The #Covid19 #Global #Pandemic: A #Natural #Experiment in the Making (Lifestyle Genomics, summary)

[Source: Lifestyle Genomics, full page: (LINK). Summary, edited.]

The Covid-19 Global Pandemic: A Natural Experiment in the Making

Mutch D.M.a

Author affiliations: a Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada

Lifestyle Genomics | DOI: https://doi.org/10.1159/000510217

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As news began to emerge from China in late 2019 of a new infectious respiratory disease, nobody realized that we were about to be enrolled into a global natural experiment. To paraphrase Craig et al. [1], a natural experiment describes an event or intervention not under the control of a researcher, where individuals in a population can be divided into exposed and unexposed groups. Unlike clinical trials and classic research studies, the intervention associated with a natural experiment is not constrained by ethics, public perception, or granting agencies. In fact, these natural experiments happen whether people want them to or not! This is exemplified by the Dutch Hunger Winter study, which relates the severe food rationing experienced in the Western part of The Netherlands during the winter of 1944–1945 with the programming of adult disease [2]. While the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), more commonly known as COVID-19, has been devastating for people worldwide, the timeline of events spanning from closures and restrictions to phased reopenings is well documented.

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Keywords: SARS-CoV-2; COVID-19; Society.

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#Public #perspectives on #protective #measures during the #COVID19 pandemic in the #Netherlands, #Germany and #Italy: A survey study (PLOS One, abstract)

[Source: PLOS One, full page: (LINK). Abstract, edited.]

OPEN ACCESS |  PEER-REVIEWED | RESEARCH ARTICLE

Public perspectives on protective measures during the COVID-19 pandemic in the Netherlands, Germany and Italy: A survey study

Karien Meier, Toivo Glatz, Mathijs C. Guijt, Marco Piccininni, Merel van der Meulen, Khaled Atmar, Anne-Tess C. Jolink, Tobias Kurth, Jessica L. Rohmann , Amir H. Zamanipoor Najafabadi , on behalf of the COVID-19 Survey Study group

Published: August 5, 2020 | DOI: https://doi.org/10.1371/journal.pone.0236917

 

Abstract

Background

The extent to which people implement government-issued protective measures is critical in preventing further spread of coronavirus disease 2019 (COVID-19) caused by coronavirus SARS-CoV-2. Our study aimed to describe the public belief in the effectiveness of protective measures, the reported implementation of these measures, and to identify communication channels used to acquire information on COVID-19 in European countries during the early stage of the pandemic.

Methods and findings

An online survey available in multiple languages was disseminated starting on March 19th, 2020. After five days, we computed descriptive statistics for countries with more than 500 respondents. Each day, we assessed enacted community containment measures by stage of stringency (I-IV). In total, 9,796 adults responded, of whom 8,611 resided in the Netherlands (stage III), 604 in Germany (stage III), and 581 in Italy (stage IV). To explore possible dynamics as containment strategies intensified, we also included 1,365 responses submitted during the following week. Participants indicated support for governmental measures related to avoiding social gatherings, selective closure of public places, and hand hygiene and respiratory measures (range for all measures: 95.0%-99.7%). Respondents from the Netherlands less frequently considered a complete social lockdown effective (59.2%), compared to respondents in Germany (76.6%) or Italy (87.2%). Italian residents applied enforced social distancing measures more frequently (range: 90.2%-99.3%, German and Dutch residents: 67.5%-97.0%) and self-initiated hygienic and social distancing behaviors (range: 36.3%-96.6%, German and Dutch residents: 28.3%-95.7%). Respondents reported being sufficiently informed about the outbreak and behaviors to avoid infection (range: 90.2%-91.1%). Information channels most commonly reported included television newspapers, official health websites, and social media. One week later, we observed no major differences in submitted responses.

Conclusions

During the early stage of the COVID-19 pandemic, belief in the effectiveness of protective measures among survey respondents from three European countries was high and participants reported feeling sufficiently informed. In March 2020, implementation of measures differed between countries and were highest among respondents from Italy, who were subjected to the most stringent lockdown measures and greatest COVID-19 burden in Europe during this period.

