structure of attitudes was described by a hierarchical model with a general factor of adherence attitude, three second-order factors with respect to the “discomfort related to face coverings”, “perceived threat of COVID-19 for oneself and others”, “rational assessment of COVID-19 pandemic”, and 7 factors of specific attitudes according to the questionnaire. The latter were 1) prosociality, 2) tolerance to physical discomfort caused by masks, 3) fear for oneself and friends and relatives, 4) COVID-19 anti-conspiracy beliefs, 5) comfort of communication while wearing a mask, 6) acceptance of restrictions of individual freedom, 7) stability of self-esteem. The specific attitudes significantly differentiated groups of participants, which differed in their adherence to mask-wearing regulations and in their motivation for inconsistent adherence. Socio-demographic differences in attitudes and adherence to mask-wearing regulations are described. It was revealed that on the attitudinal level, men were less oriented towards adherence to the mask regime. Compared to women, they expressed less prosociality and less tolerance to physical discomfort caused by masks, associated wearing masks with the manifestation of weakness, and underestimated the COVID-19 threat for themselves and for their relatives and friends. In conclusion, the issue of unidimensionality of self-reports of adherence attitudes is discussed. We sum up that prosociality, as an attitude towards the necessity to care about the health of other people, plays a central role in the adherence attitude structure. Directions for the elaboration of practical guidelines to sustain adherence to restricting regulations during the COVID-19 pandemic for different groups of participants are outlined.
Статья представляет эмпирическое исследование установок российских респондентов в отношении масочного режима в начале второй волны пандемии COVID-19 (октябрь 2020 г.; N = 884). Представлен оригинальный опросник из 7 шкал установок приверженности, определяющих следование масочному режиму. Структура установок наилучшим образом описывалась иерархической моделью с общим фактором установки приверженности, тремя факторами установок второго порядка в отношении «дискомфорта в связи с масками», «угрозы COVID-19 для себя и других», «рациональной оценки пандемии COVID-19», 7 факторами частных установок по опроснику. Их составили: 1) просоциальность; 2) толерантность к физическому дискомфорту; 3) страх за себя и близких; 4) антиконспирологическая установка в отношении COVID-19; 5) комфортность общения в маске; 6) принятие ограничений индивидуальной свободы; 7) устойчивость самооценки. Выявлено, что частные установки значимо дифференцировали группы респондентов, различавшихся соблюдением масочного режима и мотивами его неустойчивого соблюдения. Описаны социально-демографические различия в установках и приверженности масочному режиму. Показано, что на уровне установок мужчины менее ориентированы на соблюдение масочного режима: в сравнении с женщинами они менее просоциальны, ассоциируют ношение масок с проявлением слабости, приуменьшают угрозу COVID-19 для себя и близких, менее толерантны к физическому дискомфорту в связи с масками. В заключение обсуждается проблема одномерности самоотчетов об установках приверженности режиму ношения масок. Делается вывод о центральной роли просоциальности как установки на необходимость заботы о здоровье других людей. Обозначаются направления для разработки практических рекомендаций по поддержке приверженности ограничительным мерам при COVID-19 для отдельных групп респондентов.
... It was reported that till 2020, COVID-19 has diseased more than 16 million people worldwide and caused over 600,000 deaths. In the USA, it infected more than 8 million individuals and caused more than 220,000 deaths by 2020 (Scerri and Grech, 2020;JHU., 2020). ...
Purpose
Face masks are the most recommended precautionary measure since the emergence of SARS-CoV-2 since 2020 and the most useful PPE against this virus and its variants so far. This study aims to develop reusable and biodegradable mask from 100% regenerated bamboo or/and its blend. Selection of natural and regenerated textile materials is to minimize generation of solid waste. This attempt will eventually protect our earth by minimizing or better discontinuing the production of the disposable nonbiodegradable face masks available worldwide.
Design/methodology/approach
Hundred percent regenerated bamboo and 50:50 bamboo:cotton were selected to knit plain and interlock fabrics for manufacturing of reusable sustainable face masks. A 23 32-mixed-level factorial design was applied to study the effect of liquor ratio and temperatures, fabric structure, blend ratios and finishes at three different levels. Model 23 32 has two factors (liquor ratio and temperatures) at three levels and three factors (fabric structure, blend ratios and type of finish) at two levels. Knitted fabrics were then applied with antibacterial finishes; sanitized T99-19 and sanitized T27-22, separately at three different liquor ratios (1:10, 1:12 and 1:15) and temperatures (45, 55 and 65 °C) via exhaust method. After completing processing, fabric thickness, pilling resistance, dimensional stability, bursting strength, Berger whiteness index, air permeability and antibacterial properties of each trial were evaluated using standard test procedures.
Findings
Selected fabrics treated either by sanitized T27 or sanitized T99 in a liquor ratio of 1:15 against 65 °C, showed excellent bacteriostatic/bactericidal activity. However, 100% regenerated bamboo interlock knitted fabric treated with sanitized T99 in a liquor ratio of 1:15 at 65 °C has the most desired values of dimensional stability, pilling resistance, Berger whiteness, fabric thickness, air permeability and bursting strength which made it the best for the manufacturing of the masks. Reusable mask is comprised of three layers in which the first and the third layers were of selected 100% regenerated bamboo fabric while a PM2.5 filter was inserted in between. Bacterial filtration efficiency, particle filtration efficiency, biocompatibility and microbial cleanliness will be evaluated in future, to compare the performance of proposed reusable and biodegradable face mask with N95 masks and other fabric masks available commercially.
Originality/value
This study resulted in a development of reusable eco-friendly facemask which was not attempted by the preceding investigations. Outcomes of this work pave the way for a greener and safer earth by using easily obtainable regenerated bamboo fabrics, antibacterial finishes and knitted structures.
... • Used at all times, • Correctly made and fitted, • Composed of proper material [151]. ...
