argumentative essay about preventive measures against covid 19 brainly

Essay on Coronavirus Prevention

500+ words essay on coronavirus prevention.

The best way of coronavirus prevention is not getting it in the first place. After extensive research, there are now COVID-19 vaccines available to the public. Everyone must consider getting it to lead healthy lives. Further, we will look at some ways in this essay in how one can lower their chances of getting the virus or stopping it from spreading.

The Spread of Coronavirus

The COVID-19 virus spreads mainly via droplets that are sent out by people while talking, sneezing, or coughing. However, they do not generally stay in the air for long. Similarly, they cannot go farther than 6 feet.

However, this virus can also travel via tiny aerosol particles that have the capacity to linger for around three hours. Likewise, they may also travel farther away. Therefore, it is essential to wear a face covering.

The face mask can prevent you from getting the virus as it helps you to avoid breathing it in. Further, one can also catch this virus if they touch something that an infected person has touched and then they touch their eyes, mouth, or nose.

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How to Prevent Coronavirus

The first and foremost thing for coronavirus prevention is that everyone must do is get the vaccine as soon as it is their turn. It helps you avoid the virus or prevent you from falling seriously ill.  Apart from this, we must not forget to take other steps as well to reduce the risk of getting the virus.

It includes avoiding close contact with people who are sick or are showing symptoms. Make sure you are at least 6 feet away from them. Similarly, you also remain at the same distance as others if you have contracted the virus.

What’s important to know is that you may have COVID-19 and spread it to others even if you are not showing any symptoms or aren’t aware that you have COVID-19. Moreover, we must avoid crowds and indoor places that are not well-ventilated.

Most importantly, keep washing your hands frequently with soap and water. If these are not present, carry an alcohol-based sanitiser with you. It must have a minimum amount of 60% alcohol.

In addition, wearing a face mask is of utmost importance in public spaces. Such places come with a higher risk of transmission of the virus. Thus, use surgical masks if they are available.

It is important to cover your mouth and nose when you are coughing or sneezing. If you don’t have a tissue, cover it with your elbow. Do not touch your eyes, nose and mouth. Likewise, do not share dishes, towels, glasses and other household items with a sick person.

Do not forget to clean and disinfect surfaces that people touch frequently like electronics, switchboards, counters, doorknobs, and more. Also, stay at home if you feel sick and do not take public transport as well.

To sum it up, coronavirus prevention can be done easily. We must work together to create a safe environment for everyone to live healthily. Make sure to do your bit so that everyone can stay safe and fit and things may return to normal like before.

FAQ of  Essay on Coronavirus Prevention

Question 1: How long does it take for coronavirus symptoms to appear?

Answer 1: It may take around five to six days on average when someone gets infected with the virus. But, some people also take around 14 days.

Question 2: What are some coronavirus prevention tips?

Answer 2: One must get the vaccine as soon as possible. Further, always wear a mask properly and sanitize or wash your hands. Clean or disinfect areas that people touch frequently like door handles, electronics, and more. Always cover your mouth when sneezing or coughing and maintain physical distancing.

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The 12 Best COVID-19 Prevention Strategies

BY CARRIE MACMILLAN , JEREMY LEDGER October 12, 2020

Note: Information in this article was accurate at the time of original publication. Because information about COVID-19 changes rapidly, we encourage you to visit the websites of the Centers for Disease Control & Prevention (CDC), World Health Organization (WHO), and your state and local government for the latest information.

It’s been many months since COVID-19 upended our lives. We’ve adjusted to wearing masks, social distancing, constantly our washing hands , and working and learning remotely . But what do we really know about how to prevent COVID-19 infection ?

Scientists, doctors, and public health officials are still trying to fully understand how the virus spreads, what to do to prevent it, and the best ways to treat it. New findings sometimes lead to advice that conflicts with what we’ve been told previously—and it can be a challenge to keep track of it all. Fortunately, there is plenty of solid advice we can still follow. 

“It can be really exhausting to be constantly vigilant and to take precautions, like wearing a mask and physically distancing, which may be physically and emotionally uncomfortable,” says Jaimie Meyer, MD, MS , a Yale Medicine infectious disease expert. “But sustaining these types of behaviors is really key to curbing this pandemic, especially before a vaccine is available.”

Plus, cooler weather is bringing more of us indoors, which is riskier than being outside because there is less airflow and it can be more difficult to keep people 6 feet apart. What’s more, says Dr. Meyer, there’s the possibility that SARS-CoV-2 , the virus that causes COVID-19, is airborne, making ventilation even more important.

The upcoming months also bring seasonal respiratory viruses, like cold and flu , leading to concern about the possibility of a “twindemic” that may overwhelm health care systems already spread thin by COVID-19. These other illnesses can bring confusion because symptoms are very similar to those of COVID-19.

Meanwhile, COVID-19 remains with us, resulting in more than 210,000 deaths in the U.S. to date. As we leave a chaotic spring and summer behind and head into fall, now is a good time to check in with Yale Medicine experts and review the standard—and most recent—advice on how to stay safe.

1. Wear your mask

Wearing a mask that covers your mouth and nose can prevent those who have COVID-19 from spreading the virus to others. Recent evidence suggests that masks may even benefit the wearer, offering some level of protection against infections.

The Centers for Disease Control and Prevention (CDC) recommends that everyone age 2 years and older wear masks in public settings and around people who don’t live in the same household—when you can’t stay 6 feet apart from others. 

Masks should be made of two or more layers of washable, breathable fabric and fit snugly on your face. “A quick and easy test is to hold your mask up to the light. If light passes through, it’s too thin,” Dr. Meyer says. “Masks only work when they cover the nose and mouth because that is where infected droplets are expelled and because the virus infects people through the mucous membranes in their nose and throat.”

2. Stay socially distant

COVID-19 spreads mainly among people who are within 6 feet of one another (about two arms’ length) for a prolonged period (at least 15 minutes). Virus transmission can occur when an infected person coughs, sneezes, or talks, which releases droplets from the mouth or nose into the air.

People can be asymptomatic and spread the virus without knowing that they are sick, which makes it especially important to remain 6 feet away from others, whether you are inside or outside. Plus, the more people you interact with at a gathering and the longer time you spend interacting with each, the higher your risk of becoming infected with the virus by someone who has it.

If you are attending an event or gathering of some kind, it’s also important to be aware of the level of community transmission. One method of estimating how high the risk may be is referred to as R 0.

“Pronounced ‘R naught,’ and also known as the reproduction number, this is a measure of how fast a disease is spreading,” explains Onyema Ogbuagu, MBBCh , a Yale Medicine infectious disease expert. “If the reproduction number is 5.0, that means one infected person will spread the virus to an average of five people. Therefore, the lower the rate, the safer it is.”   

The R 0 for COVID-19 is believed to be in the range of 1.4 to 2.9. For comparison, measles, which has the highest reproduction number known among humans, ranges from 12 to 18. Seasonal influenza is around 0.9 and 2.1.

While R 0 refers to the basic, or initial, reproduction number, there is another measurement called R t, which is the current reproduction number and is the average number of people who become infected by an infectious person. If R t is above 1.0, it spreads quickly. If it’s below 1.0, it will eventually stop spreading. You can check the number for each state here .

3. Keep washing your hands

Washing your hands—and well—remains a key step to preventing COVID-19 infection. Wash your hands with soap often, and especially after you have been in a public place or have blown your nose, coughed, or sneezed, the CDC recommends.

You should wash your hands for at least 20 seconds and lather the back of your hands and scrub between all fingers, under all fingernails, and reach up to the wrist, the CDC advises. After washing, dry them completely (with an air dryer or paper towel) and avoid touching the sink, faucet, door handles, or other objects. If no soap is available, use a hand sanitizer with at least 60% alcohol content, and rub the sanitizer on your hands until they are dry.