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Citation: Meier K, Glatz T, Guijt MC, Piccininni M, van der Meulen M, Atmar K, et al. (2020) Public perspectives on protective measures during the COVID-19 pandemic in the Netherlands, Germany and Italy: A survey study. PLoS ONE 15(8): e0236917. https://doi.org/10.1371/journal.pone.0236917

Editor: Abdallah M. Samy, Faculty of Science, Ain Shams University (ASU), EGYPT

Received: April 13, 2020; Accepted: July 1, 2020; Published: August 5, 2020

Copyright: © 2020 Meier et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript. Data cannot be shared publicly because of we have no permission from the respondents of our survey to share the de-identified dataset with the general public (Ethics committee: METC-LDD). Data requests can be directed to our data access committee of our COVID-19 Survey Study group (contact via covid19studie@gmail.com).

Funding: The authors received no specific funding for this work.

Competing interests: Outside of the submitted work, TK reports to having contributed to an advisory board of CoLucid and a research project funded by Amgen, for which the Charité – Universitätsmedizin Berlin received an unrestricted compensation. He further reports having received honoraria from Lilly, Newsenselab, and Total for providing methodological advice, from Novartis and from Daiichi Sankyo for providing a lecture on neuroepidemiology and research methods. He is further a consulting clinical epidemiology editor at The BMJ and has received compensation for editorial services. This does not alter our adherence to PLOS ONE policies on sharing data and materials. All other authors have nothing to disclose.

Keywords: SARS-CoV-2; COVID-19; Society; Germany; Italy; Netherlands.

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Relationship of #GeorgeFloyd #protests to increases in #COVID19 cases using event study methodology (J Pub Health, abstract)

[Source: Journal of Public Health, full page: (LINK). Abstract, edited.]

Relationship of George Floyd protests to increases in COVID-19 cases using event study methodology

Randall Valentine, Dawn Valentine, Jimmie L Valentine

Journal of Public Health, fdaa127, https://doi.org/10.1093/pubmed/fdaa127

Published: 05 August 2020

 

Abstract

Background

Protests ignited by the George Floyd incident were examined for any significant impact on COVID-19 infection rates in select US cities.

Methods

Eight US cities were studied in which protestors in the tens of thousands were reported. Only cities that reside in states whose stay-at-home orders had been rescinded or expired for a minimum of 30 days were included in the sample to account for impact of growth rates solely due to economies reopening. Event study methodology was used with a 30-day estimation period to examine whether growth in COVID-19 infection rates was significant.

Results

In the eight cities analyzed, all had positive abnormal growth in infection rate. In six of the eight cities, infection rate growth was positive and significant.

Conclusions

In this study, it was apparent that violations of Centers for Disease Control and Prevention (CDC)-recommended social distancing guidelines caused a significant increase in infection rates. The data suggest that to slow the spread of COVID-19, CDC guidelines must be followed in protest situations.

COVID-19, public health, social distancing

Topic:  infections – growth rate – covid-19

Issue Section:  Original Article

Keywords: SARS-CoV-2; COVID-19; Society; Civil unrests; Epidemiology; USA.

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#Social #distancing laws cause only small #losses of #economic #activity during the #COVID19 pandemic in #Scandinavia (Proc Natl Acad Sci USA, abstract)

[Source: Proceedings of the National Academy of Sciences of the United States of America, full page: (LINK). Abstract, edited.]

Social distancing laws cause only small losses of economic activity during the COVID-19 pandemic in Scandinavia

Adam Sheridan,  Asger Lau Andersen,  Emil Toft Hansen, and Niels Johannesen

PNAS first published August 3, 2020 https://doi.org/10.1073/pnas.2010068117

Edited by Jose A. Scheinkman, Columbia University, New York, NY, and approved July 16, 2020 (received for review May 19, 2020)

 

Significance

Social distancing laws that restrict the activities of private businesses are often seen as sacrificing the economy to save lives from COVID-19. Indeed, many countries have experienced massive reductions in consumer spending around the time they began to shut down. We show that these restrictions are, in fact, responsible for only a small portion of the drop in consumer spending. This suggests that the virus itself is responsible for the majority of the economic damage. We find that social distancing laws may provide an economic benefit: the laws reduce the economic activity of the low-risk population and can thus protect those with the greatest risk of mortality from also bearing the greatest burden in terms of reduced spending.