The rise of the highly lethal severe acute respiratory syndrome-2 (SARS-2) as corona virus 2019 (COVID-19) reminded us of the history of other pandemics that happened in the last century (Spanish flu) and stayed in the current century, which include Severe-Acute-Respiratory-Syndrome (SARS), Middle-East-Respiratory-Syndrome (MERS), Corona Virus 2019 (COVID-19). We review in this report the newest findings and data on the origin of pandemic respiratory viral diseases, reservoirs, and transmission modes. We analyzed viral adaption needed for host switch and determinants of pathogenicity, causative factors of pandemic viruses, and symptoms and clinical manifestations. After that, we concluded the host factors associated with pandemics morbidity and mortality (immune responses and immunopathology, ages, and effect of pandemics on pregnancy). Additionally, we focused on the burdens of COVID-19, non-pharmaceutical interventions (quarantine, mass gatherings, facemasks, and hygiene), and medical interventions (antiviral therapies and vaccines). Finally, we investigated the nanotechnology between COVID-19 analysis and immune system boosting (Nanoparticles (NPs), antimicrobial NPs as antivirals and immune cytokines). This review presents insights about using nanomaterials to treat COVID-19, improve the bioavailability of the abused drugs, diminish their toxicity, and improve their performance.
Graphical Abstract
... Face masks have become the first line of defence in the fight against this virus, and they have become as essential to everyday life as cell phones, clothing, and other needs. 3 Layered face mask (3LFM) are used by people abundantly due to its inexpensive cost, excellent filtering capability, very low breathing resistance, hypoallergenic characteristic, fluid resistance, and antiviral properties [1]. In spite of these benefits, 3LFM has a limited operational life of only a few days, resulting in the development of trash. ...
Nowadays, wearing a 3-layered face mask (3LFM) to protect against coronavirus illness (COVID-19) has become commonplace, resulting in massive, hazardous solid waste. Since most of them are infected with viruses, a secure way of disposal is necessary to prevent further virus spread. Pyrolysis treatment has recently developed as an effective method for disposing of such hazardous waste and consequently converting them into energy products. In this regard, the goal of the present study is to physicochemically characterize the 3LFM followed by pyrolysis in a TGA to evaluate the pyrolysis performance, kinetic, and thermodynamic parameters and in a semi-batch reactor to characterize the volatile product. Furthermore, an artificial neural network (ANN) was used to forecast thermal deterioration data. The results demonstrated a strong correlation between real and anticipated values. The study proved the relevance of the ANN model and the applicability of pyrolysis for disposing of 3LFM while simultaneously producing energy products.
... Molekul yang terkadung dalam sabun membantu menghambat replikasi dari molekul lipid membrane yang ada pada coron virus, membunuh microba dan membersihkan fracmen mikroba yang berada pada kulit tangan (WHO, 2020). Pada pemakaian masker selama pandemi COVID-19, masker wajah telah digunakan sebagai tindakan pengendalian kesehatan publik dan pribadi terhadap penyebaran SARS-CoV-2 sehingga individu perlindungan diri untuk mencegah infeksi dan sebagai kontrol sumber untuk membatasi penularan virus di lingkungan komunitas atau layanan kesehatan (Scerri and Grech, 2020). ...
Background: Covid-19 pandemic has become a growing issue in Indonesia with erious attention from the government by providing a policy of implementing strict health protocols. There is a problem of high transmission which is causally due to the application of wearing masks and how to wash hands with soap that is not appropriate and facilities that are not balanced. Aims: The social service prevents the spread of Covid-19 through socializing and facilitating the community in carrying out health protocols by use mask and hand washing appropiately. Methods: Participants in community service selected by random sampling. selection of participants according to the advice of community leaders. Results: obtained as many as 70 people in Klampisan Village, Geneng District, Ngawi Regency by going from house to house by several implementing teams. the community received socialization and a package of health protocols in the form of masks and hand washing soap. The socialization was given through appeals and leaflets about preventing Covid-19 in the surrounding environment. Conclusion: health education,s appeal to prevent Covid-19 transmission and facilitate the use of masks and soap for washing hands as prevent Covid-19 in the future to leads awareness of implementing health protocols helps prevent Covid-19 in Kalmpisan Village, Geneng, Ngawi District.
... These arguments can be seen as a contributing factor to the desire to personalize the protective facemask, even at the price of reducing its functionality. The aspect of individualism versus collectivism was considered as one of the key drivers for adherence to wearing protective facemasks [6]. While in collectivistic cultures people tend to conform to social norms, in individualistic cultures they are prone to reject rules and are less likely to adapt to behavior change. ...
The global Covid 19 pandemic introduced a new item in everyday dress - the protective facemask. During 2020, fashion elements crept in the design of this primarily functional item. This research aims to analyse fashion trends in protective facemasks in the early stages of the Covid 19 pandemic. Photos with protective facemasks on social media were used, as traditional fashion photography underrepresents facemask wearing. The research showed that protective facemasks on Pinterest - a social medium used for taste discovery, showed cheerfulness, humour and individual creativity in facemask design. The uncertainty on how long non-pharmaceutical solutions in the fight against Covid 19 will be in place raises the question if fashion should be ignored. When persuading people to wear facemasks could fashion be the carrot to the stick of legislation?
... While we could not assume that all tweets were originated from a particular location, we know that certain segments of the US population were highly vocal about masks regulations during the early months of the pandemic (Scerri & Grech, 2020). This is worrisome insofar that adherence to these regulations is contingent to the information that people received and the outlook of making a change. ...
The outbreak of the SARS-CoV-2 novel coronavirus (COVID-19) has been accompanied by a large amount of misleading and false information about the virus, especially on social media. During the pandemic social media gained special interest as it went on to become an important medium of communication. This made the information being relayed on these platforms especially critical. In our work, we aim to explore the percentage of fake news being spread on Twitter as well as measure the sentiment of the public at the same time. We further study how the sentiment of fear is present among the public. In addition to that we compare the rate of spread of the virus per day with the rate of spread of fake news on Twitter. Our study is useful in establishing the role of Twitter, and social media, during a crisis, and more specifically during crisis management.
