Mark Newman
An Observational Study of Mask Guideline Compliance In An Outpatient OB/GYN Clinic Population
Wake Forest University
preponderance recent evidence indicates mask usage decreases risk sars cov2 transmission 1chu dk akl ea duda solo k yaacoub schnemann hj covid19 systematic urgent review group effort surge study authors physical distancing face masks eye protection prevent persontoperson transmission sarscov2 covid19 systematic review metaanalysislancet 2020 27 19731987abstract full text full text pdf scopus 2702 google scholar wake forest baptist health wfbh mandated masking patients visitors outpatient clinics june 1 2020 communicated via campaign digital contact healthcare portal signage outside inside clinics billboard transport advertisements telephone communication appointment reminder calls maskingsocial distancing messaging currently accounts 7080 wfbh advertising expenditures wfbh communications marketing media personal communication september 29 2020 additional advertising state municipal governments healthcare systems operating area sought determine rate quality mask compliance type mask chosen among patients visitors general obgyn mfm clinical site whose layout allowed unobstructed observation arriving patients visitors one observer mn performed 720 minutes patientvisitor surveillance single wfbh mfm general obgyn outpatient clinic 9212020 1022020 perimeter defined 30 feet entrance clinics sars cov2 screening lobby patients visitors entering perimeter assessed sex type mask correct mask use second assessment use performed entry screening lobby mask type designated cloth c paper p valved v n95kn95 e improvised none n correct mask usage defined lower face coverage per guidelines 2world health organization coronavirus disease covid19 advice public use masks2020google scholar data compared using chisquare fishers exact tests appropriate wake forest university school medicine institutional review board approved project surveillance 187 patients visitors assessed summary data presented table 1 mask usage rate high 968 subjects masked 801 using mask correctly perimeter increased 934 entry mask type associated correct use perimeter p 079 entry p 012 males nonstatistically significant trend towards correct use perimeter p006 disappeared entry p 046table 1sex mask type adequacy mask usagensexfemale150802male37198mask typecloth107572paper53283valve1370extended632improvised211none632adequacy mask coverageupon approach145801upon entry169934 open table new tab demonstrate masking outpatient setting wfbh extremely high data estimating rates consistent masking 9 counties surrounding wfbh ranges 458 surry county 706 forsyth county 3katz j sangerkatz quealy k 2020 july 17 detailed map wearing masks us new york times available httpswwwnytimescominteractive20200717upshotcoronavirusfacemaskmaphtml retrieved october 5 2020google scholar using population data 9 counties 4north carolina office state budget management countystate population projections available httpsfilesncgovncosbmdemogcountytotalspopulationoverviewhtml retrieved october 5 2020google scholar author calculates average rate consistent mask use area 611 rate masking higher estimated local rates high rate masking correction incorrect mask usage perimeter entry suggests high health literacy proper mask usage causation high level masking correct usage multifactorial may include presence state mask ordinance 5state north carolina 2020 june 24 executive order 147 extension phase 2 order new measures save lives covid19 pandemic available httpsfilesncgovgovernordocumentsfileseo147phase2extensionpdf retrieved october 5 2020google scholar marketing penetration target population conclude part multimedia campaign wfbh governmentalnongovernmental entities positively influenced masking study population study limitations include small sample size possible introduction observer biaserror observation periods single observer thorough understanding regulations discrete definition mask adequacy reduced chance introducing biaserror differences masking study population regional population may due selection bias since individuals pursue health care tend different healthpromoting habits seek health care type selection bias reduces generalizability findings invalidate observations within targeted study population study limitations notwithstanding findings indicate compliance mask usage obstetric clinic patient population good suggest multifaceted campaign promoting mask usage population successful thus far external funding sources