 

Abstract

This paper uses real-time transaction data from a large bank in Scandinavia to estimate the effect of social distancing laws on consumer spending in the coronavirus 2019 (COVID-19) pandemic. The analysis exploits a natural experiment to disentangle the effects of the virus and the laws aiming to contain it: Denmark and Sweden were similarly exposed to the pandemic but only Denmark imposed significant restrictions on social and economic activities. We estimate that aggregate spending dropped by around 25% (95% CI: 24 to 26%) in Sweden and, as a result of the shutdown, by 4 additional percentage points (95% CI: 3 to 5 percentage points [p.p.]) in Denmark. This suggests that most of the economic contraction is caused by the virus itself and occurs regardless of social distancing laws. The age gradient in the estimates suggests that social distancing reinforces the virus-induced drop in spending for low-health-risk individuals but attenuates it for high-risk individuals by lowering the overall prevalence of the virus in the society.

COVID-19 – consumer spending – social distancing – shutdown

 

Footnotes

1 To whom correspondence may be addressed. Email: adam.sheridan@econ.ku.dk.

Author contributions: A.S., A.L.A., E.T.H., and N.J. designed research; A.S., A.L.A., E.T.H., and N.J. performed research; A.S. and E.T.H. analyzed data; and A.S., A.L.A., E.T.H., and N.J. wrote the paper.

The authors declare no competing interest.

This article is a PNAS Direct Submission.

This article contains supporting information online at https://www.pnas.org/lookup/suppl/doi:10.1073/pnas.2010068117/-/DCSupplemental.
Published under the PNAS license.

Keywords: SARS-CoV-2; COVID-19; Quarantine; Denmark; Sweden; Society.

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#COVID19 Pandemic: Disparate #Health #Impact on the #Hispanic / #Latinx Population in the #USA (J Infect Dis., abstract)

[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

COVID-19 Pandemic: Disparate Health Impact on the Hispanic/Latinx Population in the United States

Raul Macias Gil, MD, Jasmine R Marcelin, MD FACP, Brenda Zuniga-Blanco, MD, Carina Marquez, MD MPH, Trini Mathew, MD MPH FACP FIDSA, Damani A Piggott, MD PhD

The Journal of Infectious Diseases, jiaa474, https://doi.org/10.1093/infdis/jiaa474

Published: 30 July 2020

 

Abstract

In December 2019, a novel coronavirus known as SARS-CoV-2, emerged in Wuhan, China, causing the Coronavirus disease 2019 we now refer to as COVID-19. The World Health Organization declared COVID-19 a pandemic on March 12th, 2020. In the United States, the COVID-19 pandemic has exposed pre-existing social and health disparities among several historically vulnerable populations, with stark differences in the proportion of minority individuals diagnosed with and dying from COVID-19. In this article we will describe the emerging disproportionate impact of COVID-19 on the Hispanic/Latinx (henceforth: Hispanic or Latinx) community in the U.S., discuss potential antecedents and consider strategies to address the disparate impact of COVID-19 on this population.

COVID-19, coronavirus, SARS-CoV-2, Hispanic, Latinx, health disparity

Issue Section: Perspectives

This content is only available as a PDF.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: SARS-CoV-2; COVID-19; Society; USA.

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The #impact of #socioeconomic #status on 30‐day #mortality in hospitalised patients with #COVID19 infection (J Med Virol., abstract)

[Source: Journal of Medical Virology, full page: (LINK). Abstract, edited.]

