Face mask use and physical distancing before and after mandatory masking: No evidence on risk compensation in public waiting lines

Effect of face-covering use on adherence to other COVID-19 protective behaviours: A systematic review

During the COVID-19 pandemic, concerns were raised that face covering use may elicit risk compensation; a false sense of security resulting in reduced adherence to other protective behaviours such as physical distancing. This systematic review aimed to investigate the effect of face covering use on adherence to other COVID-19 related protective behaviours. Medline, Embase, PsychInfo, EmCare, medRxiv preprints, Research Square and WHO COVID-19 Research Database were searched for all primary research studies published from 1st January 2020 to 17th May 2022 that investigated the effect of face covering use on adherence to other protective behaviours in public settings during the COVID-19 pandemic. Papers were selected and screened in accordance with the PRISMA framework. Backwards and forwards citation searches of included papers were also conducted on 16th September 2022, with eligible papers published between 1st January 2020 and that date being included. A quality appraisal including risk of bias was assessed using the Academy of Nutrition and Dietetics' Quality Criteria Checklist. This review is registered on PROSPERO, number CRD42022331961. 47 papers were included, with quality ranging from low to high. These papers investigated the effects of face covering use and face covering policies on adherence to six categories of behaviour: physical distancing; mobility; face-touching; hand hygiene; close contacts; and generalised protective behaviour. Results reveal no consistent evidence for or against risk compensation, with findings varying according to behaviour and across study types, and therefore confident conclusions cannot be made. Any policy decisions related to face coverings must consider the inconsistencies and caveats in this evidence base.

Perception of interpersonal distance and social distancing before and during COVID-19 pandemic

Since COVID-19 is easily transmitted among people in close physical proximity, the focus of epidemiological policy during the COVID-19 crisis included major restrictions on interpersonal distance. However, the way in which distance restrictions affected spatial perception is unclear. In the current study, we examined interpersonal distance preferences and perceptions at three time points: pre-pandemic, early post-pandemic, and late post-pandemic. The results indicate that following the pandemic outbreak, people perceived others as farther away than they actually were, suggesting that the distance restrictions were associated with an enlargement of perceived interpersonal distance. Interestingly, however, people maintained the same distance from one another as before the outbreak, indicating no change in actual distance behavior due to the risk of infection. These findings suggest that COVID-19 was associated with a change in the way distance is perceived, while in practice, people maintain the same distance as before. In contrast, COVID-related anxiety predicted both a preference for maintaining a greater distance and a bias toward underestimating perceived distance from others. Thus, individuals who were highly fearful of COVID-19 perceived other people to be closer than they actually were and preferred to maintain a larger distance from them. The results suggest that subjective risk can lead to an increased perception of danger and a subsequent change in behavior. Taken together, even when behaviors should logically change, the decision-making process can be based on distorted perceptions. This insight may be used to predict public compliance.

The COVID-19 pandemic and changes in social behavior: Protective face masks reduce deliberate social distancing preferences while leaving automatic avoidance behavior unaffected

Protective face masks were one of the central measures to counteract viral transmission in the COVID-19 pandemic. Prior research indicates that face masks impact various aspects of social cognition, such as emotion recognition and social evaluation. Whether protective masks also influence social avoidance behavior is less clear. Our project assessed direct and indirect measures of social avoidance tendencies towards masked and unmasked faces in two experiments with 311 participants during the first half of 2021. Two interventions were used in half of the participants from each sample (Experiment 1: protective face masks; Experiment 2: a disease prime video) to decrease or increase the salience of the immediate contagion threat. In the direct social avoidance measure, which asked for the deliberate decision to approach or avoid a person in a hypothetical social encounter, participants showed an increased willingness to approach masked as opposed to unmasked faces across experiments. This effect was further related to interindividual differences in pandemic threat perception in both samples. In the indirect measure, which assessed automatic social approach and avoidance tendencies, we neither observed an approach advantage towards masked faces nor an avoidance advantage for unmasked faces. Thus, while the absence of protective face masks may have led to increased deliberate social avoidance during the pandemic, no such effect was observed on automatic regulation of behavior, thus indicating the relative robustness of this latter behavior against changes in superordinate social norms.

