Face mask uptake in the absence of mandates during the COVID-19 pandemic: a qualitative interview study with Swiss residents

Abstract

Background In the COVID-19 pandemic, Switzerland introduced broad nationwide face mask mandates only by October 2020, later than other Western European countries. This study aims to assess the underlying values and considerations of individuals to wear face masks in the absence of face mask mandates in the COVID-19 pandemic in German-speaking Switzerland. Methods As part of the “Solidarity in times of a pandemic” (SolPan) research commons, we interviewed 31 participants living in the German-speaking part of Switzerland in April 2020 and 25 of them again in October 2020. Qualitative inductive thematic analysis was applied for data analysis and interpretation. Public health ethics principles guided the interpretation and organization of findings. Results Five themes were identified: Trust and governmental policy; perceived benefits of mask-wearing; perceived risks of mask-wearing; social exclusion and prejudice; and decision-making in the absence of mandates. In light of increasing infection rates in October 2020, many participants started to consider the benefits higher than the risks and were willing to accept face mask mandates in that context, despite earlier reservations. Conclusions The absence of face mask mandates underline individual autonomy but may also suppress personal responsibility due to social influence. Face masks are only temporarily acceptable in liberal Western societies and face mask mandates should be enforced only when epidemiologically necessary.

Face mask use during the COVID-19 pandemic: how risk perception, experience with COVID-19, and attitude towards government interact with country-wide policy stringency

“…Moreover, seeing others wearing a mask, a so-called descriptive norm, was found to be a strong determinant of mask use [17]. However, even without policies in place, the outbreak of COVID-19 resulted in voluntary engagement in protective behaviors, like staying at home [18] and mask-wearing [19,20].…”

Differences in Stakeholders’ Perception of the Impact of COVID-19 on Clinical Care and Decision-Making

“…The personal reflection of the pandemic consequences appears to be of high relevance since the individual perception of risk guides response and health-related decision-making [ 10 , 11 ]. The evaluation of COVID-19-related risks and decision-making processes mainly focused on prevention and vaccination behaviors [ 12 , 13 ]. However, in other clinical entities, compliance with treatment and the handling of evidence deficiencies also rapidly affected clinical management, individual behavior, and outcome [ 14 ].…”

The social and socio-political embeddedness of COVID-19 vaccination decision-making: A five-country qualitative interview study from Europe

“…On the contrary, several participants from Switzerland stressed that even though they felt that getting vaccinated should be voluntary, unvaccinated people should bear the consequences of this choice. This position illustrates the emphasis on personal responsibility, which has been part of the Swiss COVID-19 policy narrative [39] : And I think it’s absolutely legitimate, if someone has this attitude [against getting vaccinated], that they then have certain disadvantages. Be it that they have to pay for the test themselves.…”