Understanding the Impact of Face Mask Usage Through Epidemic Simulation of Large Social Networks. In: Dabbaghian V, Mago VK, editors. Theories and Simulations of Complex Social Systems. Berlin: Springer Berlin Heidelberg; 2014. pp. 97-115. [DOI: 10.1007/978-3-642-39149-1_8]

Influence of protective clothing and masks on facial trustworthiness in an investment game: insights from a Chinese population study

Facial features are important sources of information about perceived trustworthiness. Masks and protective clothing diminish the visibility of facial cues by either partially concealing the mouth and nose or covering the entire face. During the pandemic, the use of personal protective equipment affected and redefined who trusts whom in society. This study used the classical investment game of interpersonal trust with Chinese participants to explore the impact of occlusion on interpersonal trust. Faces with moderate initial trustworthiness were occluded by a mask or protective clothing in Experiment 1 and were digitally occluded by a square in Experiment 2, and faces with three levels of initial trustworthiness were occluded by a mask in Experiment 3. Results showed that both undergraduates (Experiment 1a) and non-student adults (Experiment 1b) perceived the faces with protective clothing as more trustworthy than faces wearing standard masks and faces not wearing masks. Faces with the top halves showing were perceived as trustworthy as full faces, while faces with the bottom halves showing were perceived as less trustworthy. The effect of masks is weak and complex. Masks reduced participants' trust in faces with high initial trustworthiness, had no effect on faces with low and moderate initial trustworthiness, and only slightly increased the trust of undergraduates in faces with moderate initial trustworthiness. Our findings indicate that the lack of information caused by occlusion and the social significance associated with occlusion collectively affect people's trust behavior in Chinese society. We believe the findings of this study will be useful in elucidating the effects of personal protective equipment usage on perceptions of trustworthiness.

Determinants of proper disposal of single-use masks: knowledge, perception, behavior, and intervention measures

Background

Although many studies testify to consumer behavior's role in the context of waste-related sustainability objectives, little research examined what people know, think, and feel about the environmental impacts of their personal protective equipment (PPE) or their behavior towards them, in general. Therefore, the present article complements existing information about the public perceptions, knowledge, and behavior of single-use masks in a context where the pandemic has put increasing pressure on waste management public services. From February to June 2020, municipal solid waste increased ten times in Romania. The study identified the factors that predicted the proper disposal of single-use masks and the measures preferred to prevent or minimize the negative impact of single-use mask waste.

Method

Data from a representative sample of 705 Romanians were collected using a structured questionnaire. The data were analyzed with SPSS and SmartPLS. The Cochran's Q test was run to determine the existence of differences between percentages of people who preferred various measures. Dunn's test with a Bonferroni correction was used to identify the exact pair of groups where the differences were located. The study utilized structural equation models (SEM) based on at least partial squares with SmartPLS software (3.2.8) to investigate causal links between constructs. The model considered that the dependent variable (environmentally friendly behavior: proper disposal of single-use masks) could be influenced by the knowledge, perception, behavior, and demographics variables.

Results

The findings indicated that knowledge of the type of material of single-use masks had a direct positive (β = 0.173) and significant effect on their proper disposal. The perception of mask waste impact has a negative and significant (β = -0.153, p < 0.001) impact on the proper disposal of single-use masks. This path coefficient illustrates that the worse the perceived impact of single-use masks on waste management activity, the higher the proper disposal of single-use masks. Gender has a positive (β = 0.115) and significant (p < 0.001) effect on the proper disposal of single-use masks.

Conclusions

It was concluded that the 5Rs waste management approach should be reconsidered for single-use mask waste. For example, "Reuse" and the classic "Recycle" have limited applications since they may lead to virus transmission and possible infection. "Reducing" the use of single-use masks could have repercussions on one's health. Summing up, the study outlined recommendations for effective interventions for the proper disposal of single-use masks from the perspective of behavioral studies.

Social distancing intentions to reduce the spread of COVID-19: The extended theory of planned behavior

BACKGROUND

Due to the absence of a vaccine of SARS-CoV-2 virus pandemic, the most effective way to reduce transmission of the virus is by applying social distancing practices. Exploring factors that determine whether people adopt social distancing measures is, therefore, critical to reducing the spread of the virus. This study aimed to investigate people's intentions to socially distance based on the extended Theory of Planned Behavior.

