Search

Nonpharmaceutical interventions (NPIs) like social distancing, face masks, and handwashing will continue to be a frontline defense against Covid-19 for some time. But their effectiveness depends critically on compliance by young adults, who are most likely both to become infected and to infect others. We conducted a randomized controlled trial in Bogotá, Colombia, to assess the effectiveness of informational nudges emphasizing the private and public benefits of compliance on university students' concern about Covid-19, recent compliance with NPI recommendations, and intended future compliance. Although nudges boosted concern, they had limited effects on either recent or intended future compliance. We attribute these null results to high baseline levels of information about and compliance with NPIs, an informational diminishing returns scenario that is likely to be increasingly common globally. [ABSTRACT FROM AUTHOR]

Introduction: Non-pharmaceutical interventions (NPIs) such as lockdown, social distancing and use of face coverings was adopted by the United Kingdom (UK) Armed Forces (AF) during the COVID-19 pandemic. This study assessed the impact of the use of NPIs on the incidence of influenza-like illness (ILI) in the UK AF. Methods: A longitudinal study design was adopted, and secondary data was analysed retrospectively. Clinical Read codes for ILI was used to generate data for flu seasons before and during the COVID-19 pandemic (September 2017 to April 2021). Results: Before the COVID-19 pandemic, the rate of reporting ILI was ~ 4% across all flu seasons. The count of ILI was 2.9%, 2.2% and 3.1% during 2017–18, 2018–19 and 2019–20 flu seasons respectively. During the COVID-19 pandemic, both the rate of reporting ILI (0.6%) and the count of ILI (0.5%) were significantly smaller (p <.001). The rate of reporting ILI was positively correlated with the count of ILI (r (2) =.97, p =.014). Influenza vaccination rate increased by 1.3% during the COVID-19 pandemic. Vaccination rate was negatively correlated with the rate of reporting ILI (r (2) = -.52, p = 0.24) and the count of ILI (r (2) = -.61, p = 0.19). However, this correlation was not significant. The use of NPIs was negatively correlated with the rate of reporting ILI (r (2) = -.99, p = <.001) and the count of ILI (r (2) = -.95, p = 0.026). The overall multiple regression performed was statistically significant (R2 = 0.94, F (1, 2) = 33.628, p = 0.028). The rate of reporting ILI significantly predicted the count of ILI (β = 0.609, p = 0.028) while vaccination rate did not significantly predict the count of ILI (β = -0.136, p = 0.677). Conclusions: The incidence of ILI in the UK AF was significantly reduced during the COVID-19 pandemic. The use of NPIs and the rate of reporting ILI significantly reduced the count of ILI. Being vaccinated for influenza did not significantly reduce the count of ILI. [ABSTRACT FROM AUTHOR]

The rapid spread of COVID-19 in Ethiopia was attributed to joint effects of multiple factors such as low adherence to face mask-wearing, failure to comply with social distancing measures, many people attending religious worship activities and holiday events, extensive protests, country election rallies during the pandemic, and the war between the federal government and Tigray Region. This study built a system dynamics model to capture COVID-19 characteristics, major social events, stringencies of containment measures, and vaccination dynamics. This system dynamics model served as a framework for understanding the issues and gaps in the containment measures against COVID-19 in the past period (16 scenarios) and the spread dynamics of the infectious disease over the next year under a combination of different interventions (264 scenarios). In the counterfactual analysis, we found that keeping high mask-wearing adherence since the outbreak of COVID-19 in Ethiopia could have significantly reduced the infection under the condition of low vaccination level or unavailability of the vaccine supply. Reducing or canceling major social events could achieve a better outcome than imposing constraints on people's routine life activities. The trend analysis found that increasing mask-wearing adherence and enforcing more stringent social distancing were two major measures that can significantly reduce possible infections. Higher mask-wearing adherence had more significant impacts than enforcing social distancing measures in our settings. As the vaccination rate increases, reduced efficacy could cause more infections than shortened immunological periods. Offsetting effects of multiple interventions (strengthening one or more interventions while loosening others) could be applied when the levels or stringencies of one or more interventions need to be adjusted for catering to particular needs (e.g., less stringent social distancing measures to reboot the economy or cushion insufficient resources in some areas). [ABSTRACT FROM AUTHOR]