... By May 8, 2020 the number of cases were 3,889,841 [1]. As what happened a century ago when the in uenza pandemic had hit United States at Page 3/12 1918; at that time the masks of gauze and cheesecloth became the important preventive method against the virus which is similar to what is currently used to prevent the spread of COVID-19, the uses of masks also became mandatory in any indoor or outdoor activities [2]. ...
Background and Objectives:
The Coronavirus disease 19 (COVID 19) pandemic affects 187 countries which is began in China in December 2019 and spread around the world very quickly, becoming one of the greatest threats to human life in this century. As a result, preventive measures such as wearing face mask and social distancing have been implemented to fight against spreading of the virus. This study aimed to assess adherence to face mask and social distancing during COVID19 pandemic.
Methods and Materials:
This is a Cross-sectional observational study conducted at Khartoum state, the capital of Sudan. 1222 residents have been selected randomly to participate in this study. The inclusion criteria are: Everybody lives in Khartoum state is eligible to participate in this study. The exclusion criteria are: Everybody does not live in Khartoum state.
The data was collected through structural questionnaire which include personal data and the questions which measure the adherence to face mask and social distance. And the data was analyzed by SPSS application.
Results:
The total of participants in this study was 1222. The majority of participants wear face mask only if it is necessary to enter a commercial store, governmental institution or a hospital (45.9%). The remaining portion of the participants wearing the mask only when they are with their family (11.9 %) or with friends (11.1%) or at transport (16 %) and at parties (6.5 %). On the other hand, (8.4 %) of the participants never wear a mask at all Table (4).The most of the participants practicing the social distancing only if it is needed to enter a commercial store, government institution or a hospital (41.5%), whereas the rest do it only when they are with their family (10.2 %), with friends (6.2 %), at parties (6.8 %) and at transport (11 %). However, almost quarter of them do not do social distancing at all (24.3 %).
Conclusion:
In conclusion, most of the participants in this study have poor adherence to COVID19 preventive measures, especially wearing Face Mask and social distancing. They tend to follow these preventive measures only when imposed by an authority or it is necessary to enter certain places.
... By May 8, 2020 the number of cases were 3,889,841 [1]. As what happened a century ago when the in uenza pandemic had hit United States at 1918; at that time the masks of gauze and cheesecloth became the important preventive method against the virus which is similar to what is currently used to prevent the spread of COVID-19, the uses of masks also became mandatory in any indoor or outdoor activities [2]. ...
Background and Objectives:
The Coronavirus disease 19 (COVID 19) pandemic affects 187 countries which is began in China in December 2019 and spread around the world very quickly, becoming one of the greatest threats to human life in this century. As a result, preventive measures such as wearing face mask and social distancing have been implemented to fight against spreading of the virus. This study aimed to assess adherence to face mask and social distancing during COVID19 pandemic.
Methods and Materials:
This is a Cross-sectional observational study conducted at Khartoum state, the capital of Sudan. 1222 residents have been selected randomly to participate in this study. The inclusion criteria are: Everybody lives in Khartoum state is eligible to participate in this study. The exclusion criteria are: Everybody does not live in Khartoum state.
The data was collected through structural questionnaire which include personal data and the questions which measure the adherence to face mask and social distance. And the data was analyzed by SPSS application.
Results:
The total of participants in this study was 1222. The majority of participants wear face mask only if it is necessary to enter a commercial store, governmental institution or a hospital (45.9%). The remaining portion of the participants wearing the mask only when they are with their family (11.9 %) or with friends (11.1%) or at transport (16 %) and at parties (6.5 %). On the other hand, (8.4 %) of the participants never wear a mask at all Table (4).The most of the participants practicing the social distancing only if it is needed to enter a commercial store, government institution or a hospital (41.5%), whereas the rest do it only when they are with their family (10.2 %), with friends (6.2 %), at parties (6.8 %) and at transport (11 %). However, almost quarter of them do not do social distancing at all (24.3 %).
Conclusion:
In conclusion, most of the participants in this study have poor adherence to COVID19 preventive measures, especially wearing Face Mask and social distancing. They tend to follow these preventive measures only when imposed by an authority or it is necessary to enter certain places.
... They have to wear masks, bring hand sanitizer, stay away from crowds, and so on must be resolved. (Scerri and Grech, 2020). The school area has also undergone an adjustment to education and learning, which was initially face-to-face and personal in classrooms or meetings and transferred to the network. ...
Since the policy of sending students home to study as a result of responding to the dangers of the pandemic, universities around the world have increasingly trusted distance learning solutions. The solution was to rely on digital literacy to continue and improve student learning outcomes during the COVID-19 disruption. For this reason, the researchers have proven it through analytical efforts and in-depth studies in several international publications. In short, the researchers examined each piece of evidence with a phenomenological approach to get answers to research questions that are among other things, involve a data coding system, critical evaluation, and drawing of valid and reliable final results. The data discussion concludes that world universities believe that digital technology that was increasingly trending can become a learning innovation even though the world will continue to hit global education. Hence, the researchers hope that these findings should support other studies in the future.
... In a pandemic situation where the preventive health behaviors of mask-wearing and handwashing are strongly encouraged, it is necessary to determine what motivational factors increase or decrease the chance of adopting these behaviors. Evidence suggests wearing masks and handwashing are beneficial for limiting the spread of COVID-19 and other infections (Eikenberry et al., 2020;Li et al., 2020;Scerri and Grech, 2020). However, this information is not necessarily enough to encourage this hygienic behavior. ...
The COVID-19 pandemic has seen health preventive behaviors to prevent spread of the virus become highly politicized in the United States. A clear division exists between Democrats favoring health preventive measures and Republicans often defying such measures. Amid increasing fear of the virus, the 2020 United States presidential election became central to how the pandemic should be managed. This longitudinal study examines whether the frequency of handwashing and mask-wearing changed after the United States election. The study further explores whether political partisanship played a part in the change. Results show that handwashing and mask-wearing increased among Democrats after the election. However, Republican’s use of masks and handwashing decreased. These results are explained in terms of loyalty to outgoing President Trump among Republicans and renewed feelings of efficacy among Democrats.