Though the CDC states that the primary way the virus spreads is through close person-to-person contact, it may be possible to become infected with COVID-19 by touching a surface or object that has the virus on it and then touching your own mouth, nose, or eyes.

Therefore, you should also wash your hands after touching anything that may have been contaminated—such as a banister or door handle in a public place—and before you touch your face.

While the virus can survive for a short period on some surfaces, it is unlikely to be spread from mail or from products or packaging, the CDC says. Likewise, the risk of infection from food (that you cook, is prepared in a restaurant, or is ordered via takeout) is considered to be very low, as is the risk from food packaging or bags.

Still, there is much that is unknown about the virus, and it remains advisable to wash hands thoroughly after handling any food or products that come into your home.

4. Keep holiday gatherings small

Fall and winter also bring holidays, when many families get together. This can be especially tricky for those of us who live in parts of the country where it will no longer be easy to gather outside. “After months apart during this pandemic, families may be less willing to do a group Zoom call,” says Dr. Meyer. “This may be a year where we need to get creative and rethink how to celebrate together.” 

That may simply mean more planning for the holidays, Dr. Meyer says. “Consider quarantining for 14 days prior to the event and/or having everyone get tested for COVID-19 if tests are available in your community,” she suggests. “If possible, limit gatherings to as few people as possible—perhaps just immediate family and close friends. When it is not possible to be outside, encourage your guests to wear masks indoors. Consider spreading out food and eating areas so people are distanced while eating with their masks down.”

Remember that your elderly family members and those with other medical conditions are most vulnerable to COVID-19, so take extra measures to protect them, says Dr. Meyer.

5. Dine out carefully

Although many restaurants offer outdoor dining, which experts say is the safer option, a recent CDC study showed that adults with COVID-19 infections were twice as likely to have visited a restaurant in the two weeks preceding their illness than those without an infection. 

The study did not distinguish between indoor or outdoor dining, or consider adherence to social distancing and mask use. (Those with COVID-19 infections were more likely to report having dined out at places where few other people were wearing masks or socially distancing.)

“If you are meeting with others at a restaurant and sharing tables while eating, which does not allow for appropriate social distancing and mask use, it provides opportunities for the virus to spread from person to person,” Dr. Ogbuagu notes. “The probability of spreading infection is higher with each additional person you are in contact with, especially when people congregate.”

6. Travel safely

While you should avoid traveling if you can—as the CDC says staying home is the best way to avoid COVID-19—sometimes, it is necessary. But before you leave, you can check to see if the virus is spreading at your destination. More cases at your destination increases your risk of contracting the virus and spreading it to others. You can view each state’s weekly number of cases here  on the CDC web site. 

“Also, don’t forget to check the regulations for quarantining or testing at your destination or for when you return home,” says Dr. Meyer. Whether you are traveling by car, plane, bus, or train, there are precautions you can take along the way. The CDC has a detailed list  of recommendations for each mode of transportation that mostly follows the advice listed above of practicing social distancing, wearing a mask, and washing hands, but also includes specific advice for various scenarios.

7. Get your flu shot

Health officials are concerned about an influx of flu and COVID-19 cases overwhelming hospitals. In the 2018-2019 flu season, 490,600 Americans were hospitalized for the flu, according to the CDC.

Public health experts say this is not the year to skip the flu vaccine. While measures to prevent COVID-19, including mask-wearing, washing hands, and social distancing, can also protect against the flu, the vaccine is especially important—and safe, doctors say.

Though many people claim that the flu shot “gave them the flu,” it is not possible to get infected with the influenza virus from the vaccine itself, Dr. Meyer says. “The vaccine is made up of inactivated virus and is designed to ‘tickle’ the immune system to respond to the real thing when it sees it,” she explains. “The most common side effect from the flu shot is soreness or redness at the site of the injection, which resolves within a day or two.”

The flu vaccine is recommended for everyone 6 months old and up. Talk to your doctor about finding a vaccine near you.

8. Differentiate between flu, colds, and COVID-19

Many people will likely struggle to differentiate between the flu, the common cold, and COVID-19, all of which have similar symptoms.

For example, both COVID-19 and the flu can cause fever, shortness of breath, fatigue, headache, cough, sore throat, runny nose, muscle pain, or body aches, as well as vomiting and diarrhea (though these last two are more common in children). Meanwhile, colds may be milder than the flu and are more likely to involve a runny or stuffy nose. One difference, however, is that COVID-19 is associated with a loss of taste and smell .

So, if you or someone in your family comes down with any of these symptoms, what should you do?

“First, you should stay away from others as much as possible and perform hand washing before you make contact with your face,” Dr. Ogbuagu says. “And certainly go see a doctor or to the hospital if you have serious symptoms, such as a high fever or shortness of breath. Otherwise, getting a COVID-19 test at a testing facility near you would help to define what type of respiratory illness you have and also how to advise people you had been in contact with.”

Parents, Dr. Meyer adds, will need to contact their children’s pediatricians about these symptoms because otherwise their children likely won’t be able to return to school.

“I would also add that people who are older and have underlying medical conditions should have a low threshold to seek care for any of these symptoms,” she says. “Earlier is better, especially for influenza, as we have antiviral medications that work if given within 72 hours of the onset of symptoms.”

9. Seek routine medical care

You should continue to seek any routine or emergency medical care or treatments you need. Many health centers and doctors are offering telehealth appointments (via video or phone) and most have protocols to minimize risk of exposure to the coronavirus.

Getting emergency care when you need it is especially important. Earlier in the pandemic, pediatric and adult physicians reported fewer emergency department visits, leading to a concern that patients were avoiding seeking care due to fears of contracting COVID-19.

“As important as it is to continue to engage in care for known medical issues, there is also a concern that people are falling behind on their preventive healthcare, like getting routine procedures including colonoscopies and pap smears, as well as vaccines,” Dr. Meyer says. “Those other health issues don’t go away just because there is a pandemic. Reach out to your primary care doctor if you’re unsure what you are due to receive.”

10. Be mindful of your mental health

Many people are experiencing anxiety, depression, and other mental health issues during the pandemic as it is a time of stress and uncertainty. All of this is normal, say mental health experts, who recommend that you allow yourself to embrace all emotions, including those that are unpleasant, in order to better manage them.

Experts advise limiting exposure to news if the events of the world are too much right now, practicing mindfulness (even just breathing exercises), eating healthy, and remaining physically active.

For kids, who are still adjusting to a lack of play dates, canceled activities, and different school schedules, parents can help by fully listening to their concerns and providing age-appropriate answers to their questions. By talking with kids about what they know and how they are doing, parents may be able to determine if further emotional support is needed. 

11. Watch your weight

At a time when routines are disrupted and many people are working at home—where snacks are readily available—some may be gaining weight (the so-called quarantine 15). Now more than ever, Yale Medicine doctors recommend that you focus on eating a healthy diet, incorporating regular exercise, getting good sleep, and finding healthy ways to manage stress.

Meanwhile, obesity is emerging as an independent risk factor for severe COVID-19 illness—even among younger patients. One study, which examined hospitalized COVID-19 patients under age 60, found that those with obesity were twice as likely to require hospitalization and even more likely to need critical care than those who did not have it. Given that an estimated 42% of Americans have obesity (having a body mass index equal to or more than 30), this is important.

12. Keep up the good (safety) work

It is likely that COVID-19 will be with us for a while. “But with good efforts to continue to follow the public health measures to protect each other, and, hopefully, a successful vaccine in the future, there is a light at the end of the tunnel,” Dr. Ogbuagu says.

