scholarly journals Association of social distancing and masking with risk of COVID-19

2020 ◽  
Author(s):  
Sohee Kwon ◽  
Amit D. Joshi ◽  
Chun-Han Lo ◽  
David A. Drew ◽  
Long H. Nguyen ◽  
...  
Keyword(s):  
Decision Making ◽  
Cohort Study ◽  
Severe Acute Respiratory Syndrome ◽  
Lower Risk ◽  
Unmet Need ◽  
Risk Of Infection ◽  
Social Distancing ◽  
Inform Decision Making ◽  
The U.S ◽  
Reduced Risk

AbstractGiven the continued burden of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) disease (COVID-19) across the U.S., there is a high unmet need for data to inform decision-making regarding social distancing and universal masking. We examined the association of community-level social distancing measures and individual masking with risk of predicted COVID-19 in a large prospective U.S. cohort study of 198,077 participants. Individuals living in communities with the greatest social distancing had a 31% lower risk of predicted COVID-19 compared with those living in communities with poor social distancing. Self-reported masking was associated with a 63% reduced risk of predicted COVID-19 even among individuals living in a community with poor social distancing. These findings provide support for the efficacy of mask-wearing even in settings of poor social distancing in reducing COVID-19 transmission. In the current environment of relaxed social distancing mandates and practices, universal masking may be particularly important in mitigating risk of infection.

scholarly journals Association of social distancing and face mask use with risk of COVID-19

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Sohee Kwon ◽  
Amit D. Joshi ◽  
Chun-Han Lo ◽  
David A. Drew ◽  
Long H. Nguyen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lower Risk ◽  
Unmet Need ◽  
Face Mask ◽  
Mass Vaccination ◽  
Community Level ◽  
Social Distancing ◽  
The World ◽  
Vaccination Campaigns ◽  
Reduced Risk

AbstractGiven the continued burden of COVID-19 worldwide, there is a high unmet need for data on the effect of social distancing and face mask use to mitigate the risk of COVID-19. We examined the association of community-level social distancing measures and individual face mask use with risk of predicted COVID-19 in a large prospective U.S. cohort study of 198,077 participants. Individuals living in communities with the greatest social distancing had a 31% lower risk of predicted COVID-19 compared with those living in communities with poor social distancing. Self-reported ‘always’ use of face mask was associated with a 62% reduced risk of predicted COVID-19 even among individuals living in a community with poor social distancing. These findings provide support for the efficacy of mask-wearing even in settings of poor social distancing in reducing COVID-19 transmission. Despite mass vaccination campaigns in many parts of the world, continued efforts at social distancing and face mask use remain critically important in reducing the spread of COVID-19.

scholarly journals Relationship Between COVID-19 Infection and Risk Perception, Knowledge, Attitude, and Four Nonpharmaceutical Interventions During the Late Period of the COVID-19 Epidemic in China: Online Cross-Sectional Survey of 8158 Adults (Preprint)

2020 ◽  
Author(s):  
Hong Xu ◽  
Yong Gan ◽  
Daikun Zheng ◽  
Bo Wu ◽  
Xian Zhu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Risk Perception ◽  
Positive Attitude ◽  
The Other ◽  
Protective Measure ◽  
Risk Of Infection ◽  
Social Distancing ◽  
Public Risk ◽  
Nonpharmaceutical Interventions ◽  
Reduced Risk

