Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Dec 30, 2020
Date Accepted: Aug 17, 2021
Date Submitted to PubMed: Oct 21, 2021
What had people in China done as early as Day 5-12 since the Wuhan lockdown to control COVID-19 effectively: a national population-based cross-sectional study of 23,863 university students
ABSTRACT
Background:
The COVID-19 outbreak coincided with the festive Chinese New Year (CNY) holidays (25/1/2020 to 1/2/2020, i.e., five days after the government confirmed human-to-human transmissions and stepped up national measures). The daily number of new COVID-19 cases declined continuously after a few weeks.
Objective:
This study investigated the levels of COVID-19-related personal measures (frequent face-mask use, handwashing, home-staying) taken up during the 7-day CNY holidays by 23,963 university students staying in 31 provinces in China, and associated COVID-19-related cognitive factors.
Methods:
A cross-sectional anonymous online survey was conducted during 1-10/2/2020 in China. Data of 23,863 students of 26 universities of 16 cities in 13 provincial-level regions were analyzed (mean response rate=70%). Multi-level multiple logistic regression analysis was performed.
Results:
Only 28.0% of the participants had left home for >4 hours during the 7-day CNY period (nil: 49.3%); 79.7% always used face-masks in public areas. Frequency of handwashing with soap was relatively low (26.9% for >5 times/day); 72.4% had frequently taken up ≥2 of these three measures. COVID-19-related cognitive factors (perceptions on modes of transmission, permanent bodily damage, efficacy of personal/governmental preventive measures, non-availability of vaccines/treatments) were significantly associated with the dependent variables of preventive measures. The associations of face-mask use were stronger than those of home-staying. Cautions are that 74.7% had sometimes/always touched their eyes/nose/mouth and 44.9% found their face-masks not fitting well.
Conclusions:
The levels of personal preventions, especially home-staying and face-mask use, were exceptionally strong. Health promotion may further modify the associated cognitive factors. Some structural factors (e.g., social distancing) might explain why frequencies in home-staying were higher than handwashing. The findings of this study illustrated how swift, nation-wide community personal prevention responses made during the very early phase of the outbreak had potentially contributed to effective control of the first-wave COVID-19 outbreak in China.
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