But even before a safe and effective vaccine is available, COVID-19 is a preventable disease, Dr. Meyer points out. “It just requires all of us to do the hard work of practicing the behaviors—described above—to keep our communities safe and healthy.”

Note: Information provided in Yale Medicine articles is for general informational purposes only. No content in the articles should ever be used as a substitute for medical advice from your doctor or other qualified clinician. Always seek the individual advice of your health care provider with any questions you have regarding a medical condition.   

More news from Yale Medicine

Students’ Essays on Infectious Disease Prevention, COVID-19 Published Nationwide

As part of the BIO 173: Global Change and Infectious Disease course, Professor Fred Cohan assigns students to write an essay persuading others to prevent future and mitigate present infectious diseases. If students submit their essay to a news outlet—and it’s published—Cohan awards them with extra credit.

As a result of this assignment, more than 25 students have had their work published in newspapers across the United States. Many of these essays cite and applaud the University’s Keep Wes Safe campaign and its COVID-19 testing protocols.

Cohan, professor of biology and Huffington Foundation Professor in the College of the Environment (COE), began teaching the Global Change and Infectious Disease course in 2009, when the COE was established. “I wanted very much to contribute a course to what I saw as a real game-changer in Wesleyan’s interest in the environment. The course is about all the ways that human demands on the environment have brought us infectious diseases, over past millennia and in the present, and why our environmental disturbances will continue to bring us infections into the future.”

Over the years, Cohan learned that he can sustainably teach about 170 students every year without running out of interested students. This fall, he had 207. Although he didn’t change the overall structure of his course to accommodate COVID-19 topics, he did add material on the current pandemic to various sections of the course.

“I wouldn’t say that the population of the class increased tremendously as a result of COVID-19, but I think the enthusiasm of the students for the material has increased substantially,” he said.

To accommodate online learning, Cohan shaved off 15 minutes from his normal 80-minute lectures to allow for discussion sections, led by Cohan and teaching assistants. “While the lectures mostly dealt with biology, the discussions focused on how changes in behavior and policy can solve the infectious disease problems brought by human disturbance of the environment,” he said.

Based on student responses to an introspective exam question, Cohan learned that many students enjoyed a new hope that we could each contribute to fighting infectious disease. “They discovered that the solution to infectious disease is not entirely a waiting game for the right technologies to come along,” he said. “Many enjoyed learning about fighting infectious disease from a moral and social perspective. And especially, the students enjoyed learning about the ‘socialism of the microbe,’ how preventing and curing others’ infections will prevent others’ infections from becoming our own. The students enjoyed seeing how this idea can drive both domestic and international health policies.”

A sampling of the published student essays are below:

Alexander Giummo ’22 and Mike Dunderdale’s ’23  op-ed titled “ A National Testing Proposal: Let’s Fight Back Against COVID-19 ” was published in the Journal Inquirer in Manchester, Conn.

They wrote: “With an expansive and increased testing plan for U.S. citizens, those who are COVID-positive could limit the number of contacts they have, and this would also help to enable more effective contact tracing. Testing could also allow for the return of some ‘normal’ events, such as small social gatherings, sports, and in-person class and work schedules.

“We propose a national testing strategy in line with the one that has kept Wesleyan students safe this year. The plan would require a strong push by the federal government to fund the initiative, but it is vital to successful containment of the virus.

“Twice a week, all people living in the U.S. should report to a local testing site staffed with professionals where the anterior nasal swab Polymerase Chain Reaction (PCR) test, used by Wesleyan and supported by the Broad Institute, would be implemented.”

Kalyani Mohan ’22 and Kalli Jackson ’22 penned an essay titled “ Where Public Health Meets Politics: COVID-19 in the United States ,” which was published in Wesleyan’s Arcadia Political Review .

They wrote: “While the U.S. would certainly benefit from a strengthened pandemic response team and structural changes to public health systems, that alone isn’t enough, as American society is immensely stratified, socially and culturally. The politicization of the COVID-19 pandemic shows that individualism, libertarianism and capitalism are deeply ingrained in American culture, to the extent that Americans often blind to the fact community welfare can be equivalent to personal welfare. Pandemics are multifaceted, and preventing them requires not just a cultural shift but an emotional one amongst the American people, one guided by empathy—towards other people, different communities and the planet. Politics should be a tool, not a weapon against its people.”

Sydnee Goyer ’21 and Marcel Thompson’s ’22  essay “ This Flu Season Will Be Decisive in the Fight Against COVID-19 ” also was published in Arcadia Political Review .

“With winter approaching all around the Northern Hemisphere, people are preparing for what has already been named a “twindemic,” meaning the joint threat of the coronavirus and the seasonal flu,” they wrote. “While it is known that seasonal vaccinations reduce the risk of getting the flu by up to 60% and also reduce the severity of the illness after the contamination, additional research has been conducted in order to know whether or not flu shots could reduce the risk of people getting COVID-19. In addition to the flu shot, it is essential that people remain vigilant in maintaining proper social distancing, washing your hands thoroughly, and continuing to wear masks in public spaces.”

An op-ed titled “ The Pandemic Has Shown Us How Workplace Culture Needs to Change ,” written by Adam Hickey ’22 and George Fuss ’21, was published in Park City, Utah’s The Park Record .

They wrote: “One review of academic surveys (most of which were conducted in the United States) conducted in 2019 found that between 35% and 97% of respondents in those surveys reported having attended work while they were ill, often because of workplace culture or policy which generated pressure to do so. Choosing to ignore sickness and return to the workplace while one is ill puts colleagues at risk, regardless of the perceived severity of your own illness; COVID-19 is an overbearing reminder that a disease that may cause mild, even cold-like symptoms for some can still carry fatal consequences for others.

“A mandatory paid sick leave policy for every worker, ideally across the globe, would allow essential workers to return to work when necessary while still providing enough wiggle room for economically impoverished employees to take time off without going broke if they believe they’ve contracted an illness so as not to infect the rest of their workplace and the public at large.”

Women’s cross country team members and classmates Jane Hollander ’23 and Sara Greene ’23 wrote a sports-themed essay titled “ This Season, High School Winter Sports Aren’t Worth the Risk ,” which was published in Tap into Scotch Plains/Fanwood , based in Scotch Plains, N.J. Their essay focused on the risks high school sports pose on student-athletes, their families, and the greater community.

“We don’t propose cutting off sports entirely— rather, we need to be realistic about the levels at which athletes should be participating. There are ways to make practices safer,” they wrote. “At [Wesleyan], we began the season in ‘cohorts,’ so the amount of people exposed to one another would be smaller. For non-contact sports, social distancing can be easily implemented, and for others, teams can focus on drills, strength and conditioning workouts, and skill-building exercises. Racing sports such as swim and track can compete virtually, comparing times with other schools, and team sports can focus their competition on intra-team scrimmages. These changes can allow for the continuation of a sense of normalcy and team camaraderie without the exposure to students from different geographic areas in confined, indoor spaces.”

Brook Guiffre ’23 and Maddie Clarke’s ’22  op-ed titled “ On the Pandemic ” was published in Hometown Weekly,  based in Medfield, Mass.

“The first case of COVID-19 in the United States was recorded on January 20th, 2020. For the next month and a half, the U.S. continued operating normally, while many other countries began their lockdown,” they wrote. “One month later, on February 29th, 2020, the federal government approved a national testing program, but it was too little too late. The U.S. was already in pandemic mode, and completely unprepared. Frontline workers lacked access to N-95 masks, infected patients struggled to get tested, and national leaders informed the public that COVID-19 was nothing more than the common flu. Ultimately, this unpreparedness led to thousands of avoidable deaths and long-term changes to daily life. With the risk of novel infectious diseases emerging in the future being high, it is imperative that the U.S. learn from its failure and better prepare for future pandemics now. By strengthening our public health response and re-establishing government organizations specialized in disease control, we have the ability to prevent more years spent masked and six feet apart.”

