Abstract
ObjectiveThe 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.MethodsA 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.ResultsA 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).ConclusionsDuring 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.
Highlights
Since the emergence of the Coronavirus (COVID-19) epidemic, wearing a facemask in the community has become commonplace
The constraints and discomfort caused in a population unfamiliar with this protective equipment can result in suboptimal use, leading to ineffective protection against COVID-19
We evaluated the frequency and the quality of facemask use in the general populations with different socio-spatial backgrounds, and contextual factors associated with the appropriate use of the facemask
Summary
Since the emergence of the Coronavirus (COVID-19) epidemic, wearing a facemask in the community has become commonplace. Appropriate use of facemasks is critical for protection in the community to prevent the spread of COVID-19 [2]. The constraints and discomfort caused in a population unfamiliar with this protective equipment can result in suboptimal use, leading to ineffective protection against COVID-19. Observation and quantification of the quality of facemask use is required to: assess the level of respiratory protection, inform decision makers on the effectiveness of measures, and identify levers for behavior change. We evaluated the frequency and the quality of facemask use in the general populations with different socio-spatial backgrounds, and contextual factors associated with the appropriate use of the facemask
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