The impact of socioeconomic status on 30‐day mortality in hospitalised patients with COVID‐19 infection

Mr Khurram Shahzad Khan,  Dr Giuliana Torpiano,  Ms Morag McLellan,  Mr Sajid Mahmud

First published: 30 July 2020 | DOI:  https://doi.org/10.1002/jmv.26371

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/jmv.26371

 

Abstract

Socioeconomic status (SES) impacts outcome in number of diseases. Our aim was to compare the outcome of hospitalised COVID‐19 patients in low and high SES group. Prospective cohort study of hospitalised patients with confirmed COVID‐19 in three acute hospitals. Electronic case notes were analysed for baseline characteristics and admission investigations. Scottish Index for Multiple Deprivation (SIMD) was used to divide patients into two groups: more deprived (SIMD 1–5) and less deprived (SIMD 6–10) and results compared. Poor outcome was defined as either need for intubation and/or death. 173 patients were identified, one was excluded. 108 (62.8%) were males, mean age was 68.5 ± 14.7 years. Commonest comorbidity was hypertension 87 (50.6%). 117 (68.0%) patients were in more deprived group. Baseline characteristics, admission blood profile and reason for admission were evenly matched in both groups. Outcomes were comparable in both groups: transfer to critical care (27.4% vs 27.3%, p 0.991), intubation (18.8% vs 20.2%, p 0.853), 30‐day all‐cause mortality (19.7% vs 14.5%, p 0.416) and overall poor outcome (30.8% vs 30.9%, p 0.985). Median time to discharge was 7 days longer (17 vs 10 days, p=0.018) and median time to death was 4.5 days longer in more deprived group (17 vs 12.5 days, p=0.388). Contrary to recent literature on COVID‐19 in other geographical areas, our study suggests that the SES does not have any impact on outcome of hospitalised COVID‐19 patients, however it negatively impacts length of stay.

This article is protected by copyright. All rights reserved.

Keywords: SARS-CoV-2; COVID-19; Society.

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#Social #distancing #responses to #COVID19 #emergency declarations strongly differentiated by #income (Proc Natl Acad Sci USA, abstract)

[Source: Proceedings of the National Academy of Sciences of the United States of America, full page: (LINK). Abstract, edited.]

Social distancing responses to COVID-19 emergency declarations strongly differentiated by income

Joakim A. Weill,  Matthieu Stigler,  Olivier Deschenes, and  Michael R. Springborn

PNAS first published July 29, 2020 https://doi.org/10.1073/pnas.2009412117

Edited by Douglas S. Massey, Princeton University, Princeton, NJ, and approved July 20, 2020 (received for review May 11, 2020)

 

Abstract

In the absence of a vaccine, social distancing measures are one of the primary tools to reduce the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, which causes coronavirus disease 2019 (COVID-19). We show that social distancing following US state-level emergency declarations substantially varies by income. Using mobility measures derived from mobile device location pings, we find that wealthier areas decreased mobility significantly more than poorer areas, and this general pattern holds across income quantiles, data sources, and mobility measures. Using an event study design focusing on behavior subsequent to state emergency orders, we document a reversal in the ordering of social distancing by income: Wealthy areas went from most mobile before the pandemic to least mobile, while, for multiple measures, the poorest areas went from least mobile to most. Previous research has shown that lower income communities have higher levels of preexisting health conditions and lower access to healthcare. Combining this with our core finding—that lower income communities exhibit less social distancing—suggests a double burden of the COVID-19 pandemic with stark distributional implications.

inequalities – COVID-19 – social distancing

 

Footnotes

1 To whom correspondence may be addressed. Email: jweill@ucdavis.edu.

Author contributions: J.A.W., M.S., O.D., and M.R.S. designed research; J.A.W., M.S., O.D., and M.R.S. performed research; J.A.W. and M.S. analyzed data; J.A.W., M.S., O.D., and M.R.S. wrote the paper; and J.A.W. and M.R.S. provided project management.

The authors declare no competing interest.

Data Availability: Mobility data are available from PlaceIQ via the “device exposure” variable derived by and available from ref. 16; Google Mobility Reports (available at https://www.google.com/covid19/mobility/); and SafeGraph (freely provided upon request submitted at https://www.safegraph.com/covid-19-data-consortium). ACS data are provided on the ACS website. State emergency declaration dates and code used to run the models are available on Github https://github.com/JoakimWeill/covid_mobility_income_PNAS.

Copyright © 2020 the Author(s). Published by PNAS. This open access article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND).

Keywords: SARS-CoV-2; COVID-19; Society; Poverty; Quarantine.

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#Assessment of #Community-Level #Disparities in #Coronavirus Disease 2019 (#COVID19) Infections and #Deaths in Large #US #Metropolitan Areas (JAMA Netw Open, summary)

[Source: JAMA Network Open, full page: (LINK). Summary, edited.]