BACKGROUND So far, there have been no published population studies on the relationship between a COVID-19 infection and public risk perception, information source, knowledge, attitude, and behaviors during the COVID-19 outbreak in China. OBJECTIVE This study aims to understand the relationships between COVID-19 infection; four personal nonpharmaceutical interventions (NPIs; handwashing, proper coughing habits, social distancing, and mask wearing); and public risk perception, knowledge, attitude, and other social demographic variables. METHODS An online survey of 8158 Chinese adults between February 22 and March 5, 2020, was conducted. Bivariate associations between categorical variables were examined using Fisher exact test. We also explored the determinants of four NPIs as well as their association with COVID-19 infection using logistic regression. RESULTS Of 8158 adults included, 57 (0.73%) were infected with COVID-19. The overwhelming majority of respondents showed a positive attitude (n=8094, 99.2%), positive risk perception (n=8146, 99.9%), and high knowledge levels that were among the strongest predictors of the four adopted NPIs (handwashing: n=7895, 96.8%; proper coughing: 5997/6444, 93.1%; social distancing: n=7104/8158, 87.1%; and mask wearing: 5011/5120, 97.9%). There was an increased risk of COVID-19 infection for those who did not wash their hands (2.28% vs 0.65%; risk ratio [RR] 3.53, 95% CI 1.53-8.15; <i>P</i>=.009), did not practice proper coughing (1.79% vs 0.73%; RR 2.44, 95% CI 1.15-5.15; <i>P</i>=.03), did not practice social distancing (1.52% vs 0.58%; RR 2.63, 95% CI 1.48-4.67; <i>P</i>=.002), and did not wear a mask (7.41% vs 0.6%; RR 12.38, 95% CI 5.81-26.36; <i>P</i>&lt;.001). For those who did practice all other three NPIs, wearing a mask was associated with a significantly reduced risk of infection compared to those who did not wear a mask (0.6% vs 16.7%; <i>P</i>=.04). Similarly, for those who did not practice all or part of the other three NPIs, wearing a mask was also associated with a significantly reduced risk of infection. In a penalized logistic regression model including all four NPIs, wearing a mask was the only significant predictor of COVID-19 infection among the four NPIs (odds ratio 7.20, 95% CI 2.24-23.11; <i>P</i>&lt;.001). CONCLUSIONS We found high levels of risk perception, positive attitude, desirable knowledge, as well as a high level of adopting the four NPIs. The relevant knowledge, risk perception, and attitude were strong predictors of adapting the four NPIs. Mask wearing, among the four personal NPIs, was the most effective protective measure against COVID-19 infection, with added preventive effect among those who practiced all or part of the other three NPIs.

scholarly journals Associations between wearing masks, washing hands, and social distancing practices, and risk of COVID-19 infection in public: a cohort-based case-control study in Thailand

2020 ◽  
Author(s):  
Pawinee Doung-ngern ◽  
Repeepong Suphanchaimat ◽  
Apinya Panjangampatthana ◽  
Chawisar Janekrongtham ◽  
Duangrat Ruampoom ◽  
...  
Keyword(s):  
Lower Risk ◽  
Case Control Study ◽  
Case Control ◽  
Protective Measure ◽  
Control Group ◽  
Case Group ◽  
Risk Of Infection ◽  
Mixed Effect ◽  
Social Distancing ◽  
Control Study

SummaryBackgroundEffectiveness of personal protective measure against COVID-19 infection is largely unknown.MethodsWe conducted a retrospective case-control study, using a cohort of contact tracing records in Thailand. A total of 1,050 asymptomatic contacts of COVID-19 patients between 1 and 31 March 2020 were retrospectively interviewed by phone about their protective measures against COVID-19 infection. Cases were defined as asymptomatic contacts who were diagnosed with COVID-19 by 21 April 2020. Multilevel mixed-effect logistic regression models were usedFindingsOverall, 211 (20%) were diagnosed with COVID-19 by 21 Apr 2020 (case group) while 839 (80%) were not (control group). Fourteen percent of cases (29/210) and 24% of controls (198/823) reported wearing either non-medical or medical masks all the time during the contact period. Wearing masks all the time (adjusted odds ratio [aOR] 0.23; 95%CI 0.09-0.60) was independently associated with lower risk of COVID-19 infection compared to not wearing masks, while wearing masks sometimes (aOR 0.87; 95%CI 0.41-1.84) was not. Shortest distance of contact >1 meter (aOR 0.15; 95%CI 0.04-0.63), duration of close contact ≤15 minutes (aOR 0.24; 95%CI 0.07-0.90) and washing hands often (aOR 0.33; 95%CI 0.13-0.87) were significantly associated with lower risk of infection. Sharing a cigarette (aOR 3.47; 95%CI 1.09-11.02) was associated with higher risk of infection. Those who wore masks all the time were more likely to wash hands and practice social distancing. We estimated that if everyone wore a mask all the time, washed hands often, did not share a dish, cup or cigarette, maintained distances >1 meter and spent ≤15 minutes with close contacts, cases would have been reduced by 84%.InterpretationOur findings support consistently wearing masks, washing hands, and social distancing in public to protect against COVID-19 infections. Combining measures could substantially reduce infections in Thailand.FundingThe study was supported by the DDC, MoPH, Thailand. DL is supported by the Wellcome Trust (106698/Z/14/Z).

scholarly journals Relationship Between COVID-19 Infection and Risk Perception, Knowledge, Attitude, and Four Nonpharmaceutical Interventions During the Late Period of the COVID-19 Epidemic in China: Online Cross-Sectional Survey of 8158 Adults