METHODS

A questionnaire was distributed to the sample population and collected through social media online and WhatsApp groups from March 26, 2020 to March 29, 2020. There were 823 analyzed out of 1870 responses. The extended TPB variables and risk perception were measured using a 7-point scale (scored from 1 to 7). Data were analyzed using the partial least squares (PLS) structural equation modeling method.

RESULTS

Study found that the factors influencing the intention to perform social distancing were subjective norms and perceived behavior control. Risk perception affected attitudes, subjective norms, and perceived behavioral control. Media exposure was found to determine attitudes, subjective norms, and risk perceptions. The relationship between attitudes and intentions, and media use and perceived behavior control were not significant. The better and effective risk communication that can change the level of risk perception, raise family and religious leader as well as increase to control behavior are the keys to people's perform social distancing. Results from a multigroup analysis revealed that younger individuals showed a stronger relationship between the influence of risk perception and PBC and media use on risk perception. The predictive strength of subjective norms from risk perception and risk perception from media use was more strongly associated with rural populations.

CONCLUSIONS

The results of study provide an initial understanding of the level of the public's risk perception to reduce the spread of SARS-CoV-2. Findings also revealed the role of media use in determining risk perception, attitudes and subjective norms and, in turn, change people's intention to socially distance. This study may add to the literature of behavioral changes in pandemic and provide a framework for both policymakers and practitioners to formulate effective interventions in the future.

About the Acceptance of Wearing Face Masks in Times of a Pandemic

Wearing face masks in times of COVID-19 is one of the essential keystones for effectively decreasing the rate of new infections and thus for mitigating the negative consequences for individuals as well as for society. Acceptance of wearing masks is still low in many countries, making it extremely difficult to keep the pandemic at bay. In an experimental study, participants (N = 88) had to assess how strange they felt when wearing a face mask while being exposed to displays of groups of varying numbers of mask wearers. Three different types of face masks were shown: simple homemade masks, FFP2 masks, and loop scarfs. The higher the frequency of people wearing masks in the displayed social group, the less strange the participants felt about themselves, an essential precondition for accepting wearing masks. This effect of a descriptive social norm was particularly effective when people saw others wearing less intrusive masks, here, simple homemade masks.

Face Mask Use in the Community for Reducing the Spread of COVID-19: A Systematic Review

Background: Evidence is needed on the effectiveness of wearing face masks in the community to prevent SARS-CoV-2 transmission. Methods: Systematic review and meta-analysis to investigate the efficacy and effectiveness of face mask use in a community setting and to predict the effectiveness of wearing a mask. We searched MEDLINE, EMBASE, SCISEARCH, The Cochrane Library, and pre-prints from inception to 22 April 2020 without restriction by language. We rated the certainty of evidence according to Cochrane and GRADE approach. Findings: Our search identified 35 studies, including three randomized controlled trials (RCTs) (4,017 patients), 10 comparative studies (18,984 patients), 13 predictive models, nine laboratory experimental studies. For reducing infection rates, the estimates of cluster-RCTs were in favor of wearing face masks vs. no mask, but not at statistically significant levels (adjusted OR 0.90, 95% CI 0.78-1.05). Similar findings were reported in observational studies. Mathematical models indicated an important decrease in mortality when the population mask coverage is near-universal, regardless of mask efficacy. In the best-case scenario, when the mask efficacy is at 95%, the R0 can fall to 0.99 from an initial value of 16.90. Levels of mask filtration efficiency were heterogeneous, depending on the materials used (surgical mask: 45-97%). One laboratory study suggested a viral load reduction of 0.25 (95% CI 0.09-0.67) in favor of mask vs. no mask. Interpretation: The findings of this systematic review and meta-analysis support the use of face masks in a community setting. Robust randomized trials on face mask effectiveness are needed to inform evidence-based policies. PROSPERO registration: CRD42020184963.

Wearing Face Masks Strongly Confuses Counterparts in Reading Emotions

Wearing face masks is one of the essential means to prevent the transmission of certain respiratory diseases such as coronavirus disease 2019 (COVID-19). Although acceptance of such masks is increasing in the Western hemisphere, many people feel that social interaction is affected by wearing a mask. In the present experiment, we tested the impact of face masks on the readability of emotions. The participants (N = 41, calculated by an a priori power test; random sample; healthy persons of different ages, 18–87 years) assessed the emotional expressions displayed by 12 different faces. Each face was randomly presented with six different expressions (angry, disgusted, fearful, happy, neutral, and sad) while being fully visible or partly covered by a face mask. Lower accuracy and lower confidence in one’s own assessment of the displayed emotions indicate that emotional reading was strongly irritated by the presence of a mask. We further detected specific confusion patterns, mostly pronounced in the case of misinterpreting disgusted faces as being angry plus assessing many other emotions (e.g., happy, sad, and angry) as neutral. We discuss compensatory actions that can keep social interaction effective (e.g., body language, gesture, and verbal communication), even when relevant visual information is crucially reduced.