Assessment of Community-Level Disparities in Coronavirus Disease 2019 (COVID-19) Infections and Deaths in Large US Metropolitan Areas

Samrachana Adhikari, PhD1; Nicholas P. Pantaleo, MPH1; Justin M. Feldman, ScD1; Olugbenga Ogedegbe, MD1,2; Lorna Thorpe, PhD1; Andrea B. Troxel, ScD1

Author Affiliations: 1 Department of Population Health, New York University Grossman School of Medicine; 2 Department of Medicine, New York University Grossman School of Medicine

JAMA Netw Open. 2020;3(7):e2016938. doi:10.1001/jamanetworkopen.2020.16938

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Introduction: Urban counties in large metropolitan areas in the United States are among the most affected by the coronavirus disease 2019 (COVID-19) pandemic, with high proportions of confirmed infection among those who have been tested.1 While there is growing evidence of disparities by race/ethnicity across neighborhoods,2,3 the extent to which neighborhood poverty is associated with infection and deaths is not clear. In this cross-sectional study, we examined the association of neighborhood race/ethnicity and poverty with COVID-19 infections and related deaths in urban US counties, hypothesizing disproportionate burdens in counties with a larger percentage of the population belonging to minority racial/ethnic groups and a higher rate of poverty. This study is among the first to investigate such associations in US metropolitan areas.

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Keywords: SARS-CoV-2; COVID-19; Society; USA.

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Comparison of Weighted and Unweighted #Population #Data to Assess #Inequities in #Coronavirus Disease 2019 #Deaths by #Race/Ethnicity Reported by the #US #CDC (JAMA Netw Open, summary)

[Source: JAMA Network Open, full page: (LINK). Summary, edited.]

Comparison of Weighted and Unweighted Population Data to Assess Inequities in Coronavirus Disease 2019 Deaths by Race/Ethnicity Reported by the US Centers for Disease Control and Prevention

Tori L. Cowger, MPH1,2,3; Brigette A. Davis, MPH1,3,4; Onisha S. Etkins, MS1,3,4; Keletso Makofane, MPH1,3,4; Jourdyn A. Lawrence, MSPH1,3,4; Mary T. Bassett, MD, MPH1,4; Nancy Krieger, PhD4

Author Affiliations: 1 FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; 2 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; 3 Population Health Sciences Department, Harvard Graduate School of Arts and Sciences, Cambridge, Massachusetts; 4 Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

JAMA Netw Open. 2020;3(7):e2016933. doi:10.1001/jamanetworkopen.2020.16933

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Introduction: Surveillance and mortality data show large inequities in the impact of coronavirus disease 2019 (COVID-19) by race/ethnicity.1 Currently, the US Centers for Disease Control and Prevention (CDC) does not report mortality rates by race/ethnicity. Instead, the percentage distribution of COVID-19 deaths by race/ethnicity is presented alongside a weighted distribution of the population from the CDC’s National Center for Health Statistics,2 which weights each county’s population by its share of COVID-19 deaths, not population (Figure). We investigated whether the resulting magnitude of inequities using the weighted population underestimates those observed using the total population (unweighted).

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Keywords: SARS-CoV-2; COVID-19; Society; USA.

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Comparison of #Face – #Touching #Behaviors Before and During the #Coronavirus Disease 2019 Pandemic (JAMA Netw Open, abstract)

[Source: JAMA Network Open, full page: (LINK). Abstract, edited.]

Comparison of Face-Touching Behaviors Before and During the Coronavirus Disease 2019 Pandemic

Yong-Jian Chen, MD1; Gang Qin, MD1,2; Jie Chen, MD1; Jian-Liang Xu, MD3; Ding-Yun Feng, MD4; Xiang-Yuan Wu, MD1; Xing Li, MD1

Author Affiliations: 1 Guangdong Key Laboratory of Liver Disease Research, Department of Medical Oncology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; 2 Grade 2015, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; 3 Department of Hepatobiliary Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; 4 Department of Pulmonary and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

JAMA Netw Open. 2020;3(7):e2016924. doi:10.1001/jamanetworkopen.2020.16924

 