10.2196/21372 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e21372 ◽  
Author(s):  
Hong Xu ◽  
Yong Gan ◽  
Daikun Zheng ◽  
Bo Wu ◽  
Xian Zhu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Risk Perception ◽  
Positive Attitude ◽  
The Other ◽  
Protective Measure ◽  
Risk Of Infection ◽  
Social Distancing ◽  
Public Risk ◽  
Nonpharmaceutical Interventions ◽  
Reduced Risk

Background So far, there have been no published population studies on the relationship between a COVID-19 infection and public risk perception, information source, knowledge, attitude, and behaviors during the COVID-19 outbreak in China. Objective This study aims to understand the relationships between COVID-19 infection; four personal nonpharmaceutical interventions (NPIs; handwashing, proper coughing habits, social distancing, and mask wearing); and public risk perception, knowledge, attitude, and other social demographic variables. Methods An online survey of 8158 Chinese adults between February 22 and March 5, 2020, was conducted. Bivariate associations between categorical variables were examined using Fisher exact test. We also explored the determinants of four NPIs as well as their association with COVID-19 infection using logistic regression. Results Of 8158 adults included, 57 (0.73%) were infected with COVID-19. The overwhelming majority of respondents showed a positive attitude (n=8094, 99.2%), positive risk perception (n=8146, 99.9%), and high knowledge levels that were among the strongest predictors of the four adopted NPIs (handwashing: n=7895, 96.8%; proper coughing: 5997/6444, 93.1%; social distancing: n=7104/8158, 87.1%; and mask wearing: 5011/5120, 97.9%). There was an increased risk of COVID-19 infection for those who did not wash their hands (2.28% vs 0.65%; risk ratio [RR] 3.53, 95% CI 1.53-8.15; P=.009), did not practice proper coughing (1.79% vs 0.73%; RR 2.44, 95% CI 1.15-5.15; P=.03), did not practice social distancing (1.52% vs 0.58%; RR 2.63, 95% CI 1.48-4.67; P=.002), and did not wear a mask (7.41% vs 0.6%; RR 12.38, 95% CI 5.81-26.36; P<.001). For those who did practice all other three NPIs, wearing a mask was associated with a significantly reduced risk of infection compared to those who did not wear a mask (0.6% vs 16.7%; P=.04). Similarly, for those who did not practice all or part of the other three NPIs, wearing a mask was also associated with a significantly reduced risk of infection. In a penalized logistic regression model including all four NPIs, wearing a mask was the only significant predictor of COVID-19 infection among the four NPIs (odds ratio 7.20, 95% CI 2.24-23.11; P<.001). Conclusions We found high levels of risk perception, positive attitude, desirable knowledge, as well as a high level of adopting the four NPIs. The relevant knowledge, risk perception, and attitude were strong predictors of adapting the four NPIs. Mask wearing, among the four personal NPIs, was the most effective protective measure against COVID-19 infection, with added preventive effect among those who practiced all or part of the other three NPIs.

The Mechanics of Individually- and Socially-Optimal Decisions during an Epidemic

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Guillaume Vandenbroucke
Keyword(s):  
Social Interactions ◽  
Lower Risk ◽  
Risk Of Infection ◽  
Social Contacts ◽  
Social Distancing ◽  
Optimal Decisions ◽  
The Future ◽  
The Cost

Abstract I present a model where work implies social interactions and the spread of a disease is described by an SIR-type framework. Upon the outbreak of a disease reduced social contacts are decided at the cost of lower consumption. Private individuals do not internalize the effects of their decisions on the evolution of the epidemic while the planner does. Specifically, the planner internalizes that an early reduction in contacts implies fewer infectious in the future and, therefore, a lower risk of infection. This additional (relative to private individuals) benefit of reduced contacts implies that the planner’s solution feature more social distancing early in the epidemics. The planner also internalizes that some infectious eventually recover and contribute further to a lower risk of infection. These mechanisms imply that the planner obtains a flatter infection curve than that generated by private individuals’ responses.

scholarly journals Are morbidity and mortality estimates from randomized controlled trials externally valid? A comparison of outcomes among infants enrolled into an RCT or a cohort study in Botswana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Neil Thivalapill ◽  
Shahin Lockman ◽  
Kathleen Powis ◽  
Rebecca Zash ◽  
Jean Leidner ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cohort Study ◽  
Lower Risk ◽  
Causal Effect ◽  
Clinical Care ◽  
Morbidity And Mortality ◽  
National Standard ◽  
Randomized Controlled ◽  
Study Setting ◽  
The U.S

