Dynamics of mask use as a prevention strategy against SARS-Cov-2 in Panama

Abstract

AbstractBackgroundEarly in the SARS-CoV-2 pandemic, many national public health authorities implemented non-pharmaceutical interventions to mitigate disease outbreaks. Panamá established mandatory mask use two months after its first documented case. Initial compliance was high, but diverse masks were used in public areas. We studied behavioral dynamics of mask use through the first two COVID waves in Panama, to improve implementation of effective, low-cost public health containment measures, when populations are exposed to novel air-borne pathogens.MethodsMask use behavior was recorded from pedestrians in four Panamanian populations (August to December 2020). We recorded facial coverings; and if used, the type of mask, and gender and estimated age of the wearer.FindingsPeople were highly compliant (> 95%) with mask mandates, and demonstrated important population-level behaviours: 1) decreasing use of cloth masks over time, and increasing use of surgical masks; 2) mask use was 3-fold lower in sub-urban neighborhoods than other public areas; and 3) young people were least likely to wear masks.InterpretationResults help focus highly-effective, low-cost, public health interventions for managing and controlling a pandemic. Considerations of behavioural preferences for different masks, relative to pricing and availability, are essential for optimizing public health policies. Policies to increase availability of effective masks, and behavioral nudges to increase acceptance, and to facilitate mask usage, during the on-going SARS-CoV-2 pandemic, and for future pandemics of respiratory pathogens, are key tools, especially for nations lagging in access to expensive vaccines and pharmacological approaches.Funding11-2020 SNI Grant, SENACYT.