Preventive behavior of Vietnamese people in response to the COVID-19 pandemic

We sought to evaluate the adherence of Vietnamese adults to Coronavirus Disease 2019 (COVID-19) preventive measures, and gain insight into the effects of the epidemic on the daily lives of Vietnamese people. An online questionnaire was administered from March 31 to April 6, 2020. The questionnaire assessed personal preventive behavior (such as physical distancing, wearing a face mask, cough etiquette, regular handwashing and using an alcohol hand sanitizer, body temperature check, and disinfecting mobile phones) and community preventive behavior (such as avoiding meetings, large gatherings, going to the market, avoiding travel in a vehicle/bus with more than 10 persons, and not traveling outside of the local area during the lockdown). A total adherence score was calculated by summing the scores of the 9 personal and the 11 community prevention questions. In total, 2175 respondents completed the questionnaire; mean age: 31.4 ± 10.7; (range: 18–69); 66.9% were women; 54.2% were health professionals and 22.8% were medical students. The mean adherence scores for personal and community preventive measures were 7.23 ± 1.63 (range 1–9) and 9.57 ± 1.12 (range 1–11), respectively. Perceived adaptation of the community to lockdown (Beta (β) = 2.64, 95% Confidence Interval (CI) 1.25–4.03), fears/worries concerning one’s health (β = 2.87, 95% CI 0.04–5.70), residing in large cities (β = 19.40, 95% CI 13.78–25.03), access to official COVID-19 information sources (β = 16.45, 95% CI 6.82–26.08), and working in healthcare/medical students (β = 22.53, 95% CI 16.00–29.07) were associated with a higher adherence score to anti-COVID instructions. In conclusion, this study confirmed a high degree of adherence to personal and community preventive behavior among Vietnamese people. Our findings are consistent with the epidemiology of COVID-19 in Vietnam, where there have been few infections and no recorded deaths up to the first week of July 2020.

The impact of opening dedicated clinics on disease transmission during an influenza pandemic

Dedicated clinics can be established in an influenza pandemic to isolate people and potentially reduce opportunities for influenza transmission. However, their operation requires resources and their existence may attract the worried-well. In this study, we quantify the impact of opening dedicated influenza clinics during a pandemic based on an agent-based simulation model across a time-varying social network of households, workplaces, schools, community locations, and health facilities in the state of Georgia. We calculate performance measures, including peak prevalence and total attack rate, while accounting for clinic operations, including timing and location. We find that opening clinics can reduce disease spread and hospitalizations even when visited by the worried-well, open for limited weeks, or open in limited locations, and especially when the clinics are in operation during times of highest prevalence. Specifically, peak prevalence, total attack rate, and hospitalization reduced 0.07–0.32%, 0.40–1.51%, 0.02–0.09%, respectively, by operating clinics for the pandemic duration.

A mathematical model for assessing the effectiveness of protective devices in reducing risk of infection by inhalable droplets

Respiratory protective devices (RPDs) are critical for reducing the spread of infection via inhalable droplets. In determining the type of RPD to deploy, it is important to know the reduction in the infection rate that the RPD enables for the given pathogen and population. This paper extends a previously developed susceptible-infected-recovered (SIR) epidemic model to analyse the effect of a protection strategy. An approximate solution to the modified SIR equations, which compares well with a full numerical solution to the equations, was used to derive a simple threshold equation for predicting when growth of the infected population will occur for a given protection strategy. The threshold equation is cast in terms of a generalized reproduction number, which contains the characteristics of the RPDs deployed by the susceptible and infected populations, as well as the degree of compliance in wearing the equipment by both populations. An example calculation showed that with 50% of the susceptible population deploying RPDs that transmit 15% of pathogens, and an unprotected infected population, an otherwise growing infection rate can be converted to one that decays. When the infected population deploys RPDs, the transmission rate for the RPDs worn by the susceptible population can be higher.