Abstract Background The external validity of the randomized controlled trial (RCT) refers to the extent to which the results of the RCT apply to the relevant, non-trial population and is impacted by its eligibility criteria, its organization, and its delivery of the intervention. Here, we compared the outcomes of mortality and hospitalization between an RCT and a cohort study that concurrently enrolled HIV-exposed uninfected (HEU) newborns in Botswana. Methods The Mpepu Study (the RCT) was a clinical trial which determined that co-trimoxazole (CTX) provided no survival benefit for HEUs, allowing both arms of the RCT to be used. The Maikaelelo study (the cohort study) was a prospective observational study that enrolled HEU newborns with telephone follow-up and no in-person visits. Rates of death and hospitalization in the pooled population, were modeled using cox-proportional hazards models for time to death or time to first hospitalization, with study setting (RCT vs. cohort study) as an independent variable. The causal effect of study setting on morbidity and mortality was obtained through a treatment effects approach. Results In total, 4,010 infants were included; 1,306 were enrolled into the cohort study and 2,704 were enrolled into the RCT. No significant differences in mortality were observed between the two study settings (HR: 1.28, 95% CI: 0.76, 2.13), but RCT participants had a lower risk of hospitalization (HR: 0.72, 95% CI: 0.58, 0.89) that decreased with age. However, RCT participants had a higher risk of hospitalization within the first six months of life. The causal risk difference in hospitalizations attributable to the RCT setting was -0.03 (95% CI: -0.05, -0.01). Conclusions Children in an RCT with rigorous application of national standard of care guidelines experienced a significantly lower risk of hospitalization than children participating in a cohort study that did not alter clinical care. Future research is needed to further investigate outcome disparities when real-world results fail to mirror those achieved in a clinical trial. Trial registration The Mpepu Trial was funded by the U.S. National Institutes of Health (No. NCT01229761) and the Maikaelelo Study was funded primarily by the U.S. Centers for Disease Control and Prevention (32AI007433-21).

scholarly journals Association between living with children and outcomes from COVID-19: an OpenSAFELY cohort study of 12 million adults in England

2020 ◽  
Author(s):  
Harriet Forbes ◽  
Caroline E Morton ◽  
Seb Bacon ◽  
Helen I McDonald ◽  
Caroline Minassian ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lower Risk ◽  
Close Contact ◽  
Population Based ◽  
School Closure ◽  
Risk Of Death ◽  
Increased Risk ◽  
Working Age ◽  
Changes In Risk ◽  
Reduced Risk

AbstractBackgroundClose contact with children may provide cross-reactive immunity to SARs-CoV-2 due to more frequent prior coryzal infections from seasonal coronaviruses. Alternatively, close contact with children may increase risk of SARs-CoV-2 infection. We investigated whether risk of infection with SARs-CoV-2 and severe outcomes differed between adults living with and without children.MethodsWorking on behalf of NHS England, we conducted a population-based cohort study using primary care data and pseudonymously-linked hospital and intensive care admissions, and death records, from patients registered in general practices representing 40% of England. Using multivariable Cox regression, we calculated fully-adjusted hazard ratios (HR) of outcomes from 1st February-3rd August 2020 comparing adults living with and without children in the household.FindingsAmong 9,157,814 adults ≤65 years, living with children 0-11 years was not associated with increased risks of recorded SARS-CoV-2 infection, COVID-19 related hospital or ICU admission but was associated with reduced risk of COVID-19 death (HR 0.75, 95%CI 0.62-0.92). Living with children aged 12-18 years was associated with a small increased risk of recorded SARS-CoV-2 infection (HR 1.08, 95%CI 1.03-1.13), but not associated with other COVID-19 outcomes. Living with children of any age was also associated with lower risk of dying from non-COVID-19 causes. Among 2,567,671 adults >65 years there was no association between living with children and outcomes related to SARS-CoV-2. We observed no consistent changes in risk following school closure.InterpretationFor adults living with children there is no evidence of an increased risk of severe COVID-19 outcomes. These findings have implications for determining the benefit-harm balance of children attending school in the COVID-19 pandemic.FundingThis work was supported by the Medical Research Council MR/V015737/1.Research in contextEvidence before this studyWe searched MEDLINE on 19th October 2020 for population-based epidemiological studies comparing the risk of SARS-CoV-2 infection and COVID-19 disease in people living with and without children. We searched for articles published in 2020, with abstracts available, and terms “(children or parents or dependants) AND (COVID or SARS-CoV-2 or coronavirus) AND (rate or hazard or odds or risk), in the title, abstract or keywords. 244 papers were identified for screening but none were relevant. One additional study in preprint was identified on medRxiv and found a reduced risk of hospitalisation for COVID-19 and a positive SARS-CoV-2 infection among adult healthcare workers living with children.Added value of this studyThis is the first population-based study to investigate whether the risk of recorded SARS-CoV-2 infection and severe outcomes from COVID-19 differ between adults living in households with and without school-aged children during the UK pandemic. Our findings show that for adults living with children there is no evidence of an increased risk of severe COVID-19 outcomes although there may be a slightly increased risk of recorded SARS-CoV-2 infection for working-age adults living with children aged 12 to 18 years. Working-age adults living with children 0 to 11 years have a lower risk of death from COVID-19 compared to adults living without children, with the effect size being comparable to their lower risk of death from any cause. We observed no consistent changes in risk of recorded SARS-CoV-2 infection and severe outcomes from COVID-19 comparing periods before and after school closure.Implications of all the available evidenceOur results demonstrate no evidence of serious harms from COVID-19 to adults in close contact with children, compared to those living in households without children. This has implications for determining the benefit-harm balance of children attending school in the COVID-19 pandemic.