In addition, their other essay, “ On Mass Extinction ,” was also published by Hometown Weekly .

“The sixth mass extinction—which scientists have coined as the Holocene Extinction—is upon us. According to the United Nations, around one million plant and animal species are currently in danger of extinction, and many more within the next decade. While other extinctions have occurred in Earth’s history, none have occurred at such a rapid rate,” they wrote. “For the sake of both biodiversity and infectious diseases, it is in our best interest to stop pushing this Holocene Extinction further.”

An essay titled “ Learning from Our Mistakes: How to Protect Ourselves and Our Communities from Diseases ,” written by Nicole Veru ’21 and Zoe Darmon ’21, was published in My Hometown Bronxville, based in Bronxville, N.Y.

“We can protect ourselves and others from future infectious diseases by ensuring that we are vaccinated,” they wrote. “Vaccines have high levels of success if enough people get them. Due to vaccines, society is no longer ravaged by childhood diseases such as mumps, rubella, measles, and smallpox. We have been able to eradicate diseases through vaccines; smallpox, one of the world’s most consequential diseases, was eradicated from the world in the 1970s.

“In 2000, the U.S. was nearly free of measles, yet, due to hesitations by anti-vaxxers, there continues to be cases. From 2000–2015 there were over 18 measles outbreaks in the U.S. This is because unless a disease is completely eradicated, there will be a new generation susceptible.

“Although vaccines are not 100% effective at preventing infection, if we continue to get vaccinated, we protect ourselves and those around us. If enough people are vaccinated, societies can develop herd immunity. The amount of people vaccinated to obtain herd immunity depends on the disease, but if this fraction is obtained, the spread of disease is contained. Through herd immunity, we protect those who may not be able to get vaccinated, such as people who are immunocompromised and the tiny portion of people for whom the vaccine is not effective.”

Dhruvi Rana ’22 and Bryce Gillis ’22 co-authored an op-ed titled “ We Must Educate Those Who Remain Skeptical of the Dangers of COVID-19 ,” which was published in Rhode Island Central .

“As Rhode Island enters the winter season, temperatures are beginning to drop and many studies have demonstrated that colder weather and lower humidity are correlated with higher transmissibility of SARS-CoV-2, the virus that causes COVID-19,” they wrote. “By simply talking or breathing, we release respiratory droplets and aerosols (tiny fluid particles which could carry the coronavirus pathogen), which can remain in the air for minutes to hours.

“In order to establish herd immunity in the US, we must educate those who remain skeptical of the dangers of COVID-19.  Whether community-driven or state-funded, educational campaigns are needed to ensure that everyone fully comprehends how severe COVID-19 is and the significance of airborne transmission. While we await a vaccine, it is necessary now more than ever that we social distance, avoid crowds, and wear masks, given that colder temperatures will likely yield increased transmission of the virus.”

Danielle Rinaldi ’21 and Verónica Matos Socorro ’21 published their op-ed titled “ Community Forum: How Mask-Wearing Demands a Cultural Reset ” in the Ewing Observer , based in Lawrence, N.J.

“In their own attempt to change personal behavior during the pandemic, Wesleyan University has mandated mask-wearing in almost every facet of campus life,” they wrote. “As members of our community, we must recognize that mask-wearing is something we are all responsible and accountable for, not only because it is a form of protection for us, but just as important for others as well. However, it seems as though both Covid fatigue and complacency are dominating the mindsets of Americans, leading to even more unwillingness to mask up. Ultimately, it is inevitable that this pandemic will not be the last in our lifespan due to global warming creating irreversible losses in biodiversity. As a result, it is imperative that we adopt the norm of mask-wearing now and undergo a culture shift of the abandonment of an individualistic mindset, and instead, create a society that prioritizes taking care of others for the benefit of all.”

Shayna Dollinger ’22 and Hayley Lipson ’21  wrote an essay titled “ My Pandemic Year in College Has Brought Pride and Purpose. ” Dollinger submitted the piece, rewritten in first person, to Jewish News of Northern California . Read more about Dollinger’s publication in this News @ Wesleyan article .

“I lay in the dead grass, a 6-by-6-foot square all to myself. I cheer for my best friend, who is on the stage constructed at the bottom of Foss hill, dancing with her Bollywood dance group. Masks cover their ordinarily smiling faces as their bodies move in sync. Looking around at friends and classmates, each in their own 6-by-6 world, I feel an overwhelming sense of normalcy.

“One of the ways in which Wesleyan has prevented outbreaks on campus is by holding safe, socially distanced events that students want to attend. By giving us places to be and things to do on the weekends, we are discouraged from breaking rules and causing outbreaks at ‘super-spreader’ events.”

An op-ed written by Luna Mac-Williams ’22 and Daëlle Coriolan ’24 titled “ Collectivist Practices to Combat COVID-19 ” was published in the Wesleyan Argus .

“We are embroiled in a global pandemic that disproportionately affects poor communities of color, and in the midst of a higher cultural consciousness of systemic inequities,” they wrote. “A cultural shift to center collectivist thought and action not only would prove helpful in disease prevention, but also belongs in conversation with the Black Lives Matter movement. Collectivist models of thinking effectively target the needs of vulnerable populations including the sick, the disenfranchised, the systematically marginalized. Collectivist systems provide care, decentering the capitalist, individualist system, and focusing on how communities can work to be self-sufficient and uplift our own neighbors.”

An essay written by Maria Noto ’21 , titled “ U.S. Individualism Has Deadly Consequences ,” is published in the Oneonta Daily Star , based in Oneonta, N.Y.

She wrote, “When analyzing the cultures of certain East Asian countries, several differences stand out. For instance, when people are sick and during the cold and flu season, many East Asian cultures, including South Korea, use mask-wearing. What is considered a threat to freedom by some Americans is a preventive action and community obligation in this example. This, along with many other cultural differences, is insightful in understanding their ability to contain the virus.

“These differences are deeply seeded in the values of a culture. However, there is hope for the U.S. and other individualistic cultures in recognizing and adopting these community-centered approaches. Our mindset needs to be revolutionized with the help of federal and local assistance: mandating masks, passing another stimulus package, contact tracing, etc… However, these measures will be unsuccessful unless everyone participates for the good of a community.”

A published op-ed by Madison Szabo ’23 , Caitlyn Ferrante ’23 ran in the Two Rivers Times . The piece is titled “ Anxiety and Aspiration: Analyzing the Politicization of the Pandemic .”

John Lee ’21 and Taylor Goodman-Leong ’21 have published their op-ed titled “ Reassessing the media’s approach to COVID-19 ” in Weekly Monday Cafe 24 (Page 2).

An essay by Eleanor Raab ’21 and Elizabeth Nefferdorf ’22 titled “ Preventing the Next Epidemic ” was published in The Almanac .

• Keep Wes Safe
• student publications
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• Research article
• Open access
• Published: 29 April 2021

Effectiveness of personal protective health behaviour against COVID-19

• Chon Fu Lio 1 ,
• Hou Hon Cheong 1 ,
• Chin Ion Lei 2 , 3 ,
• Iek Long Lo 4 ,
• Lan Yao 4 ,
• Chong Lam 5 &
• Iek Hou Leong 5  

BMC Public Health volume  21 , Article number:  827 ( 2021 ) Cite this article

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Novel coronavirus disease 2019 (COVID-19) has become a pandemic, and over 80 million cases and over 1.8 million deaths were reported in 2020. This highly contagious virus is spread primarily via respiratory droplets from face-to-face contact and contaminated surfaces as well as potential aerosol spread. Over half of transmissions occur from presymptomatic and asymptomatic carriers. Although several vaccines are currently available for emergency use, there are uncertainties regarding the duration of protection and the efficacy of preventing asymptomatic spread. Thus, personal protective health behaviour and measures against COVID-19 are still widely recommended after immunization. This study aimed to clarify the efficacy of these measures, and the results may provide valuable guidance to policymakers to educate the general public about how to reduce the individual-level risk of COVID-19 infection.