... Secondly, using a novel dataset of survey responses in 69 countries around the world across months-long waves of surveys containing 847 thousand responses in 51 languages, we investigate the effect of community mask adherence (how many people in a community wear masks) and community mask attitudes (how many people in a community believe that masks are an important for COVID- 19) on country-level cases and deaths. This is especially important as similar community and adherence drivers behind mask avoidance [38] might impact the on-going deployment of vaccines. ...
We extend previous studies on the impact of masks on COVID-19 outcomes by investigating an unprecedented breadth and depth of health outcomes, geographical resolutions, types of mask mandates, early versus later waves and controlling for other government interventions, mobility testing rate and weather. We show that mask mandates are associated with a statistically significant decrease in new cases (-3.55 per 100K), deaths (-0.13 per 100K), and the proportion of hospital admissions (-2.38 percentage points) up to 40 days after the introduction of mask mandates both at the state and county level. These effects are large, corresponding to 14% of the highest recorded number of cases, 13% of deaths, and 7% of admission proportion. We also find that mask mandates are linked to a 23.4 percentage point increase in mask adherence in four diverse states. Given the recent lifting of mandates, we estimate that the ending of mask mandates in these states is associated with a decrease of -3.19 percentage points in mask adherence and 12 per 100K (13% of the highest recorded number) of daily new cases with no significant effect on hospitalizations and deaths. Lastly, using a large novel survey dataset of 847 thousand responses in 69 countries, we introduce the novel results that community mask adherence and community attitudes towards masks are associated with a reduction in COVID-19 cases and deaths. Our results have policy implications for reinforcing the need to maintain and encourage mask-wearing by the public, especially in light of some states starting to remove their mask mandates.
... After the World Health Organization had declared that the coronavirus (Covid-19) is a global epidemic [1], face masks have become the first prevention measure used to limit the spread of the virus, and the masks have become one of the basic necessities of daily life, similarly to mobile phones, clothes, etc. [2]. Therefore, the countries were quick to buy and store large batches of face masks as they were getting ready for any circumstances [3]. ...
In the times of Covid-19, face masks are considered to be the main source of protection against the virus that reduces its spread. These masks are classified as single-use medical products with a very short service life, estimated at few days, hence millions of contaminated masks are generated daily in the form of hazardous materials, what requires to develop a safe method to dispose of them, especially since some of them are loaded with viruses. 3-ply face masks (3PFM) represent the major fraction of this waste and are composed mainly from polypropylene and melt blown filter with high content of volatile substances (96.6 wt.%), what makes pyrolysis treatment an emerging technology that could be used to dispose of face masks and convert them into energy products. In this context, this work aims to study pyrolysis kinetic behaviour and TG-FTIR-GC–MS analysis of 3PFM. The research started with analysis of 3PFM using elemental analysis, proximate analysis, and compositional analyses. Afterwards, TG-FTIR system was used to study the thermal and chemical decomposition of 3PFM analyzed at different heating rates: 5, 10, 15, 20, 25, and 30 °C/min. The GC/MS system was used to observe the synthesized volatile products at the maximum decomposition temperatures. After that, isoconversional methods, the advanced nonlinear integral isoconversional method, and the iterative linear integral isoconversional method were used to determine the activation energies of mask pyrolysis, while the distributed activation energy model and the independent parallel reactions kinetic model were used to fit TGA and DTG curves with deviations below <1. The TGA-DTG results showed that 3PFM can decompose in three different periods with a total weight loss of 95 % and maximum decomposition in the range 405−510 °C, while the FTIR spectra and GC–MS analysis exhibited that – CH (aromatic and aliphatic) and 2,4-Dimethyl-1-heptene (28–43 % based on heating rate) represented the major compounds in the released volatile components. Finally, Vyazovkin and the iterative linear integral isoconversional methods gave activation energies almost similar to that obtained by the KAS isoconversional method.
... Moreover, its usage is mandated across the countries hit hardest by the virus. Wearing masks in public gatherings or crowded areas may help in restricting the contagion of disease from the infected individuals (Scerri & Grech, 2020). Its potential in controlling airborne transmission has been recognized by (Abboah-Offei et al., 2021) in a review article based on 58 case studies. ...
Introduction
The advent of COVID-19 has impinged millions of people. The increased concern of the virus spread in confined spaces due to meteorological factors has sequentially fostered the need to improve indoor air quality.
Objective
This paper aims to review control measures and preventive sustainable solutions for the future that can deliberately help in bringing down the impact of declined air quality and prevent future biological attacks from affecting the occupant’s health.
Methodology
Anontology chart is constructed based on the set objectives and review of all the possible measures to improve the indoor air quality taking into account the affecting parameters has been done.
Observations
An integrated approach considering non-pharmaceutical and engineering control measures together for a healthy indoor environment should be contemplated rather than discretizing the available solutions. Maintaining social distance by reducing occupant density and implementing a modified ventilation system with advance filters for decontamination of viral load can help in sustaining healthy indoor air quality.
Conclusion
The review paper in the main, provides a brief overview of all the improvement techniques bearing in mind thermal comfort and safety of occupants and looks for a common ground for all the technologies based on literature survey and offers recommendation for a sustainable future.
... Lyu and Wehby [44] showed that mask mandates in a number of states were associated with lowering infection rates by 0.9%-2% after wearing masks for 1-21 days. However, when the government mandates mask-wearing in public, many people feel their constitutional rights and freedom of choice are being violated [45]. As a result, there is a need to increase awareness about the fact that wearing masks can protect others from contracting COVID-19 even though they do not fully protect the person wearing the mask from the infection [46]. ...
ABSTRACT
Background:
Despite the presence of scientific evidence supporting the importance of wearing masks to curtail the widespread of the COVID-19 virus, wearing masks has stirred up a significant debate particularly on social media.
Objective:
To investigate the topics associated with the public discourse against wearing masks. Further, we study the relationship between the anti-mask discourse on social media and the number of new COVID-19 cases.