scholarly journals The Relationship Between COVID-19 Infection and Risk Perception, Knowledge, Attitude As Well As Four Non-pharmaceutical Interventions (NPIs) During the Late Period Of The COVID-19 Epidemic In China – An Online Cross-sectional Survey of 8158 Adults

2020 ◽  
Author(s):  
Hong Xu ◽  
Yong Gan ◽  
Daikun Zheng ◽  
Bo Wu ◽  
Xian Zhu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Risk Perception ◽  
Positive Attitude ◽  
Hand Washing ◽  
The Other ◽  
Risk Of Infection ◽  
Social Distancing ◽  
The Relationship ◽  
Reduced Risk ◽  
Pharmaceutical Interventions

AbstractBackgroundSo far, there has been no published population study on the relationship between COVID-19 infection and public’s risk perception, information source, knowledge, attitude and four non-pharmaceutical interventions(NPI: hand washing, proper coughing habits, social distancing and mask wearing) during the COVID-19 outbreak in China.MethodsAn online survey of 8158 Chinese adults between 22 February to 5 March 2020 was conducted. Bivariate associations between categorical variables were examined using Fisher exact test. We also explored the determinants of four NPIs as well as their association with COVID-19 infection using logistic regression.ResultsOf 8158 adults included, 57 (0.73%) were infected with COVID-19. The overwhelming majority of respondents showed a positive attitude (99.2%), positive risk perception (99.9%) and high knowledge levels that were among the strongest predictors of four highly adopted NPIs (hand washing:96.8%; proper coughing: 93.1%; social distancing:87.1%; mask wearing:97.9%). There was an increased risk of COVID-19 infection for those who not washing hands (2.28% vs 0.65%; RR=3.53: 95%CI: 1.53-8.15; P<0.009); not practicing proper coughing (1.79% vs 0.73%; RR=2.44: 95%CI: 1.15-5.15;P=0.026); not practicing social distancing (1.52% vs 0.58%; RR=2.63:95%CI:1.48 – 4.67; P=0.002); and not wearing a mask (7.41% vs 0.6%; RR=12.38:95%CI:5.81-26.36; P<0.001). For those who did practice all other three NPIs, wearing mask was associated with significantly reduced risk of infection compared to those who did not wear a mask (0.6% vs 16.7%; p=0.035). Similarly, for those who did not practice all or part of the other three NPIs, wearing mask was also associated with significantly reduced risk of infection. In a penalised logistic regression model including all four NPIs, wearing a mask was the only significant predictor of COVID-19 infection among four NPIs (OR=7.20; 95%CI:2.24-23.11; p<0.001).ConclusionsWe found high levels of risk perception, positive attitude, desirable knowledge as well as a high level of adopting four NPIs. The relevant knowledge, risk perception and attitude were strong predictors of adapting the four NPIs. Mask wearing, among four personal NPIs, was the most effective protective measure against COVID-19 infection with added preventive effect among those who practised all or part of the other three NPIs.

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