This case-control study enrolled 24 laboratory-confirmed COVID-19 patients from Centro Hospitalar Conde de São Januário (C.H.C.S.J.), which was the only hospital designated to manage COVID-19 patients in Macao SAR, China, and 1113 control participants who completed a 14-day mandatory quarantine in 12 designated hotels due to returning from high-risk countries between 17 March and 15 April 2020. A questionnaire was developed to extract demographic information, contact history, and personal health behaviour.

Participants primarily came from the United Kingdom (33.2%), followed by the United States (10.5%) and Portugal (10.2%). Independent factors for COVID-19 infection were having physical contact with confirmed/suspected COVID-19 patients (adjusted OR, 12.108 [95% CI, 3.380–43.376], P  < 0.005), participating in high-risk gathering activities (adjusted OR, 1.129 [95% CI, 1.048–1.216], P  < 0.005), handwashing after outdoor activity (adjusted OR, 0.021 [95% CI, 0.003–0.134], P  < 0.005), handwashing before touching the mouth and nose area (adjusted OR, 0.303 [95% CI, 0.114–0.808], P  < 0.05), and wearing a mask whenever outdoors (adjusted OR, 0.307 [95% CI, 0.109–0.867], P  < 0.05). The daily count of handwashing remained similar between groups. Only 31.6% of participants had a sufficient 20-s handwashing duration.

Conclusions

Participating in high-risk gatherings, wearing a mask whenever outdoors, and practising hand hygiene at key times should be advocated to the public to mitigate COVID-19 infection.

Peer Review reports

Coronavirus disease 2019 (COVID-19) evolved from a global public health emergency to a pandemic after the declaration by the World Health Organization (WHO) on March 11, 2020 [ 1 ]. The outbreak caused public fear and serious burdens on healthcare systems, social relationships and economies worldwide. As of January 3, 2021, over 80 million cases had been confirmed, with more than 1.8 million deaths globally [ 2 ]. Nevertheless, the high transmissibility from pre- or asymptomatic patients concurred with virus RNA levels peaking at day 4 from symptom onset, possibly exacerbating the spread [ 3 ]. This highly contagious virus is spread primarily via respiratory droplets from face-to-face contact and contaminated surfaces as well as potential aerosol spread [ 4 ]. It is estimated that over half of transmissions occur from presymptomatic and asymptomatic carriers [ 5 ]. Although vaccines for COVID-19 have become available recently, there are uncertainties regarding the duration of protection and the efficacy of preventing asymptomatic spread [ 6 ].

Initially, various public health policies were adopted among different countries to attempt to mitigate the outbreak, and the preliminary outcomes of these measures including “lockdown” or sanitary cordon, travel restrictions, quarantines for travellers, stay-at-home orders, closure of schools and business, and bans on gatherings were encouraging [ 7 , 8 , 9 , 10 , 11 ]. It is recognized that some leading causes of morbidity and mortality could be attributed to health determinants associated with the health behaviour of individuals, such as the adoption of health behaviour against virus transmission (e.g., hand washing and use of masks outdoors) and the avoidance of health-harming behaviours (e.g., touching the face and gathering for occasions) [ 12 ]. Though personal hygiene practices such as washing hands, wearing masks, and maintaining social distance are widely recommended to the public based on the knowledge of droplet transmission, there is still scarce evidence of the effectiveness of these personal measures in preventing COVID-19 infection at the individual level.

Therefore, a case-control study was conducted to determine the risk and protective factors for COVID-19 infection at the individual level, with a specific emphasis on personal behaviours such as mask use, the number of gatherings, and hand hygiene practices. A questionnaire was designed to extract related information among COVID-19 patients in Centro Hospitalar Conde de São Januário (C.H.C.S.J.), the only hospital designated to manage COVID-19 patients in Macao SAR. People who had been in a COVID-19 high-risk foreign country undergoing a 14-day mandatory quarantine in 12 designated hotels in Macao SAR served as the control group. This article is structurally divided into the introduction, methods describing the study design and statistical analysis, the results of effect sizes of different measures against COVID-19 infection, discussion and conclusions.

Study design and population

A cross-sectional questionnaire survey was conducted in Macao from March 17, 2020, to April 15, 2020 (the flowchart of participant recruitment in the case-control study is shown in Fig.  1 ). The study population consisted of the following: 1) people who had been in a COVID-19 high-risk foreign country in the past 14 days before entry to Macao and would have completed a 14-day mandatory quarantine in 12 designated hotels in Macao before the end of the study period and 2) people diagnosed with COVID-19 and hospitalized in C.H.C.S.J., the only hospital designated to manage COVID-19 cases. All participants who could understand and complete the questionnaire written in Chinese, English or Portuguese were included.

Flowchart of participant recruitment in the case-control study

Instrument and data collection

For the case group, 35 patients were included, 3 patients under the age of 15 were excluded, and 6 patients refused to participate. For the control group, 2981 travellers were initially included, 1813 of whom refused to participate, while 14 respondents under the age of 15 and 41 questionnaires without crucial data were subsequently excluded. The exclusion criteria included age less than 15 years, refusal to participate and questionnaires with missing crucial data. Questions covered the following topics: personal data and information, personal health status and living habits, epidemic prevention and control situation of the main country in which one stayed, contact history, personal protective health behaviour and measures before returning to Macao. The detailed content can be found in the questionnaire template in the Additional file 1 .

Informed consent

The Macao Health Bureau, Centro Hospitalar Conde de São Januário, Medical Ethical Committee approved the research protocol. All procedures performed in the study involving human participants were consistent with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. All participants gave informed consent via web-based systems before answering questionnaires. Using a paper questionnaire, written informed consent was acquired and collected.

Statistical analysis

Descriptive statistics for demographic information, preventive policy, contact history, and personal protective health behaviour and measures were calculated. Then, patients were divided into “COVID-19 infected” and “non-infected” groups. Differences in percentages between groups were examined using Pearson’s chi-square test or Fisher’s exact test. Student’s t-test or Mann–Whitney U test was utilized to examine the differences among continuous variables depending on the data normality. Univariate logistic regression was used to identify factors associated with COVID-19 infection. Then, those significant factors were pooled and selected to build a multivariate logistic model via a forward-selection stepwise method. The level of statistical significance was set at α = 0.05. R (version 3.5.2, R Development Core Team 2018) was used to conduct statistical analyses.

Overall, 1137 questionnaires were considered effective and were analysed accordingly. The total response rate was 37.7% (1137/3013), and the response rate of the infected group was 75% (24/32). Demographic information and the comparison between infected and non-infected groups are summarized in Table  1 . The majority of the participants were aged between 20 and 44 years (65.5%) and had received secondary education or above (55.5%). Overall, 93% of participants denied having any chronic diseases. The most common comorbid diseases were hypertension (3.3%), followed by diabetes mellitus (1.1%) and dyslipidaemia (0.9%). The majority of respondents were non-smokers (80.7%). The top 10 countries in which the participants stayed before returning to Macao were the United Kingdom (33.2%), United States (10.5%), Portugal (10.2%), Australia (9.1%), Canada (4.7%), Philippines (3.5%), China (3.3%), Malaysia (2.4%), Cambodia (2.2%), and Thailand (2%). The main reasons for staying abroad were “study abroad” (60.9%), “visiting relatives” (12.9%), “travel” (11.6%), and “business trip” (6.0%).