Background: In response to the novel Coronavirus Disease 2019 (COVID-19) pandemic, the Department of Veterans Affairs (VA) Million Veteran Program (MVP) organized efforts to better understand the impact of COVID-19 on Veterans by developing and deploying a self-reported survey. Methods: The MVP COVID-19 Survey was developed to collect COVID-19 specific elements including symptoms, diagnosis, hospitalization, behavioral and psychosocial factors and to augment existing MVP data with longitudinal collection of key domains in physical and mental health. Due to the rapidly evolving nature of the pandemic, a multipronged strategy was implemented to widely disseminate the COVID-19 Survey and capture data using both the online platform and mailings. Results: We limited the findings of this paper to the initial phase of survey dissemination which began in May 2020. A total of 729,625 eligible MVP Veterans were invited to complete version 1 of the COVID-19 Survey. As of October 31, 2020, 58,159 surveys have been returned. The mean and standard deviation (SD) age of responders was 71 (11) years, 8.6% were female, 8.2% were Black, 5.6% were Hispanic, and 446 (0.8%) self-reported a COVID-19 diagnosis. Over 90% of responders reported wearing masks, practicing social distancing, and frequent hand washing. Conclusion: The MVP COVID-19 Survey provides a systematic collection of data regarding COVID-19 behaviors among Veterans and represents one of the first large-scale, national surveillance efforts of COVID-19 in the Veteran population. Continued work will examine the overall response to the survey with comparison to available VA health record data. [ABSTRACT FROM AUTHOR]

Governments around the world are seeking to slow the spread of Covid-19 by implementing measures that encourage, or mandate, changes in people's behaviour. These changes include the wearing of face masks, social distancing, and testing and self-isolating when unwell. The success of these measures depends on the commitment of individuals to change their behaviour accordingly. Understanding and predicting the motivation of individuals to change their behaviour is therefore critical in assessing the likely effectiveness of these measures in slowing the spread of the virus. In this paper we draw on a novel framework, the I3 Compliance Response Framework, to understand and predict the motivation of residents in Auckland, New Zealand, to comply with measures to prevent the spread of Covid-19. The Framework is based on two concepts. The first uses the involvement construct to predict the motivation of individuals to comply. The second separates the influence of the policy measure from the influence of the policy outcome on the motivation of individuals to comply. In short, the Framework differentiates between the strength of individuals' motivation and their beliefs about the advantages and disadvantages of policy outcomes and policy measures. We found this differentiation was useful in predicting an individual's possible behavioural responses to a measure and discuss how it could assist government agencies to develop strategies to enhance compliance. [ABSTRACT FROM AUTHOR]

The global pandemic of COVID-19 revealed the dynamic heterogeneity in how individuals respond to infection risks, government orders, and community-specific social norms. Here we demonstrate how both individual observation and social learning are likely to shape behavioral, and therefore epidemiological, dynamics over time. Efforts to delay and reduce infections can compromise their own success, especially when disease risk and social learning interact within sub-populations, as when people observe others who are (a) infected and/or (b) socially distancing to protect themselves from infection. Simulating socially-learning agents who observe effects of a contagious virus, our modelling results are consistent with with 2020 data on mask-wearing in the U.S. and also concur with general observations of cohort induced differences in reactions to public health recommendations. We show how shifting reliance on types of learning affect the course of an outbreak, and could therefore factor into policy-based interventions incorporating age-based cohort differences in response behavior. [ABSTRACT FROM AUTHOR]

By September 2020, COVID-19 had claimed the lives of almost 1 million people worldwide, including more than 400,000 in the U.S. and Europe [1] To slow the spread of the virus, health officials advised social distancing, regular handwashing, and wearing a face covering [2]. We hypothesized that public adherence to the health guidance would be influenced by prevailing social norms, and the prevalence of these behaviors among others. We focused on mask-wearing behavior during fall 2020, and coded livestream public webcam footage of 1,200 individuals across seven cities. Results showed that only 50% of participants were correctly wearing a mask in public, and that this percentage varied as a function of the mask-wearing behavior of close and distant others in the immediate physical vicinity. How social normative information might be used to increase mask-wearing behavior is discussed. "Cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus—particularly when used universally within a community setting" CDC Director Dr. Robert Redfield in July 2020. [ABSTRACT FROM AUTHOR]

Humans typically create and maintain social bonds through interactions that occur at close social distances. The interpersonal distance of at least 1 m recommended as a relevant measure for COVID-19 contagion containment requires a significant change in everyday behavior. In a web-based experimental study conducted during the first pandemic wave (mid-April 2020), we asked 242 participants to regulate their preferred distance towards confederates who did or did not wear protective masks and gloves and whose COVID-19 test results were positive, negative, or unknown. Information concerning dispositional factors (perceived vulnerability to disease, moral attitudes, and prosocial tendencies) and situational factors (perceived severity of the situation in the country, frequency of physical and virtual social contacts, and attitudes toward quarantine) that may modulate compliance with safety prescriptions was also acquired. A Bayesian analysis approach was adopted. Individual differences did not modulate interpersonal distance. We found strong evidence in favor of a reduction of interpersonal distance towards individuals wearing protective equipment and who tested negative to COVID-19. Importantly, shorter interpersonal distances were maintained towards confederates wearing protective gear, even when their COVID-19 test result was unknown or positive. This protective equipment-related regulation of interpersonal distance may reflect an underestimation of perceived vulnerability to infection; this perception must be discouraged when pursuing individual and collective health-safety measures. [ABSTRACT FROM AUTHOR]