Key Points

  • Question  – Is wearing face masks associated with reduced face-touching behaviors?
  • Findings  – In this cross-sectional study, including 4699 individuals before the coronavirus disease 2019 (COVID-19) pandemic and 2887 individuals during the COVID-19 pandemic, mandatory mask-wearing policies were associated with increased mask wearing among the general population during the COVID-19 pandemic. Wearing masks, either medical or fabric, was associated with reduced face-touching behavior, especially touching of the eyes, nose, and mouth.
  • Meaning  – These findings suggest that mandatory mask-wearing policies were associated with reducing face-touching behavior among the general population in public areas, which may help to prevent contact transmission of COVID-19.

 

Abstract

Importance  

There is insufficient evidence on the efficacy of masks in the general population for the prevention of coronavirus disease 2019 (COVID-19) in public areas. Therefore, it is imperative to investigate the association of mandatory mask-wearing policies with behaviors associated with the transmission of COVID-19.

Objective  

To assess the association of mask wearing with face-touching behavior among the general population in public areas.

Design, Setting, and Participants  

This cross-sectional study used videos recorded in public transportation stations, streets, and parks among the general population in China, Japan, South Korea, Western Europe (ie, England, France, Germany, Spain, and Italy), and the US to analyze mask-wearing and face-touching behavior in public areas. Videos before the COVID-19 pandemic were defined as those recorded from January 2018 to October 2019, and those during the COVID-19 pandemic were defined as those recorded during February 2020 to March 2020 in China, Japan, and South Korea and during March 2020 in Western Europe and the US. Individuals who clearly displayed their face and face-touching behavior were included, and those whose behaviors were influenced by filming or public events were excluded.

Exposures  

Mandatory mask-wearing policies enacted at various time points in China, Japan, South Korea, Western Europe, and the US.

Main Outcomes and Measures  

Proportion of individuals wearing masks and incidence of face touching.

Results  

This study included 4699 individuals before the COVID-19 pandemic and 2887 individuals during the pandemic. During the periods studied, mask wearing increased in all regions except the US, from 20 of 1745 individuals (1.1%) to 1090 of 1097 individuals (99.4%) in mainland China (P < .001), 44 of 1422 individuals (3.1%) to 346 of 893 individuals (38.7%) in Japan (P < .001), 6 of 717 individuals (0.8%) to 277 of 324 individuals (85.5% ) in South Korea (P < .001), 1 of 546 individuals (0.2%) to 6 of 379 individuals (1.6%) in Western Europe (P = .02), and 1 of 269 individuals (0.4%) to 4 of 194 individuals (2.1%) in the US (P = .17). Surgical masks were predominant in China (989 masks [89.1%]), and fabric masks were predominant in the other regions (Japan: 371 masks [95.1%]; South Korea: 240 masks [84.8%]; Western Europe: 6 masks [85.7%]; US: 5 masks [100%]). Face-touching behaviors decreased from before COVID-19 to during COVID-19 among individuals in China (72 incidences of 1745 observations [4.1%] to 12 incidences of 1097 observations [1.1%]; P < .001), South Korea (80 incidences of 717 observations [11.2%] to 7 incidences of 324 observations [2.2%]; P < .001), and Europe (62 incidences of 546 observations [11.4%] to 23 incidences of 379 observations [6.1%]; P = .01). Logistic regression found that mask wearing was associated with a reduction in face touching in China (odds ratio [OR], 3.91; 95% CI, 2.11-7.24) and South Korea (OR, 6.69; 95% CI, 2.69-16.69) and of touching the nose, mouth, and eyes (China: OR, 8.60; 95% CI, 2.65-27.86; South Korea: OR, 29.27; 95% CI, 1.79-478.22).

Conclusions and Relevance  

The findings of this cross-sectional study suggest that mandatory mask-wearing policies were associated with increased mask wearing during the COVID-19 pandemic. Mask wearing was associated with reduced face-touching behavior, especially touching of the eyes, nose, and mouth, which may prevent contact transmission of COVID-19 among the general population in public areas.

Keywords: SARS-CoV-2; COVID-19; Facemasks; Society; China.

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