Methods:
Using hashtags against wearing masks, we collected a total of 51,170 English tweets between January 1st, 2020 and October 27th, 2020. We used machine learning techniques to analyze the data collected. We investigate the relationship between the volume of tweets that are against mask-wearing and the daily volume of new COVID-19 cases using the Pearson Correlation between the two time series.
Results:
The results and analysis showed that social media could help identify important insights related to wearing masks. The results of topic mining identified 10 categories/themes of user concerns dominated by 1) constitutional rights and freedom of choice followed by 2) conspiracy theory, population control and big pharma, and 3) Fake news, fake numbers, fake pandemic. Combined, these three categories represent almost 65% of the volume of tweets against masks. The relationship between the volume of tweets against wearing masks and the reported new COVID-19 cases depicts a strong correlation where the rise in the volume of negative tweets is leading the rise in the number of new cases by nine days.
Conclusions:
The findings demonstrated the potential of mining social media for understanding the public discourse about public health issues such as wearing masks during the COVID-19 pandemic. The results emphasize the relationship between the discourse on social media and the potential impact on real events like changing the course of the pandemic. Policy makers are advised to proactively address public perception and work on shaping this perception through raising awareness, debunking negative sentiments, and prioritizing early policy intervention toward the most prevalent topics.
... Research has revealed that belief in COVID-19-related conspiracy theories is a predictor of resistance to adopting preventive behaviors in the United States [44]. One study suggested that resistance to government advice to wear a mask is also based on the concepts of individualism and distrust of authorities [45]. Further research is warranted to examine the reasons why risk deniers with low protective behavior adoption resist wearing masks. ...
The present study aimed to identify the distinct levels of risk perception and preventive behaviors during the coronavirus disease 2019 (COVID-19) outbreak among people in Taiwan and to examine the roles of information sources in various levels of risk perception and preventive behavior. The online survey recruited 1984 participants through a Facebook advertisement. Their self-reported risk perception, adopted preventive behaviors and COVID-19-related information were collected. We analyzed individuals’ risk perception and adopted preventive behaviors by using latent profile analysis and conducted multinomial logistic regression of latent class membership on COVID-19-related information sources. Four latent classes were identified, including the risk neutrals with high preventive behaviors, the risk exaggerators with high preventive behaviors, the risk deniers with moderate preventive behaviors, and the risk deniers with low preventive behaviors. Compared with the risk neutrals, the risk exaggerators with high preventive behaviors were more likely to obtain COVID-19 information from multiple sources, whereas the risk deniers with moderate preventive behaviors and risk deniers with low preventive behaviors were less likely to obtain COVID-19 information compared with the risk neutrals. Governments and health professions should take the variety of risk perception and adopted preventive behaviors into consideration when disseminating information on COVID-19 to the general public.
... The coronavirus disease 2019 (COVID-19) pandemic has rebooted Americans' debate over the effectiveness of mask-wearing that arose during the 1918-1919 influenza epidemic [1], which has also become part of the political terrain. Differently from many Asian nations, such as China and South Korea, that have enforced a universal masking policy since the initial stage, public health officials in the U.S. first denied the requirement of mask-wearing in February but then recommended the wearing of facial masks as a supplemental measure to hygiene and social distancing in early April 2020. ...
During the COVID-19 pandemic, older adults appear to be more susceptible to the coronavirus disease. Although the health stakes are higher for older adults, individuals of all ages should adopt preventive measures to contain the human-to-human transmission of the virus. This study conducted a national online survey of 1843 adults at the early stage of the COVID-19 pandemic in the U.S. to examine age disparities in preventive behaviors against the virus. The results show that older generations, motivated by a higher perceived severity of the disease, were more likely to take the precautionary actions recommended by the U.S. Centers for Disease Control and Prevention (CDC) than younger generations. This thus suggests that persuasive health messages addressing the severity of COVID-19 might reduce the generational gap and promote preventive behaviors among
young people, to protect themselves and the elderly
... On 11 March 2020, the World health Organization (WHO) declared COVID-19 a pandemic, and until now, the health sector is struggling to fight this rapidly expanding virus, with a total of 88 million cases and around 2 million deaths worldwide at the time of writing this article. Non compliance with social distancing, hand washing, wearing of face masks and other public health measures has dramatically increased the infectivity rates and depleted essential health sector resources [2]. ...
The coronavirus disease 2019 (COVID-19) have devastated the globe and continues to be a protracted saga. In the absence of specific efficacious medical remedies, efforts to encounter and contain this emerging virus concentrated on vaccine production. A plethora of novel vaccines has been under development by major companies in different countries. To date, around 60 vaccines are in clinical trials with many other ones continuously added to the evolving pipeline. The variety in their corresponding designed platform and phases, warrants to tackle and understand what is being presented in the literature and launched in the market. Thus, this study is intended to enlighten and educate the medical community by reviewing the different vaccine platforms, and briefly explaining their mechanism of action with an emphasis on those that reached most advanced stages.
... For example, lockdowns and business closures have not significantly decreased the infection rates of people from poorer communities as they cannot stop going to work [65] while unfortunately having a disproportionate impact on their financial health [73]. This is especially important as similar demographic drivers behind mask avoidance [17][18][19]82] might impact successful deployment of vaccines. ...
Using publicly available data, we quantify the impact of mask adherence and mask mandates on COVID-19 outcomes. We show that mask mandates are associated with a statistically significant decrease in daily new cases (-3.24 per 100K), deaths (-0.19 per 100K), and the proportion of hospital admissions (-2.47%) due to COVID-19 between February 1 and September 27, 2020. These effects are large, corresponding to 13% of the highest recorded number of cases, 20% of deaths, and 7% of admission proportion. We also find that mask mandates are linked to a 23.4 percentage point increase in mask adherence in four diverse states, and that mask adherence is associated with improved COVID-19 outcomes. Lastly, using a large novel survey in 68 countries, we find that community mask adherence and attitudes towards masks are associated with a reduction in COVID-19 cases and deaths. Our results have relevant policy implications, indicating the need to maintain and encourage mask-wearing.