Personal protective health behaviour and measures for COVID-19 in the local community in which the participants stayed before returning to Macao

Within 14 days before returning to Macao, the majority of respondents (79.3%) stated that COVID-19 was spreading in the countries in which they stayed (Table  2 ). In total, 42.9% of participants were requested to undergo self-quarantine at home. There were seemingly lower proportions of traffic restrictions (20.8% vs 33.2%; P  = 0.201) and closures of public entertainment venues (37.5% vs 49.2%; P  = 0.255) in the COVID-19-infected group than in the non-infected group in the countries in which they stayed; however, the statistical power was insufficient to differentiate the extent of these differences due to the limited sample size in the COVID-19 patient group.

Contact history and frequency of outdoor activities

In total, only a minority of participants had visited medical facilities for any reason (4.9%) and had contact with those who had respiratory symptoms (8%) or confirmed/suspected COVID-19 patients (2.2%) (Table  3 ). Notably, there were significantly higher percentages of these activities in the infected group than in the non-infected group, such as having physical contact with those who had respiratory symptoms (25% vs 7.6%; P  = 0.002) or confirmed/suspected COVID-19 patients (16.7% vs 1.9%; P  = 0.001). Moreover, compared to the non-infected populations, the infected group presented fewer protective measures during/after contact with high-risk people, such as washing hands (50% vs 95.3%; P  = 0.005) and wearing a mask (16.7% vs 67.1%; P  = 0.022) following contact with someone who was symptomatic. Participants were asked to calculate the total number of outdoor activities within a 14-day interval before returning to Macao. Notably, there were significantly more high-risk gathering activities defined by interacting with people within 2 m without wearing a mask (5.4 ± 10.1 vs 0.7 ± 2.3; P  = 0.034) in the infected group than in the non-infected group within 14 days before returning to Macao.

Mask usage behaviour, timing and duration for handwashing

More than half (63.5%) of the participants admitted that they wore a mask whenever they stayed outdoors within 14 days before returning to Macao. There was a larger proportion of non-infected participants wearing a mask whenever outdoors than the infected group (63.5% vs 25.0%; P  < 0.001) (Table  4 ). The majority of participants believed that there was a lower chance of accidentally touching the mouth and nose area after wearing a mask (79.8%), and almost all of them acknowledged that hand hygiene was still important after mask usage (95.1%).

With regard to hand hygiene, the practice of handwashing was substantially less common in the infected population than in the non-infected population, such as handwashing after handling food or cooking (75% vs 94.2%; P  < 0.001), after a toilet trip (79.2% vs 91.5%; P  = 0.035), after outdoor activity (83.3% vs 99.5%, P  < 0.001), after sneezing or coughing (54.2% vs 80.5%; P  = 0.001), after handling pets (58.3% vs 81.2%; P  = 0.005), and before touching the mouth and nose area (50.0% vs 86.5%; P  < 0.001). However, only approximately one-third of the total population (31.6%) achieved a sufficient 20-s duration for handwashing. Furthermore, only 16.7% of the infected population washed hands for over 20 s each time, compared with 31.9% in the noninfected group ( P  = 0.125), and the mean duration of handwashing each time was less than 20 s in the infected group (18.8 ± 11.2 s). On the other hand, the average number of handwashes with soap or alcoholic sanitizers per day remained similar between the two groups (9.1 ± 8.4 vs 9.2 ± 8.4, P  = 0.958).

Risk and protective factors associated with COVID-19 infection

In univariate analysis (Table  5 ), those who had physical contact with people having respiratory symptoms (crude OR, 10.4 [95% CI, 3.270–33.079], P  < 0.005) or confirmed/suspected COVID-19 patients (crude OR, 12.381 [95% CI, 4.261–35.973], P  < 0.005) had a higher risk of COVID-19 infection than those who did not. A risk reduction of 80.9% was noted in those who wore masks whenever outdoors (crude OR, 0.191 [95% CI, 0.075–0.486], P  < 0.005) compared with those who did not. Outdoor activities, such as “high-risk gathering”, defined as interacting with people within 2 m without wearing masks, significantly increased the COVID-19 risk by up to 15.5% each time (crude OR, 1.155 [95% CI, 1.089–1.225], P  < 0.005). Decent handwashing habits showed protective effects on COVID-19 infection, such as after handling food or cooking (crude OR, 0.186 [95% CI, 0.071–0.485], P  < 0.005), after a toilet trip (crude OR, 0.355 [95% CI, 0.130–0.971], P  < 0.05), after outdoor activity (crude OR, 0.027 [95% CI, 0.007–0.104], P  < 0.005), after sneezing or coughing (crude OR, 0.286 [95% CI, 0.127–0.648], P  < 0.005), after handling pets (crude OR, 0.324 [95% CI, 0.142–0.739], P  < 0.01), and before touching the mouth and nose area (crude OR, 0.156 [95% CI, 0.069–0.353], P  < 0.005). In multivariate logistic regression via a forward-selection stepwise method, independent factors for COVID-19 infection were having physical contact with confirmed/suspected COVID-19 patients (adjusted OR, 12.108 [95% CI, 3.380–43.376], P  < 0.005), wearing a mask whenever outdoors (adjusted OR, 0.307 [95% CI, 0.109–0.867], P  < 0.05), the number of high-risk gathering activities (interact with people within 2 m without wearing a mask) in a 14-day interval (adjusted OR, 1.129 [95% CI, 1.048–1.216], P  < 0.005), handwashing after outdoor activity (adjusted OR, 0.021 [95% CI, 0.003–0.134], P  < 0.005), and before touching the mouth and nose area (adjusted OR, 0.303 [95% CI, 0.114–0.808], P  < 0.05).

Ultimately, our findings showed that the most commonly advised measures were effective against COVID-19 infection. Most of the participants in both the infected and non-infected groups were healthy, young students studying abroad. The infected group consisted of large numbers of people returning from the United Kingdom and the Philippines. This factor somehow correlated with these countries’ community outbreaks during that period. Moreover, COVID-19 patients responded that there were fewer public preventive measures taken in the local community where they stayed before returning to Macao SAR, such as closing entertainment venues, traffic restrictions, and testing COVID-19 for all symptomatic patients. From Wuhan’s report in China, suspending intracity public transport, closing entertainment venues, and banning public gatherings were associated with reductions in case incidence [ 13 ]. Although the statistical power was insufficient to distinguish differences in public measures among the uninfected and infected groups in this study, our data showed that each high-risk gathering activity (interacting with people within 2 m without wearing a mask) increased the risk of COVID-19 infection by 12.9%.

Significant exposure to COVID-19 was commonly defined as face-to-face contact within 6 ft (~ 1.83 m) with symptomatic COVID-19 patients that was sustained for at least a few minutes [ 14 ]. The transmission of viruses was reported to be lower with physical distancing of 1 m or more, for which protection would be increased with increasing distance [ 15 ]. Based on our data, physical contact with suspected/confirmed COVID-19 cases increased the risk of infection by 12-fold. While this contact history may be retrospective in nature, this finding revealed the differences in personal hygiene behaviour between the control group and the COVID-19 infection group when they had contact with symptomatic individuals. In the infection group, 50.4% fewer people wore a mask when contacting people with respiratory symptoms, and 45.3% fewer people washed hands afterwards. As a result, we believe that personal protective health behaviour such as hand hygiene, especially after high-risk activities, and mask-wearing could be crucial to prevent transmission from highly contagious individuals. However, in this study, the small sample size of patients with definite contact history limited the calculation of the actual effect size of these protective measures.