People interact closer when a face mask is worn but risk compensation is at best partial

BACKGROUND

Wearing a face mask and keeping a minimal distance from others are common nonpharmaceutical interventions that governments may mandate or recommend to contain the spread of infectious diseases. The article addresses the following questions: (i) Do people interact closer when the face mask is worn? (ii) Do people interact closer because they believe that the mask reduces the risk of contagion? (iii) If the mask induces people to interact closer, does the increase in risk entailed by shorter distances entirely offset the decrease in risk offered by the mask?

METHODS

With a view to maximizing both the external and the internal validity of the study, between 2021 and 2022 we performed a large field experiment on real-life interactions (n > 4500) and a controlled laboratory experiment in virtual reality.

RESULTS

Converging between the field and the lab, the results indicate that in general people interact closer when the mask is worn, and in particular when they believe that the mask reduces the risk of contagion. However, even assuming a very low filtration efficacy and an extremely large distance-reducing effect of the mask, the counteracting effect of shorter interpersonal distances is never strong enough to entirely offset the mask's protection.

CONCLUSION

The distance-reducing effect of the mask is real but warrants no serious objection against a face mask policy.

How Rice Fights Pandemics: Nature-Crop-Human Interactions Shaped COVID-19 Outcomes

Wealthy nations led health preparedness rankings in 2019, yet many poor nations controlled COVID-19 better. We argue that a history of rice farming explains why some societies did better. We outline how traditional rice farming led to tight social norms and low-mobility social networks. These social structures helped coordinate societies against COVID-19. Study 1 compares rice- and wheat-farming prefectures within China. Comparing within China allows for controlled comparisons of regions with the same national government, language family, and other potential confounds. Study 2 tests whether the findings generalize to cultures globally. The data show rice-farming nations have tighter social norms and less-mobile relationships, which predict better COVID outcomes. Rice-farming nations suffered just 3% of the COVID deaths of nonrice nations. These findings suggest that long-run cultural differences influence how rice societies-with over 50% of the world's population-controlled COVID-19. The culture was critical, yet the preparedness rankings mostly ignored it.

Is self-reported depression, HIV status, COVID-19 health risk profile and SARS-CoV-2 exposure associated with difficulty in adhering to COVID-19 prevention measures among residents in West Africa?

BACKGROUND

The aim of this study was to determine whether self-reported depression, coronavirus disease of 2019 (COVID-19) health risk profile, HIV status, and SARS-CoV-2 exposure were associated with the use of COVID-19 prevention measures.

METHODS

This survey collected data electronically between June 29 and December 31, 2020 from a convenient sample of 5050 adults 18 years and above living in 12 West African countries. The dependent variables were: social distancing, working remotely, difficulty obtaining face masks and difficulty washing hands often. The independent variables were self-reported depression, having a health risk for COVID-19 (high, moderate and little/no risk), living with HIV and COVID-19 status (SARS-CoV-2 positive tests, having COVID-19 symptoms but not getting tested, having a close friend who tested positive for SARS-CoV-2 and knowing someone who died from COVID-19). Four binary logistic regression models were developed to model the associations between the dependent and independent variables, adjusting for socio-demographic variables (age, gender, educational status, employment status and living status).

RESULTS

There were 2412 (47.8%) male participants and the mean (standard deviation) age was 36.94 (11.47) years. Respondents who reported depression had higher odds of working remotely (AOR: 1.341), and having difficulty obtaining face masks (AOR: 1.923;) and washing hands often (AOR: 1.263). People living with HIV had significantly lower odds of having difficulty washing hands often (AOR: 0.483). Respondents with moderate health risk for COVID-19 had significantly higher odds of social distancing (AOR: 1.144) and those with high health risk had difficulty obtaining face masks (AOR: 1.910). Respondents who had a close friend who tested positive for SARS-CoV-2 (AOR: 1.132) and knew someone who died of COVID-19 (AOR: 1.094) had significantly higher odds of social distancing. Those who tested positive for SARS-CoV-2 had significantly lower odds of social distancing (AOR: 0.629) and working remotely (AOR: 0.713). Those who had symptoms of COVID-19 but did not get tested had significantly lower odds of social distancing (AOR: 0.783) but significantly higher odds of working remotely (AOR: 1.277).

CONCLUSIONS

The study signifies a disparity in the access to and use of COVID-19 preventative measures that is allied to the health and COVID-19 status of residents in West Africa. Present findings point to risk compensation behaviours in explaining this outcome.