Este artigo busca analisar a retórica anti-máscara construída no canal de YouTube conspiracionista MetafisicaMente. Analisaremos especificamente o vídeo “SubliminarMente – Desmascarando a Focinheira do Sistema – COVID-19(84)”, postado em 31/05/2020. Nosso objetivo é entender como é construída a retórica anti-máscara, que se mostrou um empecilho e causou transtornos durante o combate à pandemia. Realizamos uma análise interpretativa do vídeo sob luz de uma literatura sobre teorias da conspiração. Nossos resultados apontam que o canal faz uma eclética negociação com diferentes epistemologias na construção do seu conspiracionismo.
Objective
The COVID-19 pandemic highlighted a fragile preparation by countries and regions for epidemic events, exposing exacerbated nationalisms in pandemic mitigation and control actions. Both conditions decisively compromise the effectiveness and efficiency of pandemic control capacity. It is important to develop frameworks that help overcome frailties in response to epidemics.
Methods
Thematic literature review and discussions with multiple national and international entities. The discussions were not specific to the article, hence were not considered as formal information collection. Based on this information, an attempt was made to build a tool for responding to the identified problems.
Results
Proposal of the 2PF tool.
Conclusion
The proposed 2PF tool is aligned with the Sendai Framework and proposals from international bodies, such as HERA, among others. It aims to be a framework for operationalizing these agreements, at least in part of its dimensions. The general idea is that pandemic preparedness cannot fail or to all other disaster risks and similar recognized by the UN. The response to pandemics must be based essentially on international action and closer collaboration between countries and regions.
Given the intimacy of food preparation and service, the close proximity of diners and staff, the general inability to eat comfortably while masked, the warm emotional atmospherics of restaurants, and the limits to restaurant ventilation, the current SARS-CoV-2/COVID-19 pandemic has meant shutdowns of restaurants across the United States early in the pandemic and then partial re-openings later with public health constraints. Some restaurants applied for the Small Business Administration (SBA)'s Paycheck Protection Program's funds in March 2020 to cover 2.5 months maximum of costs. Huge swaths of the restaurant industry have closed permanently, and many others are slated to close in the near future. Based on a content analysis, this work explores the plight of restaurant workers in the academic research and mass media literature and applies abductive reasoning to propose an approach for a policy mix that may better inform the present challenges with social justice considerations.
Facemasks have become requisite amid the COVID-19 pandemic. We explore facemasking behaviors, preferences, and attitudes among emerging adults, a “distinct period demographically” within the lifespan. Public opinion polls conducted in May 2020 found that emerging adults were the least compliant when compared to other demographic groups. To understand why, we developed a survey instrument that was administered to a demographically representative quota sample of 1,005 participants. Demographic comparisons revealed that behaviors and attitudes differed significantly by political beliefs, gender, living situation, and race. An exploratory factor analysis revealed six underlying variables: (a) facemask avoidance; (b) concerned adherence (c) vexed faultfinding; (d) statement making; (e) fashion enthusiasm; and (f) hygiene adherence. All factors varied significantly by political affiliation, and in some cases by gender, race, living situation, location, and work/education status. Significant correlations were present between all factors except fashion enthusiasm and vexed faultfinding.
COVID-19 is characterized by an infectious pre-symptomatic period, when newly infected individuals can unwittingly infect others. We are interested in what benefits facemasks could offer as a non-pharmaceutical intervention, especially in the settings where high-technology interventions, such as contact tracing using mobile apps or rapid case detection via molecular tests, are not sustainable. Here, we report the results of two mathematical models and show that facemask use by the public could make a major contribution to reducing the impact of the COVID-19 pandemic. Our intention is to provide a simple modelling framework to examine the dynamics of COVID-19 epidemics when facemasks are worn by the public, with or without imposed ‘lock-down’ periods. Our results are illustrated for a number of plausible values for parameter ranges describing epidemiological processes and mechanistic properties of facemasks, in the absence of current measurements for these values. We show that, when facemasks are used by the public all the time (not just from when symptoms first appear), the effective reproduction number, Re, can be decreased below 1, leading to the mitigation of epidemic spread. Under certain conditions, when lock-down periods are implemented in combination with 100% facemask use, there is vastly less disease spread, secondary and tertiary waves are flattened and the epidemic is brought under control. The effect occurs even when it is assumed that facemasks are only 50% effective at capturing exhaled virus inoculum with an equal or lower efficiency on inhalation. Facemask use by the public has been suggested to be ineffective because wearers may touch their faces more often, thus increasing the probability of contracting COVID-19. For completeness, our models show that facemask adoption provides population-level benefits, even in circumstances where wearers are placed at increased risk. At the time of writing, facemask use by the public has not been recommended in many countries, but a recommendation for wearing face-coverings has just been announced for Scotland. Even if facemask use began after the start of the first lock-down period, our results show that benefits could still accrue by reducing the risk of the occurrence of further COVID-19 waves. We examine the effects of different rates of facemask adoption without lock-down periods and show that, even at lower levels of adoption, benefits accrue to the facemask wearers. These analyses may explain why some countries, where adoption of facemask use by the public is around 100%, have experienced significantly lower rates of COVID-19 spread and associated deaths. We conclude that facemask use by the public, when used in combination with physical distancing or periods of lock-down, may provide an acceptable way of managing the COVID-19 pandemic and re-opening economic activity. These results are relevant to the developed as well as the developing world, where large numbers of people are resource poor, but fabrication of home-made, effective facemasks is possible. A key message from our analyses to aid the widespread adoption of facemasks would be: ‘my mask protects you, your mask protects me’.
