Face Masks Use in the Public Domain and its Determinants During the SARS-Cov-2 Epidemic in Poland; a Non-Participatory Covert Observational Study
Abstract Background: Face masks play an important role in protection from acquiring SARS-Cov-2, however, if used incorrectly they may increase transmission risk. Many countries, including Poland, currently recommend the use of masks in their pandemic control plans. The study objective was to assess the practices of the public in the case of face masks/N95 respirators utilization during the SARS-Cov-2 pandemic in Poland and to evaluate factors influencing their use.Methods: This non-participatory covert observational study was conducted on 3 separate occasions, (10.05/18.05/25.05.2020). At each point, 82 medical students observed 10 consecutive individuals (2460 total) appearing in the public space in 13 Polish regions which differed regarding SARS-Cov-2 pandemic risk. A structured observation checklist served as a survey tool.Results: A total of 2353 observations were included; the female/male ratio was similar (1.02-1.13-1.03 respectively) at the 3 occasions, as well as the age distribution, with those aged 21-60 years predominant (70.8%-71.9%-70.2% respectively). Most of participants (73.6%; 552/750) were using facial masks at the first time point, which decreased in the 2nd and 3rd week (544/818; 66.5% and 516/785; 65.7% respectively). A predominance of cloth masks was observed at all time points (64.7%-62.3%-62.6% respectively) followed by medical masks (23.4%-28.5%-26.9% respectively). Female gender (OR=1.75-1.47-1.53 respectively), age >40 years (OR=1.46-1.48 respectively), a closed space (OR=2.56-2.63-2.36 respectively) were each associated with higher mask usage. Those playing sports were about two times less likely to use facial masks (OR=0.64-0.54-0.54 respectively) than when compared to other activities. The percentage of those using masks correctly decreased gradually over time (364/552; 65.9%; 339/544; 62.3% and 304/516; 58.9% respectively); more females wore masks correctly (p<0.05). Breaches in nose covering (47.3%-52.7%) and hanging masks around the neck (39.2%-42.6%) were the most common incorrect practices while wearing a mask. Conclusions: Cloth masks were predominantly used in the public space. Practices regarding the facial masks usage were found to be inadequate, especially among young males, and tended to decrease over time. Awareness campaigns regarding the need of the proper use of face masks by utilizing all communication channels available would be helpful during this pandemic to increase compliance.