The WHO stated that the use of a mask alone is insufficient to provide an adequate level of protection and that other measures such as hand hygiene should also be adopted to prevent human-to-human transmission of COVID-19 [ 16 ]. Traditionally, the role of wearing a mask by a healthy citizen has been controversial, and the limited evidence has mostly been associated with a healthcare setting [ 17 , 18 ]. From a systematic review and meta-analysis, face mask use could result in a large reduction in the risk of reduction (pooled adjusted odds ratio 0.18) [ 15 ]. Our data showed similar evidence in that outdoor mask wearing in healthy populations reduced COVID-19 risk by 69.3% after adjusting for contact history, hand hygiene practice, and high-risk gathering activities. However, the questionnaire in this study did not specify the type of face mask worn. Although incorrect use of masks may lead to virus colonization and self-contamination, [ 19 ] 79.9% of our participants thought that mask wearing reduced the frequency of accidentally touching the mouth and nose area, with 95.1% of them recognizing the importance of hand hygiene after using a mask. This result indicated that most of the participants had a good perceived hygiene attitude on mask usage; hence, the protective effect might exceed the potential risk in this circumstance. We believe that mask wearing by “non-sick” people could potentially block the spread of contagious droplets from asymptomatic patients during social activities as well as provide the wearer with a symbol to enhance the awareness of protective measures and generate a sense of safety and well-being. Nonetheless, multiple factors should be taken into consideration before implementing a universal mask policy in a healthy population, including cultural differences, scientific evidence in different settings, adequacy of perceived knowledge on mask use in the general population, adaptation difficulties in people with special needs and, most importantly, the scarcity of resources and logistic support [ 20 , 21 , 22 , 23 ].

Previous studies mostly aimed to evaluate the protective efficacy of physical distancing, wearing masks, eye protection, etc., in both healthcare and non-healthcare settings [ 15 , 24 , 25 ]. However, there is still scarce evidence regarding hand hygiene in preventing individual COVID-19 infections. Hand hygiene is regarded as one of the most effective measures for transmissible disease prevention [ 18 , 26 ]. Special emphases were placed on the timing and duration of cleaning in this study. Our data suggested that the most important protective factor for COVID-19 was the timing of hand hygiene practice and not the frequency. The habit of frequent handwashing after outdoor activities and before touching the mouth/nose area reduced the risk of infection by 97.9 and 69.7%, respectively. There is evidence that viruses can remain viable and infectious on surfaces for up to days, leading to plausible fomite transmission [ 27 ]. Transmission of the virus via contaminated surfaces was also proven to be a possible means other than via respiratory droplets from face-to-face contact [ 28 , 29 ]. These results reiterate the importance of practising hand hygiene following outdoor activities, even if no obvious high-risk contact was noted, as the battlefield is limited not only to healthcare settings but also to asymptomatic or presymptomatic carriers in public places [ 4 ]. Nevertheless, the duration of handwashing was seemingly shorter in the infected group than in the non-infected group, although the difference was not statistically significant. The primary challenges associated with hand hygiene efficacy are the laxity of practice and atopic dermatitis [ 30 , 31 ]. A cross-sectional survey of the general public reported that only approximately 31% of the expected behaviour and practices were observed in at least 80% of the participants [ 32 ]. Our data showed that the percentages of each hand hygiene behaviour were higher than those reported previously [ 32 ]. This fact may contribute to awareness of the COVID-19 pandemic and active advocation and education to the public by different authorities and organizations. During the 2003 SARS outbreak, compliance with hand hygiene practice was also improved among medical students [ 33 ].

This study had several limitations. First, this was a retrospective survey, and recall bias was inevitable. However, the effect of bias was minimized since the information requested was about simple concrete behaviour and events that happened recently, and the associations had strong effect sizes. Second, the sample size of the infected group was relatively small compared to that of the non-infected group, which was limited due to the unavailability of confirmed cases. In addition, the low response rate in the control group may have been a consequence of implementing an internet-based questionnaire. Future studies may consider using reminders to boost the response rate. Third, the lack of objective evaluation of behaviour and practice may not reflect the consistency between attitude and actual behaviour. Furthermore, the results may be limited to the Asian population during the COVID-19 outbreak, and generalization of these interpretations to other populations should be thoughtfully considered.

Our data provide evidence of the effectiveness of personal protective measures against COVID-19 infection. Although vaccines are now available for emergency use in many countries, there is some uncertainty around the efficacy of stopping asymptomatic spread via vaccination. It is not unreasonable that policymakers continue to educate the public about avoiding high-risk gatherings, wearing a mask whenever outdoors, and practising decent hand hygiene along with the immunization scheme. Based on the relatively small sample size in our patient group, future studies may recruit more participants to validate the effectiveness of these measures in different populations.

Availability of data and materials

The dataset supporting the conclusions of this article is included within the article and its additional file [see Additional file  1 ].

Abbreviations

Novel coronavirus disease 2019; WHO: World Health Organization

Centro Hospitalar Conde de São Januário

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C.I.L. and I.L.L. conceived and designed the study. C.F.L. and H.H.C. wrote the main manuscript text and prepared figures and tables. L.Y., C.L. and I.H.L. analysed the data. All authors reviewed the manuscript and contributed to the preparation of the manuscript. The author(s) read and approved the final manuscript.

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Lio, C.F., Cheong, H.H., Lei, C.I. et al. Effectiveness of personal protective health behaviour against COVID-19. BMC Public Health 21 , 827 (2021). https://doi.org/10.1186/s12889-021-10680-5

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Global strategies and effectiveness for COVID-19 prevention through contact tracing, screening, quarantine, and isolation: a systematic review

• Tadele Girum 1 ,
• Kifle Lentiro 1 ,
• Mulugeta Geremew 2 ,
• Biru Migora 2 &
• Sisay Shewamare 3  

Tropical Medicine and Health volume  48 , Article number:  91 ( 2020 ) Cite this article

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COVID-19 is an emerging disease caused by highly contagious virus called SARS-CoV-2. It caused an extensive health and economic burden around the globe. There is no proven effective treatment yet, except certain preventive mechanisms. Some studies assessing the effects of different preventive strategies have been published. However, there is no conclusive evidence. Therefore, this study aimed to review evidences related to COVID-19 prevention strategies achieved through contact tracing, screening, quarantine, and isolation to determine best practices.

We conducted a systematic review in accordance with the PRISMA and Cochrane guidelines by searching articles from major medical databases such as PubMed/Medline, Global Health Database, Embase, CINAHL, Google Scholar, and clinical trial registries. Non-randomized and modeling articles published to date in areas of COVID prevention with contact tracing, screening, quarantine, and isolation were included. Two experts screened the articles and assessed risk of bias with ROBINS-I tool and certainty of evidence with GRADE approach. The findings were presented narratively and in tabular form.

We included 22 (9 observational and 13 modeling) studies. The studies consistently reported the benefit of quarantine, contact tracing, screening, and isolation in different settings. Model estimates indicated that quarantine of exposed people averted 44 to 81% of incident cases and 31 to 63% of deaths. Quarantine along with others can also halve the reproductive number and reduce the incidence, thus, shortening the epidemic period effectively. Early initiation of quarantine, operating large-scale screenings, strong contact tracing systems, and isolation of cases can effectively reduce the epidemic. However, adhering only to screening and isolation with lower coverage can miss more than 75% of asymptomatic cases; hence, it is not effective.

Quarantine, contact tracing, screening, and isolation are effective measures of COVID-19 prevention, particularly when integrated together. In order to be more effective, quarantine should be implemented early and should cover a larger community.

