by Nazeem Muhajarine and Miles Fahlman

Nazeem Muhajarine, PhD, is a social epidemiologist and public health researcher at the University of Saskatchewan’s Department of Community Health and Epidemiology; Miles Fahlman is a medical anthropologist who had researched the first SARS outbreak. For more information on Social Contours and COVID-19 study: https://spheru.ca/covid-19/covid-19.php

Nazeem Muhajarine is also the Primary Investigator for the Mozambique Canada Maternal Health Project that is working on educating and implementing methods to avoid COVID 19 spread in Inhambane Province, Mozambique. www.maternalhealthmozcan.ca.

As our province “re-opens” and we begin to resume more of our normal activities, the simple question of whether or not to wear a face mask has received mixed reactions: some people have been quick to adopt this practice, believing it can help reduce their risk of getting or spreading the virus, while others resist, unconvinced. 

The mixed messaging from public health at the beginning of the pandemic didn’t help matters. But over time, it has become more and more apparent that wearing reusable cloth face masks is one of the key strategies for keeping the pandemic under control, along with physical distancing, hand washing, and staying home when sick. In response, a huge cottage industry has sprung up, with many people sewing masks at home and sharing patterns online; as well, a growing number of retailers are selling masks in varied styles and colours, promoting them as a fashionable accessory in the ‘new normal’ wardrobe.

While the Saskatchewan Health Authority agrees that wearing cloth face masks can “play an important role” in controlling the spread of the virus, there is very little known about how widespread mask wearing is in Saskatchewan, who is most likely to wear a mask, and how mask wearing relates to other preventive behaviours.

This is where the “Social contours and COVID-19” project comes in (https://spheru.ca/covid-19/results/phase1.php). In Saskatchewan, starting on the first day of the “Re-Open” plan, we collected data from more than 2000 residents during the months of May and June (8% from rural areas, 26% from mid-sized cities and towns, 19% from Regina, and 47% from Saskatoon).

In the June survey, we asked, “In the last 7 days, when you were inside a building (other than your home) where it was hard to maintain social distancing, how often did you wear a face mask?” Of the 1033 Saskatchewan residents who took part in this survey in June, 53 said they hadn’t been in an indoor space, leaving 980 who had. Of these, 43% said they wore a mask all or most of the time, 12% some of the time, and 44% little or none of the time. The likelihood of wearing a mask was related to gender, age, and where people live. Wearing masks all or most of the time was more common among women (46% vs 36% of men); those who are older than 65 (52% vs 40% younger than 50) , and people living in Saskatoon (53% vs 44% in Regina, 31% in mid-sized cities and town, and 25% in rural Saskatchewan).

These characteristics describe who is more likely to wear a mask, but they don’t explain why. We found that people’s behaviour was strongly related to how serious they think COVID-19 is, both personally and in their community. Among those who thought that they would likely get ‘very sick’ or die if they became infected, 68% wore masks frequently, compared to only 30% of those who believed they would not get sick at all. 65% of those who said COVID is a ‘very big’ threat to the health of their community wore masks frequently, versus only 14% who said that COVID is a “very small” threat.

Face masks are known to be more effective at preventing a wearer who is infected from spreading the virus than they are at protecting a wearer from becoming infected. We found this to be another factor associated with mask wearing: Those who were very concerned they would spread the virus to others were more than twice as likely to wear masks frequently, compared to those who were slightly or hardly concerned (49% vs 23%).

Some public health officials have expressed concern that people might think wearing a mask means they don’t have to practice other preventive behaviours. In fact, we found that those who wear mask frequently are more likely to also report other practices that are known to prevent the spread of the virus. When out in public, almost all frequent mask wearers (91%) maintain physical distancing all or most of the time; most (84%) always wash their hands after being away from their home; and just over half (54%) always try to avoid touching their face when out in public. 

Our survey shows that more than half of Saskatchewan residents have adopted the new practice of wearing a face mask at least some of the time, especially those who believe themselves to be at higher risk of severe illness and who are concerned about spreading the virus to others, those who live in regions with more COVID-19 cases, and those who see the virus as a bigger threat to their community. Mask wearing does not make people less concerned about other healthy practices; on the contrary, individuals who wear masks frequently are also very likely to follow public health recommendations regarding physical distancing, hand washing, and not touching their face.     

It’s important to know as much as we can about this new virus and to have information specific to our province and our communities. This means not just how many cases there are and where they are generally located, but what people are thinking and doing. Understanding what is going on in Saskatchewan regarding the spread of the coronavirus can help all of us—ordinary citizens as well as public health authorities—do our part to keep the pandemic under control.

In the social contours voluntary survey of Saskatchewan adult population, the margin of error is estimated at +/- 3%, 19 out of 20 times, for any estimates of 40-50%.

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