Only one in three wears masks properly in Chennai, reveals study

At a time when Tamil Nadu has won praise for its handling of the COVID-19 pandemic, the citizens of state capital Chennai appear to be found wanting when it comes to wearing face masks correctly.

A recent research paper claims that only one in three in Chennai wears masks the correct way, covering mouth, nose and chin.

The study was conducted by the researchers from the public health department, Greater Chennai Corporation, Division of Non-Communicable Diseases, and Division of Epidemiology, both associated with ICMR-National Institute of Epidemiology, Chennai. The results were published in the September 24 issue of PLOS ONE journal and made public on September 25.

Two rounds of studies were carried out in Chennai in October and December 2020. In the first round, the team observed a total of 3,600 individuals out of which 1,800 were studied for outdoor mask compliance in both slums and non-slums areas of the city. In the second round, they observed a total of 3,200 individuals, of which 1,600 were studied for outdoor mask compliance in both slums and non-slums areas. A total of 640 individuals were studied in the indoor public places in both slums and non-slums areas, and 1,650 individuals in 11 shopping malls.

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The individuals studied belonged to both genders. They were then divided into four sub-groups: children/adolescents, young adults, middle-aged and elderly. The team categorised the mask wearing into three — appropriate use (covering mouth, nose and chin), inappropriate use (mask worn either below nose or mouth) and no mask.

“Although the law mandated mask use and imposed penalty for violators, compliance was low in outdoor public places. In areas with strict enforcement, such as shopping malls, the compliance was higher,” the paper said.

Notably, several countries witnessed a second wave of the pandemic, and a few reported the circulation of much-virulent UK and South African variants of the virus as well. Despite the circulation of newer strains and introduction of vaccine, wearing masks remained the core mitigation strategy. Studies have proven the protective role of face masks in preventing COVID-19 transmission. Research shows mask mandate in the USA helped decrease the growth rate of COVID-19, hospitalisation and mortality. Therefore, it is critical to monitor mask compliance for coronavirus control, the paper suggested.

“In our setting, nearly one-fifth of the subjects did not wear the mask appropriately. Lack of appropriate use or loosely fitted masks offered no protection to the wearer and also others. These could be minimised by wearing the mask with knotted ear loops,” the authors said.

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The team has also observed that there was a decline in mask compliance in the southern region of Chennai as compared to other regions. This can be possibly attributed to the low-risk perception among residents of the southern region as the region reported lowest cases throughout the first wave, they claimed.

“The reasons for the overall increase in non-compliance of the mask were multi-factorial. Between the first and second round of the survey, there was a decline in reported cases and test positive rate (TPR) in the city, resulting in resumption of social activities such as gatherings. The relaxation of restrictions might have led to the perception that pandemic was over and masks were not required. Wearing a face mask is considered a sign of weakness and stigma in some settings which influences the intention to wear a mask,” the authors added.

The paper concluded by stating that nearly one-third residents of Chennai, across different age groups and genders, correctly wear masks in public places. The researchers recommended conducting periodic surveys, enforcement of mask compliance in public places, and mass media campaigns to promote appropriate mask use.