During the COVID-19 pandemic participants prefer settings with a face mask, no interaction and at a closer distance

Peripersonal space is the space surrounding our body, where multisensory integration of stimuli and action execution take place. The size of peripersonal space is flexible and subject to change by various personal and situational factors. The dynamic representation of our peripersonal space modulates our spatial behaviors towards other individuals. During the COVID-19 pandemic, this spatial behavior was modified by two further factors: social distancing and wearing a face mask. Evidence from offline and online studies on the impact of a face mask on pro-social behavior is mixed. In an attempt to clarify the role of face masks as pro-social or anti-social signals, 235 observers participated in the present online study. They watched pictures of two models standing at three different distances from each other (50, 90 and 150 cm), who were either wearing a face mask or not and were either interacting by initiating a hand shake or just standing still. The observers’ task was to classify the model by gender. Our results show that observers react fastest, and therefore show least avoidance, for the shortest distances (50 and 90 cm) but only when models wear a face mask and do not interact. Thus, our results document both pro- and anti-social consequences of face masks as a result of the complex interplay between social distancing and interactive behavior. Practical implications of these findings are discussed.

Face masks reduce interpersonal distance in virtual reality

During the COVID-19 pandemic several behavioral measures have been implemented to reduce viral transmission. While these measures reduce the risk of infections, they may also increase risk behavior. Here, we experimentally investigate the influence of face masks on physical distancing. Eighty-four participants with or without face masks passed virtual agents in a supermarket environment to reach a target while interpersonal distance was recorded. Agents differed in wearing face masks and age (young, elderly). In addition, situational constraints varied in whether keeping a distance of 1.5 m required an effortful detour or not. Wearing face masks (both self and other) reduced physical distancing. This reduction was most prominent when keeping the recommended distance was effortful, suggesting an influence of situational constraints. Similarly, increased distances to elderly were only observed when keeping a recommended distance was effortless. These findings highlight contextual constraints in compensation behavior and have important implications for safety policies.

No evidence that mask-wearing in public places elicits risk compensation behavior during the COVID-19 pandemic

Face masks have been widely employed as a personal protective measure during the COVID-19 pandemic. However, concerns remain that masks create a false sense of security that reduces adherence to other public health measures, including social distancing. This paper tested whether mask-wearing was negatively associated with social distancing compliance. In two studies, we combined video-observational records of public mask-wearing in two Dutch cities with a natural-experimental approach to evaluate the effect of an area-based mask mandate. We found no observational evidence of an association between mask-wearing and social distancing but found a positive link between crowding and social distancing violations. Our natural-experimental analysis showed that an area-based mask mandate did not significantly affect social distancing or crowding levels. Our results alleviate the concern that mask use reduces social distancing compliance or increases crowding levels. On the other hand, crowding reduction may be a viable strategy to mitigate social distancing violations.

Facial mask personalization encourages facial mask wearing in times of COVID-19

One of the most cost-effective strategies for fighting the spread of COVID-19 is the use of facial masks. Despite health officials’ strong efforts to communicate the importance or wearing a mask, compliance has been low in many countries. In the present paper we propose a novel behavior-intervention strategy to encourage people to wear facial masks. Three studies show that the personalization of a mask, as a form of identity expression, increases mask wearing intentions and, by extension, the percentage of individuals who wear facial masks. Given that mask wearing remains a necessity after deployment of the first vaccines, novel approaches to encouraging mask wearing are essential. Linking facial mask wearing to an individual’s identity is a promising strategy.

Face masks, public policies and slowing the spread of COVID-19: Evidence from Canada

We estimate the impact of indoor face mask mandates and other non-pharmaceutical interventions (NPI) on COVID-19 case growth in Canada. Mask mandate introduction was staggered from mid-June to mid-August 2020 in the 34 public health regions in Ontario, Canada's largest province by population. Using this variation, we find that mask mandates are associated with a 22 percent weekly reduction in new COVID-19 cases, relative to the trend in absence of mandate. Province-level data provide corroborating evidence. We control for mobility behaviour using Google geo-location data and for lagged case totals and case growth as information variables. Our analysis of additional survey data shows that mask mandates led to an increase of about 27 percentage points in self-reported mask wearing in public. Counterfactual policy simulations suggest that adopting a nationwide mask mandate in June could have reduced the total number of diagnosed COVID-19 cases in Canada by over 50,000 over the period July-November 2020. Jointly, our results indicate that mandating mask wearing in indoor public places can be a powerful policy tool to slow the spread of COVID-19.