Improper use of masks, poor social distancing may be spreading COVID in Kerala: Study
File photo of people wearing masks as a precaution against the coronavirus outside a hospital in Thrissur, Kerala. IANS

Improper use of masks, poor social distancing may be spreading COVID in Kerala: Study

Kochi, October 5, 2020

Improper use of masks and poor social distancing may be spreading COVID in Kerala, says a state-wide study.

The Global Institute of Public Health, Thiruvananthapuram had conducted a study to assess the usage of the mask and the practice of social distancing in the state. The study found that although 96% of people wore masks across the state, 16% wore them improperly (without covering of nose or mouth) and nearly 20% moved about without the face masks.

Social distancing practices were also found to be less in districts with the highest number of reported cases (Thiruvananthapuram and Malappuram) during the month of August.

The study revealed that a high prevalence of the universal mask compliance was seen in the state of Kerala during the COVID-19 pandemic but a considerable number of people are unprotected due to improper usage of masks.

Social distancing compliance was lower in districts with more cases which could have contributed to higher cases in the high zone districts.

The majority of the people (87%) wore cloth mask followed by a surgical mask (10%) and N95 mask (3%).

The state was divided into three zones depending on the cumulative number of COVID-19 cases reported as of August 28. Districts with total cases exceeding 8,000 were classified as High zone, Those with 4,000-8,000 as Mid Zone and those with less than 4,000 cases as Low Zone.

This was a cross-sectional observational study using the method of photo-epidemiology, a reliable method of assessing the prevalence of mask use at the population level during outbreaks.

Photos in public spaces were obtained from all the 14 districts of the state by the Master of Public Health students of the Institute. These photographs were taken across the day for nine days from August 28 to September 5 to overlap with the public holidays during the Onam festival.

The photos were taken using smartphone cameras from different types of locations including public places, hospital premises, indoor gathering locations etc.

As many as 1,445 photos capturing 6,208 people from all the 14 districts were taken in which images of 4,500 people with clear face in the photo was used for analysis.

Proper mask usage was the highest in Malappuram district (85.8%) and lowest in Idukki district (62.4%).

Thiruvananthapuram recorded mask usage of 85.5%, Ernakulum 82.9% and Kozhikode 79.7%. Mask usage estimated at a supervised shopping mall in Thiruvananthapuram was 100%.

The study termed the high percentage of mask compliance (96%) as encouraging and might contribute to the fact that Kerala was 13th in terms of COVID-19 prevalence compared to other Indian states (until and during August 2020 when the study was conducted).

However, 16% of the people wore masks improperly (lack of coverage of nose or mouth) amounting to nearly 20% of people without the protection of face masks which was cause for concern.

In the month of September, the COVID cases in Kerala increased considerably and the state is currently 3rd in India in terms of active cases and 10th in terms of cumulative cases.

Average people per photo frame was used as a surrogate of social distancing in the study.

Crowding was significantly higher in the high zone districts followed by mid zone and low zone. This could be indicative of the fact that despite high compliance of mask usage, inadequate social distancing measures could have contributed to more cases in the high zone districts, the report said.


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