Wearing masks in public spaces in Poland during SARS-Cov-2 epidemic: an observational study

Background Face masks can all be effective means of controlling SARS-CoV-2 transmission. In Poland, obligatory wearing of masks in public spaces was introduced on April 10th, 2020. Objective To assess use of masks in public spaces in Poland during the third wave of SARS-Cov-2 epidemic. Methods A non-participatory covert observational study was conducted during the 3rd wave, on three dates (20.03/27.03/03.04.2021) at public spaces in 12 provinces with different SARS-Cov-2 infection risks according to the R number. Ten consecutive individuals were observed by each of 91 medical students, using a structured checklist. Results Among 3283 observed individuals, the female/male ratios were 1.1/1.1/0.9 on the three dates. Around three quarters were using masks: 76.2% (858/1126) on date 1, 76.3% (867/1137) on date 2; and 79.7% (813/1020) on date 3. Medical masks predominated on all dates (52.4%-50.5%-55.8%), followed by cloth (34.6%-37.6%-33.0%). Location in a closed space (OR = 3.47-2.64-2.84) was associated with higher usage. Participants in sports were about two-three times less likely to use masks (OR = 0.52-0.58-0.34) as compared to other activities. The proportion using masks correctly was as follows: 62.6% (537/858); 63.1% (547/867); 57.7% (469/813) respectively; significant between-gender difference was observed regarding date 1 (date 1: 306/458, 66.8% females vs 231/400, 57.8% males; p = 0.006, date 2: 284/459, 61.9% females vs 263/408, 64.5% males; p = 0.43, and date 3: 232/408, 56.9% females vs 237/405, 58.5% males; p = 0.63). Uncovered noses (55.5%-59.5%) and masks around the neck (18.1%-24.7%) were the most frequent incorrect practices. Conclusions The results show an essential difference between governmental regulations and how the general public responds to the SARS-Cov-2 pandemic in the context of mask usage. Medical masks were predominantly used in public spaces, however, almost every third individual wore masks incorrectly. Key messages Knowledge translation with the use of adequate communication channels, would be helpful to increase compliance and correct usage. This message can be used to target specific practices when developing public health campaigns which should be then rigorously evaluated for their effectiveness.