Compared with the volume of data on coronavirus disease 2019 (COVID-19) outbreaks among older adults, relatively few data are available concerning COVID-19 in younger, healthy persons in the United States (1,2). In late March 2020, the aircraft carrier USS Theodore Roosevelt arrived at port in Guam after numerous U.S. service members onboard developed COVID-19. In April, the U.S. Navy and CDC investigated this outbreak, and the demographic, epidemiologic, and laboratory findings among a convenience sample of 382 service members serving aboard the aircraft carrier are reported in this study. The outbreak was characterized by widespread transmission with relatively mild symptoms and asymptomatic infection among this sample of mostly young, healthy adults with close, congregate exposures. Service members who reported taking preventive measures had a lower infection rate than did those who did not report taking these measures (e.g., wearing a face covering, 55.8% versus 80.8%; avoiding common areas, 53.8% versus 67.5%; and observing social distancing, 54.7% versus 70.0%, respectively). The presence of neutralizing antibodies, which represent antibodies that inhibit SARS-CoV-2, among the majority (59.2%) of those with antibody responses is a promising indicator of at least short-term immunity. This report improves the understanding of COVID-19 in the U.S. military and among young adults in congregate settings and reinforces the importance of preventive measures to lower risk for infection in similar environments.
The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.
Objective
Previous meta‐analyses concluded that there was insufficient evidence to determine the effect of N95 respirators. We aimed to assess the effectiveness of N95 respirators versus surgical masks for prevention of influenza by collecting randomized controlled trials (RCTs).
Methods
We searched PubMed, EMbase and The Cochrane Library from the inception to January 27, 2020 to identify relevant systematic reviews. The RCTs included in systematic reviews were identified. Then we searched the latest published RCTs from the above three databases and searched ClinicalTrials.gov for unpublished RCTs. Two reviewers independently extracted the data and assessed risk of bias. Meta‐analyses were conducted to calculate pooled estimates by using RevMan 5.3 software.
Results
A total of six RCTs involving 9 171 participants were included. There were no statistically significant differences in preventing laboratory‐confirmed influenza (RR = 1.09, 95% CI 0.92‐1.28, P > .05), laboratory‐confirmed respiratory viral infections (RR = 0.89, 95% CI 0.70‐1.11), laboratory‐confirmed respiratory infection (RR = 0.74, 95% CI 0.42‐1.29) and influenzalike illness (RR = 0.61, 95% CI 0.33‐1.14) using N95 respirators and surgical masks. Meta‐analysis indicated a protective effect of N95 respirators against laboratory‐confirmed bacterial colonization (RR = 0.58, 95% CI 0.43‐0.78).
Conclusion
The use of N95 respirators compared with surgical masks is not associated with a lower risk of laboratory‐confirmed influenza. It suggests that N95 respirators should not be recommended for general public and nonhigh‐risk medical staff those are not in close contact with influenza patients or suspected patients.
Measures of seasonal influenza control are generally divided into two categories: pharmaceutical and non-pharmaceutical interventions. The effectiveness of these measures remains unclear, because of insufficient study sample size and/or differences in study settings. This observational epidemiological study involved all elementary schoolchildren in Matsumoto City, Japan, with seasonal influenza during the 2014/2015 season. Questionnaires, including experiences with influenza diagnosis and socio-demographic factors, were distributed to all 29 public elementary schools, involving 13,217 children, at the end of February 2015. Data were obtained from 10,524 children and analyzed with multivariate logistic regression analysis. The result showed that vaccination (odds ratio 0.866, 95% confidence interval 0.786–0.954) and wearing masks (0.859, 0.778–0.949) had significant protective association. Hand washing (1.447, 1.274–1.644) and gargling (1.319, 1.183–1.471), however, were not associated with protection. In the natural setting, hand washing and gargling showed a negative association, which may have been due to inappropriate infection control measures or aggregating infected and non-infected children to conduct those measures. These results may indicate a pathway for influenza transmission and explain why seasonal influenza control remains difficult in school settings. The overall effectiveness of vaccination and mask wearing was 9.9% and 8.6%, respectively. After dividing children into higher (grades 4–6) and lower (grade 1–3) grade groups, the effectiveness of vaccination became greater in the lower grade group, and the effectiveness of wearing masks became greater in the higher grade group. These results may provide valuable information about designing infection control measures that allocate resources among children.
SARS has been called the first global epidemic of the 21st century and has been the cause of a massive and varied public health response in many countries of the world. This report describes observations made by two authors on a journey from Manchester in the United Kingdom to Chiang Mai in Thailand during the peak of global transmission. The public response to SARS, particularly characterised by the wearing of face masks, seemed to outstrip official guidance. Though of uncertain protective benefit, the wearing of masks may have contributed to the awareness of the collective and personal responsibility in combating infectious disease. Active and empowered involvement of the general public in implementing and cooperating with public health control measures supported by national and international authorities has clearly helped to bring SARS under control. The public health significance of such potent symbols as the face mask may be considered in strategies to tackle other emerging infections.
Background: There is limited information on the effect of age on the transmission of SARS-CoV-2 infection in different settings, including primary, secondary and high schools, households, and the whole community. We undertook a literature review of published studies/data on detection of SARSCoV-2 infection in contacts of COVID-19 cases, as well as serological studies, and studies of infections in the school setting to examine those issues. Results: Our literature review presents evidence for significantly lower susceptibility to infection for children aged under 10 years compared to adults given the same exposure, for elevated susceptibility to infection in adults aged over 60y compared to younger/middle aged adults, and for the risk of SARS-CoV-2 infection associated with sleeping close to an infected individual. Published serological studies also suggest that younger adults (particularly those aged under 35y) often have high cumulative rates of SARS-CoV-2 infection in the community. Additionally, there is some evidence of robust spread of SARS-CoV-2 in secondary/high schools, and there appears to be more limited spread in primary schools. Some countries with relatively large class sizes in primary schools (e.g. Chile and Israel) reported sizeable outbreaks in some of those schools, though routes of transmission of infection to both students and staff are not clear from current reports. Conclusions: Opening secondary/high schools is likely to contribute to the spread of SARS-CoV-2, and, if implemented, it should require both lower levels of community transmission and greater safeguards to reduce transmission. Compared to secondary/high schools, opening primary schools and daycare facilities may have a more limited effect on the spread of SARS-CoV-2 in the community, particularly under smaller class sizes and in the presence of mitigation measures. Efforts to avoid crowding in the classroom and other mitigation measures should be implemented, to the extent possible, when opening primary schools. Efforts should be undertaken to diminish the mixing in younger adults to mitigate the spread of the epidemic in the whole community. The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC 4.0 International license.
