The Association of Incidence of Face-Touching Behaviors with Masks Wearing Rates During the Coronavirus Disease 2019 Pandemic

Abstract

Background: Mandatory mask wearing policy for general population in public areas were the most controversial mitigative measure for the coronavirus disease 2019 (COVID-19) pandemic. Thus, it was imperative to investigate its influence on the incidence of face touching behaviors. Methods: Videos displaying mask-wearing and face-touching behaviors of general population in public areas were analyzed. Period before the COVID-19 epidemic were defined as January 2018 to October 2019, and those during the pandemic were from February 2020 to August 2020 in East Asia, and March to August 2020 in Europe and United States (US). Findings: 37 videos (4699 individuals) before the pandemic with 135 videos (8217 individuals) were included. The mask wearing rates all increased significantly during the pandemic. However, the incidence of face touching behaviors maintained. The incidence of eyes, nose and mouth touching behaviors decreased in East Asia and Europe, instead of US. Mask wearing rates was negatively related to incidences of face touching behaviors, especially in East Asia. Surprisingly, when mask wearing rates were >0% and Interpretation: The incidence of face touching behaviors of general population in public areas was negatively associated with mask wearing rates. However, Mandatory mask wearing polices were risky in population with low adherence to masks, among whom, the face touching behaviors in public areas might increase with mask wearing rates rise. Funding: This study was supported by Guangzhou Science and Technology Project (201904010461).Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: This study was approved by the Clinical Ethics Review Board of the Third Affiliated Hospital of Sun Yat-sen University and Sun Yat-sen University. Informed consent was waived according to ethical review of biomedical research involving humans by Order of the National Health and Family Planning Commission of the People’s Republic of China No. 11.