Non-pharmaceutical interventions and risk of COVID-19 infection: survey of U.K. public from November 2020 - May 2021

Nick A Francis; Taeko Becque; Merlin Willcox; Alastair D Hay; Mark Lown; Richard Clarke; Beth Stuart; Lucy Yardley; Michael Moore; Joëlle Houriet; Paul Little

doi:10.1186/s12889-023-15209-6

Non-pharmaceutical interventions and risk of COVID-19 infection: survey of U.K. public from November 2020 - May 2021

BMC Public Health. 2023 Feb 24;23(1):389. doi: 10.1186/s12889-023-15209-6.

Authors

Nick A Francis¹, Taeko Becque², Merlin Willcox², Alastair D Hay³, Mark Lown², Richard Clarke⁴, Beth Stuart⁵, Lucy Yardley^{6

7}, Michael Moore², Joëlle Houriet⁸, Paul Little²

Affiliations

¹ Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, NIHR School for Primary Care Research, University of Southampton, Aldermoor Health Centre, Southampton, SO16 5ST, UK. Nick.francis@soton.ac.uk.
² Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, NIHR School for Primary Care Research, University of Southampton, Aldermoor Health Centre, Southampton, SO16 5ST, UK.
³ Centre for Academic Primary Care, Bristol Medical School: Population Health Sciences, NIHR School for Primary Care Research, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.
⁴ School of Natural and Social Sciences, University of Gloucestershire, Francis Close Hall, Swindon Road, Cheltenham, GL50 4AZ, UK.
⁵ Pragmatic Clinical Trials Unit, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
⁶ School of Psychology, University of Southampton, Highfield Campus, Southampton, SO17 1BJ, UK.
⁷ School of Psychological Science, University of Bristol, 12A Priory Road, Bristol, BS8 1TR, UK.
⁸ Antenna Foundation, Avenue de La Grenade 24, 1207, Geneva, Switzerland.

Abstract

Introduction: Non-pharmaceutical interventions (NPIs), such as handwashing, social distancing and face mask wearing, have been widely promoted to reduce the spread of COVID-19. This study aimed to explore the relationship between self-reported use of NPIs and COVID-19 infection.

Methods: We conducted an online questionnaire study recruiting members of the UK public from November 2020 to May 2021. The association between self-reported COVID-19 illness and reported use of NPIs was explored using logistic regression and controlling for participant characteristics, month of questionnaire completion, and vaccine status. Participants who had been exposed to COVID-19 in their household in the previous 2 weeks were excluded.

Results: Twenty-seven thousand seven hundred fifty-eight participants were included and 2,814 (10.1%) reported having a COVID-19 infection. The odds of COVID-19 infection were reduced with use of a face covering in unadjusted (OR 0.17 (95% CI: 0.15 to 0.20) and adjusted (aOR 0.19, 95% CI 0.16 to 0.23) analyses. Social distancing (OR 0.27, 95% CI: 0.22 to 0.31; aOR 0.35, 95% CI 0.28 to 0.43) and handwashing when arriving home (OR 0.57, 95% CI 0.46 to 0.73; aOR 0.63, 95% CI: 0.48 to 0.83) also reduced the odds of COVID-19. Being in crowded places of 10-100 people (OR 1.89, 95% CI: 1.70 to 2.11; aOR 1.62, 95% CI: 1.42 to 1.85) and > 100 people (OR 2.33, 95% CI: 2.11 to 2.58; aOR 1.73, 95% CI: 1.53 to 1.97) were both associated with increased odds of COVID-19 infection. Handwashing before eating, avoiding touching the face, and cleaning things with virus on were all associated with increased odds of COVID-19 infections.

Conclusions: This large observational study found evidence for strong protective effects for individuals from use of face coverings, social distancing (including avoiding crowded places) and handwashing on arriving home on developing COVID-19 infection. We also found evidence for an increased risk associated with other behaviours, possibly from recall bias.

Keywords: COVID-19; Face covering; Handwashing; Non-pharmaceutical interventions; Risk; Social distancing.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / prevention & control
Hand Disinfection
Humans
SARS-CoV-2
Self Report
Surveys and Questionnaires

Grants and funding

496/NIHR School for Primary Care Research