One of the main challenges during the COVID-19 pandemic is the lack of safety measures and guidelines to reduce the risk of viral spread among people during gatherings. This study was conducted to evaluate the distance of oral and nasal droplet spread in a model that simulates coughing and sneezing in a public setting, specifically a school setting, to guide faculty and staff members with safety measures and guidelines to reduce droplet spread. Several models were prepared to observe and visualize the spread of fluid simulating respiratory droplets in places such as the classroom and the cafeteria, in which a student would be more susceptible to contract a virus since individuals cannot wear masks while eating. For all trials, a 2.54 centimeter balloon with 0.3 milliliters of diluted fluorescent paint was placed inside a mannequin head and was exploded outwards from the mannequin's mouth at 5 pounds per square inch (psi). Using a black light, the expelled fluorescent macroscopic droplets were visualized. When applying safety precautions and guidelines such as mandating face masks, the results of the experiments conducted in this study with a surgical mask, were extremely positive. However, without other safety precautions such as face masks and barriers, social distancing proved to be ineffective. In conclusion the most effective way to prevent droplet spread during activities where masks simply cannot be worn, such as eating, is to apply barriers between the individuals. Applying barriers and wearing masks successfully prevented macroscopic droplet spread. [ABSTRACT FROM AUTHOR]

In the absence of vaccines or causal therapies, behavioral measures such as wearing face masks and maintaining social distance are central to fighting Covid-19. Yet, their benefits are often questioned by the population and the level of adherence to the measures is variable. We examined in representative samples across eight countries (N = 7,568) whether adherence reported around June 1, 2020 predicted the increase in Covid-19 mortality by August 31, 2020. Mortality increased 81.3% in low adherence countries (United States, Sweden, Poland, Russia), 8.4% in high adherence countries (Germany, France, Spain, United Kingdom). Across countries adherence and subsequent mortality increases correlated with r = -0.91. No African or South American countries were included in the present study, which limits the generalizability of the findings. While reported Covid-19 mortality is likely to be influenced by other factors, the almost tenfold difference in additional mortality is significant, and may inform decisions when choosing whether to prioritize individual liberty rights or health-protective measures. [ABSTRACT FROM AUTHOR]

Current facemask research focuses on material characterization and efficiency; however, facemasks are often not tested such that aerosol distributions are evaluated from the gaps in the sides, bottom, and nose areas. Poor evaluation methods could lead to misinformation on optimal facemasks use; a high-throughput, reproducible method which illuminates the issue of fit influencing aerosol transmission is needed. To this end, we have created an in vitro model to quantify particle transmission by mimicking exhalation aerosols in a 3D printed face-nose-mouth replica via a nebulizer and quantifying particle counts using a hand-held particle counter. A sewn, sewn with pipe cleaner nose piece, and sewn with a coffee filter facemask were used to evaluate current common homemade sewn facemask designs, benchmarked against industry standard surgical, N95 respirator tightly fit, and N95 respirator loosely fit facemasks. All facemasks have significantly reduced particle counts in front of the facemask, but the side and top of the facemask showed increases in particle counts over the no facemask condition at that same position, suggesting that some proportion of aerosols are being redirected to these gaps. An altered size distribution of aerosols that escape at the vulnerable positions was observed; escaped particles have larger count median diameters, with a decreased ratio of smaller to larger particles, possibly due to hygroscopic growth or aggregation. Of the homemade sewn facemasks, the facemask with a coffee filter insert performed the best at reducing escaped aerosols, with increased efficiency also observed for sewn masks with a pipe cleaner nose piece. Importantly, there were minimal differences between facemasks at increasing distances, which supports that social distance is a critical element in reducing aerosol transmission. This work brings to light the importance of quantifying particle count in positions other than directly in front of the facemask and identifies areas of research to be explored. [ABSTRACT FROM AUTHOR]

In the context of the Covid-19 pandemic, barrier gestures such as regular hand-washing, social distancing, and wearing a face mask are highly recommended. Critically, interpersonal distance (IPD) depends on the affective dimension of social interaction, which might be affected by the current Covid-19 context. In the present internet-based experimental study, we analyzed the preferred IPD of 457 French participants when facing human-like characters that were either wearing a face mask or displaying a neutral, happy or angry facial expression. Results showed that IPD was significantly reduced when characters were wearing a face mask, as they were perceived as more trustworthy compared to the other conditions. Importantly, IPD was even more reduced in participants infected with Covid-19 or living in low-risk areas, while it was not affected by the predicted health of the characters. These findings shed further light on the psychological factors that motivate IPD adjustments, in particular when facing a collective threat. They are also of crucial importance for policy makers as they reveal that despite the indisputable value of wearing a face mask in the current pandemic context, their use should be accompanied by an emphasis on social distancing to prevent detrimental health consequences. [ABSTRACT FROM AUTHOR]