Background
Assessing the burden of COVID-19 on the basis of medically attended case numbers is suboptimal given its reliance on testing strategy, changing case definitions, and disease presentation. Population-based serosurveys measuring anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies provide one method for estimating infection rates and monitoring the progression of the epidemic. Here, we estimate weekly seroprevalence of anti-SARS-CoV-2 antibodies in the population of Geneva, Switzerland, during the epidemic.
Methods
The SEROCoV-POP study is a population-based study of former participants of the Bus Santé study and their household members. We planned a series of 12 consecutive weekly serosurveys among randomly selected participants from a previous population-representative survey, and their household members aged 5 years and older. We tested each participant for anti-SARS-CoV-2-IgG antibodies using a commercially available ELISA. We estimated seroprevalence using a Bayesian logistic regression model taking into account test performance and adjusting for the age and sex of Geneva's population. Here we present results from the first 5 weeks of the study.
Findings
Between April 6 and May 9, 2020, we enrolled 2766 participants from 1339 households, with a demographic distribution similar to that of the canton of Geneva. In the first week, we estimated a seroprevalence of 4·8% (95% CI 2·4–8·0, n=341). The estimate increased to 8·5% (5·9–11·4, n=469) in the second week, to 10·9% (7·9–14·4, n=577) in the third week, 6·6% (4·3–9·4, n=604) in the fourth week, and 10·8% (8·2–13·9, n=775) in the fifth week. Individuals aged 5–9 years (relative risk [RR] 0·32 [95% CI 0·11–0·63]) and those older than 65 years (RR 0·50 [0·28–0·78]) had a significantly lower risk of being seropositive than those aged 20–49 years. After accounting for the time to seroconversion, we estimated that for every reported confirmed case, there were 11·6 infections in the community.
Interpretation
These results suggest that most of the population of Geneva remained uninfected during this wave of the pandemic, despite the high prevalence of COVID-19 in the region (5000 reported clinical cases over <2·5 months in the population of half a million people). Assuming that the presence of IgG antibodies is associated with immunity, these results highlight that the epidemic is far from coming to an end by means of fewer susceptible people in the population. Further, a significantly lower seroprevalence was observed for children aged 5–9 years and adults older than 65 years, compared with those aged 10–64 years. These results will inform countries considering the easing of restrictions aimed at curbing transmission.
Funding
Swiss Federal Office of Public Health, Swiss School of Public Health (Corona Immunitas research program), Fondation de Bienfaisance du Groupe Pictet, Fondation Ancrage, Fondation Privée des Hôpitaux Universitaires de Genève, and Center for Emerging Viral Diseases.
The Spanish influenza arrived in the United States at a time when new forms of mass transportation, mass media, mass consumption, and mass warfare had vastly expanded the public places in which communicable diseases could spread. Faced with a deadly “crowd” disease, public health authorities tried to implement social-distancing measures at an unprecedented level of intensity. Recent historical work suggests that the early and sustained imposition of gathering bans, school closures, and other social-distancing measures significantly reduced mortality rates during the 1918–1919 epidemics. This finding makes it all the more important to understand the sources of resistance to such measures, especially since social-distancing measures remain a vital tool in managing the current H1N1 influenza pandemic. To that end, this historical analysis revisits the public health lessons learned during the 1918–1919 pandemic and reflects on their relevance for the present.
This article reports the first meta-analysis of the literature on protection motivation theory (Rogers, 1975, 1983; Rogers & Prentice-Dunn, 1997), a model of disease prevention and health promotion that has generated research for over two decades. The literature review included 65 relevant studies (N= approximately 30,000) that represented over 20 health issues. The mean overall effect size (d+= 0.52) was of moderate magnitude. In general, increases in threat severity, threat vulnerability, response efficacy, and self-efficacy facilitated adaptive intentions or behaviors. Conversely, decreases in maladaptive response rewards and adaptive response costs increased adaptive intentions or behaviors. This held true whether the measures were based on intentions or behaviors, and suggests that PMT components may be useful for individual and community interventions.
Behavioural responses to influenza pandemics can significantly influence the impact on public health. Protection motivation theory (PMT) provides a framework for understanding how people respond to health threats such as pandemics. The main aim of this study was to model the relative contribution of the components of PMT (threat and coping appraisal) to intentions to perform two behaviours recommended by the UK government in a pandemic: stay at home when ill and keep going to work when well.
A 2×2 factorial design was used to test the effect of scenarios describing pandemic severity (low vs. high threat) and advice messages (standard government advice vs. theory-based advice) on measures of threat and coping appraisal, and intentions to carry out the two recommended behaviours.
A web-based survey designed to assess threat appraisal, coping appraisal, and behavioural intentions was completed by 883 adults (December 2009-January 2010) drawn from University College London staff and the local community. Structural equation modelling was used to test the PMT framework. Results: Perceived pandemic severity influenced threat and coping appraisals and intentions. Structural equation modelling revealed that coping appraisal (i.e., perceptions of the costs, benefits, and feasibility of the recommended behaviours) was the principal predictor of variability in intentions for both behaviours and for both pandemic scenarios.
Coping appraisals appear to be an important, and hitherto underresearched, predictor of how people may behave in pandemics, and our findings provide encouraging preliminary evidence that it may be possible to change these perceptions.
The Spanish influenza arrived in the United States at a time when new forms of mass transportation, mass media, mass consumption, and mass warfare had vastly expanded the public places in which communicable diseases could spread. Faced with a deadly "crowd" disease, public health authorities tried to implement social-distancing measures at an unprecedented level of intensity. Recent historical work suggests that the early and sustained imposition of gathering bans, school closures, and other social-distancing measures significantly reduced mortality rates during the 1918-1919 epidemics. This finding makes it all the more important to understand the sources of resistance to such measures, especially since social-distancing measures remain a vital tool in managing the current H1N1 influenza pandemic. To that end, this historical analysis revisits the public health lessons learned during the 1918-1919 pandemic and reflects on their relevance for the present.
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