Face coverings for covid-19: from medical intervention to social practice

Westhuizen, Helene-Mari van der; Kotze, Koot; Tonkin‐Crine, Sarah; Gobat, Nina; Greenhalgh, Trisha

doi:10.1136/bmj.m3021

Cited by 64 publications

(53 citation statements)

References 12 publications

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“…On the other hand, the good quality cloth masks with suitable sizes may fit better on the face making them more comfortable. The personalization of the designs of cloth facemasks could make them a fashion accessory allowing for better user compliance [ 3 ]. However, recent doubts were expressed in France regarding the capacities of “homemade cloth mask” to protect against SARS-CoV-2 contaminations [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

How do the general population behave with facemasks to prevent COVID-19 in the community? A multi-site observational study

Deschanvres

Hawranek²,

Peiffer-Smadja

et al. 2021

Antimicrob Resist Infect Control

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Objective The appropriate use of facemasks, recommended or mandated by authorities, is critical to prevent the spread of COVID-19 in the community. We aim to evaluate frequency and quality of facemask use in general populations. Methods A multi-site observational study was carried out from June to July 2020 in the west of France. An observer was positioned at a predetermined place, facing a landmark, and all individual passing between the observer and the landmark were included. The observer collected information on facemask use (type, quality of positioning), location and demographic characteristics. Results A total of 3354 observations were recorded. A facemask was worn by 56.4% (n = 1892) of individuals, including surgical facemasks (56.8%, n = 1075) and cloth masks (43.2%, n = 817). The facemask was correctly positioned in 75.2% (n = 1422) of cases. The factors independently associated with wearing a facemask were being indoors (adjusted odds ratio [aOR], 2.7; 95% confidence interval [CI] 2.28–3.19), being in a mandatory area (aOR, 6.92; 95% CI 5–9.7), female gender (aOR, 1.75; 95% CI 1.54–2.04), age 41–65 years (aOR, 1.7; 95% CI 1.43–2.02) and age > 65 years (aOR, 2.28; 95% CI 1.83–2.85). The factors independently associated with correct mask position were rural location (aOR, 1.38; 95% CI 1.07–1.79), being in an indoor area (aOR, 1.85; 95% CI 1.49–2.3), use of clothmask (aOR, 1.53; 95% CI 1.23–1.91), and age > 40 years (aOR, 1.75 95%CI 1.37–2.23). Conclusions During the initial phase of the COVID-19 pandemic, the frequency and quality of facemask wearing remained low in the community setting. Young people in general, and men in particular, represent the priority targets for information campaigns. Simplifying the rules to require universal mandatory facemasking seemed to be the best approach for health authorities.

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Section: Discussionmentioning

confidence: 99%

How do the general population behave with facemasks to prevent COVID-19 in the community? A multi-site observational study

Deschanvres

Hawranek²,

Peiffer-Smadja

et al. 2021

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

show abstract

“…Mask wearing can help to reduce transmission of the coronavirus. Widespread compliance with mask mandates in many localities across the U.S. suggests that a valuable norm may be developing that will have longer term positive consequences for pandemic response (50). However, at the state-level, the politicization of this important intervention has delayed the adoption of broad, consistent mandates on an affordable and effective behavior to reduce coronavirus spread.…”

Section: Discussionmentioning

confidence: 99%

Governor partisanship explains the adoption of statewide mask mandates in response to COVID-19

Adolph

Amano

Bang-Jensen

et al. 2020

Preprint

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Public mask use has emerged as a key tool in response to COVID-19. We develop and document a classification of statewide mask mandates that reveals variation in their scope and timing. Some U.S. states quickly mandated the wearing of face coverings in most public spaces, whereas others issued narrow mandates or no mandate at all. We consider how differences in COVID-19 epidemiological indicators, state capacity, and partisan politics affect when states adopted broad mask mandates. The most important predictor is whether a state is led by a Republican governor. These states were much slower to adopt mandates, if they did so at all. COVID-19 indicators such as confirmed cases or deaths per million are much less important predictors of statewide mask mandates. This finding highlights a key challenge to public efforts to increase mask-wearing, widely believed to be one of the most effective tools for preventing the spread of SARS-CoV-2 while restoring economic activity.

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“…Good quality cloth masks that can be customized with various sizes and patterns may adapt better to the face, making them more comfortable, and may lead to better engagement by users. 3 The use of facemasks was significantly lower and more often worn incorrectly in the population <40 years and in males independently of non-use of the mask. This finding is consistent with the increase in COVID-19 cases in the younger population during the post lockdown period.…”

Section: Discussionmentioning

confidence: 93%

How do the general population behave with facemasks to prevent COVID-19 in the community?

Deschanvres

Hawranek

Peiffer-Smadja

et al. 2020

Preprint

View full text Add to dashboard Cite

IMPORTANCE The appropriate use of facemasks, recommended or mandated by authorities, is critical to protect the community and prevent the spread of COVID-19. OBJECTIVE To evaluate the frequency and quality of facemask use in general populations of different socio-spatial backgrounds. DESIGN A multi-site observational study carried out from 25 June 2020 to 21 July 2020. SETTING The observations were carried out in 43 different locations in a region in the west of France, representing various areas: rural and urban, indoor and outdoor, and in areas where masks were mandated or not. An observer was positioned at a predetermined place, facing a landmark, and collected information about the use of facemasks and socio-demographic data. PARTICIPANTS All individual passing between the observer and the landmark were included. EXPOSURE The observer collected information on whether a mask was worn, the type of mask used, the quality of the positioning, gender, and the age category of each individual. MAIN OUTCOMES AND MEASURES The main outcomes were the use of a facemask and the quality of the positioning. Factors associated with these outcomes were identified. RESULTS A total of 3354 observations were recorded. A facemask was worn by 56.4% (n=1892) of individuals, varying from 49% (n=1359) in non-mandatory areas and 91.7% (n=533) in mandatory areas, including surgical facemasks (56.8%, n=1075) and cloth masks (43.2%, n=817). The facemask was correctly positioned in 75.2% (n=1422) of cases. The factors independently associated with wearing a facemask were being indoors (adjusted odds ratio [aOR], 0.37; 95% confidence interval [CI], 0.31-0.44), being in a mandatory area (aOR, 0.14; 95%CI, 0.10-0.20), female gender (aOR, 0.57; 95%CI, 0.49-0.66), and age >40 years (aOR, 0.54; 95%CI, 0.46-0.63). The factors independently associated with correct mask position were rural location (aOR, 0.76; 95%CI, 0.97-0.98), being in an indoor area (aOR, 0.49; 95%CI, 0.38-0.65), use of a cloth mask (aOR, 0.65; 95%CI, 0.52-0.81), and age >40 years (aOR, 0.61; 95%CI 0.49-0.76). CONCLUSIONS AND RELEVANCE Information campaigns should promote the use of cloth masks. Young people in general and men in particular are the priority targets. Simplifying the rules to require universal mandatory masking seems to be the best approach for health authorities.

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Face coverings for covid-19: from medical intervention to social practice

Abstract: Helene-Mari van der Westhuizen and colleagues argue that face coverings should be considered not as medical equipment but as a social practice informed by norms and expectations

Cited by 64 publications

References 12 publications

How do the general population behave with facemasks to prevent COVID-19 in the community? A multi-site observational study

How do the general population behave with facemasks to prevent COVID-19 in the community? A multi-site observational study

Governor partisanship explains the adoption of statewide mask mandates in response to COVID-19

How do the general population behave with facemasks to prevent COVID-19 in the community?

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