Introduction

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The novel coronavirus was first identified in December 2019 in Wuhan China, then spread globally within weeks and resulted in an ongoing pandemic [ 1 , 2 , 3 , 4 , 5 ]. Currently, coronavirus is affecting 213 countries and territories around the world. As of 27 May 2020, more than 5.7 million cases and 353,664 deaths were reported globally [ 2 , 3 ]. Thirteen percent of the closed cohorts and 2–5% of the total cohort reportedly died [ 2 , 3 , 4 , 5 ]. The USA, Brazil, Russia, Spain, Italy, France, and the UK are the most affected countries [ 3 , 4 , 5 , 6 , 7 ].

The full spectrum of COVID-19 infection ranges from subclinical self-limiting respiratory tract illness to severe progressive pneumonia with multi-organ failure and death. As evidenced from studies and reports, more than 80% of cases remained asymptomatic and 15% of cases appeared as mild cases with common symptoms like fever, cough, fatigue, and loss of smell and taste [ 2 , 3 , 4 , 5 , 6 ]. Severe disease onset that needs intensive care might result in death due to massive alveolar damage and progressive respiratory failure [ 1 , 4 , 5 , 6 , 7 , 8 ].

The virus transmits through direct and indirect contacts. Person-to-person transmissions primarily occur during close contact, droplets produced through coughing, sneezing, and talking. Indirect transmission occurs through touching contaminated surfaces or objects and then touching the face. It is more contagious during the first few days after the onset of symptoms, but asymptomatic cases can also spread the disease [ 5 , 6 , 7 , 8 ].

Recommended prevention measures was designed based on overcoming the mode of transmissions including frequent hand washing, maintaining physical distance, quarantine, covering the mouth and nose during coughs, and avoiding contamination of face with unwashed hands. In addition, use of mask is recommended particularly for suspected individuals and their caregivers. There is limited evidence against the community wide use of masks in healthy individuals. However, most of these preventive measures are recommended and were not researched well [ 4 , 5 , 6 , 7 , 8 ].

To the extent of our search, there is no systematic review on the preventive aspects and effectiveness of COVID-19 infection through contact tracing, screening, quarantine, and isolation. The findings were inconclusive; in some studies, certain preventive mechanisms were shown to have minimal effects, while in others different preventive mechanisms have better effect than expected. On the other hand, some studies have reported that integration of interventions is more effective than specific interventions [ 2 , 6 , 8 ].

Therefore, we aimed to conduct a comprehensive systematic review through reviewing globally published studies on the strategies and effectiveness of different preventive mechanisms (contact tracing, screening, quarantine, and isolation) developed to prevent and control COVID-19. This synthesized measure will be important to bring conclusive evidence, so that policy makers and other stakeholders could have clear evidence to rely on during decision making.

To support the existing local and national COVID-19 prevention program with tangible evidence, we conducted a systematic review on global strategies for COVID-19 prevention through contact tracing, screening, quarantine, and isolation. We aimed to answer issues related to alternative strategic implementation and effectiveness in the prevention of the disease or death. The following key questions were considered:

Is contact tracing, screening, quarantine, and isolation effective to control the COVID-19 outbreak?

Is there difference in the effectiveness of contact tracing, screening, quarantine, and isolation in different settings?

How and when these strategies should be applied to control the COVID-19 outbreak?

We conducted the review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidance for reporting of systematic reviews and meta-analyses [ 9 ] and the Cochrane Handbook of Systematic Review [ 10 ] through systematic literature search of articles published to date (June 02/2020) containing information on COVID-19 prevention by contact tracing, screening, quarantine, and isolation. First, a working protocol was developed (but unpublished) and followed in the process.

Eligibility (inclusion and exclusion) criteria for the review

Based on the relevance of the reported evidence for decision making at local, national, and international levels, the papers were selected and prioritized for the review. The relevant outcomes observed in the review were reduction in incidence, transmission, adverse outcome, and cost-effectiveness of COVID-19 prevention through contact tracing, screening, quarantine, and isolation.

Types of studies

Due to the infancy of the epidemic, lack of researches, and ethical concerns, randomized controlled trials were not included. Therefore, we considered non-randomized observational studies and modeling (mathematical and/or epidemiological) studies to supplement the existing evidences.

We included cohort studies, case-control studies, time series, case series, and mathematical modeling studies conducted anywhere, in any area, and in any setting reported in the English language. Whereas, commentaries, letter to editor, case reports, and governmental reports were excluded.

Types of participants

Depending on the type of the research, for each preventive methods, different participants were included. These includes individuals who have had contacts with confirmed or suspected case of COVID-19, or individuals who lived in areas with COVID-19 outbreak, or individuals considered to be at high risk for COVID-19/suspected cases or cases of COVID-19 infection. The number of participants varies according to the individual researches. Individuals who have confirmed other symptomatic respiratory diseases were excluded.

Types of interventions

We included different types of interventions applied specifically or in combination, either voluntary or mandatory and in different settings (facility or community). In comparative studies, the interventions were compared with the non-applied groups or other comparison groups. We excluded interventions other than the aforementioned strategies.

Types of outcome measures

To identify the extent to which these interventions were applied globally and to measure their effectiveness in COVID-19 prevention, we used the following outcome measures: incidence of COVID-19, onward transmission, mortality or other adverse outcomes, and cost-effectiveness. We did not address secondary outcomes such as psychological impacts, economic impacts, and social impacts.

Literature search strategy

A systematic literature search of articles was done by information system professionals and the researchers. Articles published between January 1, 2020, and June 2, 2020, containing information on different prevention strategies such as contact tracing, screening, quarantine, and isolation, and studies assessing their effectiveness were retained for the review. Electronic bibliographic databases and libraries such as PubMed/Medline, Global Health Database, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature; Ebsco), the Cochrane Library, and African Index Medicus were used.

In addition, we searched gray literatures, pre-prints, and resource centers of The Lancet , JAMA , and N Engl J Med . Lastly, we screened the reference lists of systematic reviews for additional source. Combination of the following search terms were used with (AND, OR, NOT) Boolean (Search) Operators.

Corona virus

Coronavirus Infections

Novel corona

Prevention/control

• Contact tracing

1 or 2 or 3 or 4 or 5 and 6 and 7 or 8 or 9 or 10

Data collection and analysis

Study selection process.

The team screened all the titles and abstracts based on predefined eligibility criteria. Two authors independently screened the titles and abstracts and reached consensus by discussion or by involving a third author. After that, the review author team retrieved the full texts of all included abstracts. Two review authors screened all the full-text publications independently, and disagreements were resolved with consensus or by a third person involvement.

Data extraction and management

Titles and abstracts found through primary electronic search were thoroughly assessed for the possibility of reporting the intended outcome and filtered for potential eligibility. One of the review authors who have experience extracted data from the included studies into standardized tables, and the second author checked completeness. From each eligible research, the following information was extracted based on the preformed format: author information, title, study participants, study design, study setting, type of intervention, length of intervention, year of publication, study duration, eligibility criteria, rate, and effect of intervention measures. For modeling studies, the data extraction items also included the type of model and the data source.

Assessment of risk of bias in included studies

Risk of bias was assessed through evaluating reliability and validity of data in included studies based on the Risk-Of-Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool [ 11 ]. The first author rated the risk of bias, the second author checked the ratings, and the third author was involved in the disagreements. For each studies, the study design, participants, outcome, and presence of bias were assessed based on the eligibility criteria and quality assessment check list. Moreover, all studies with the same participants and outcome were measured using the same standard.

On the other hand, modeling studies were assessed by the International Society for Pharmaco-economics and Outcomes (ISPOR) and the Society for Medical Decision making (SMDM) for dynamic mathematical transmission model tools [ 12 ]. Modeling studies that fulfilled all the three criteria were rated as “no concerns to minor concerns, ” and if one or more categories were unclear, it is rated as “moderate concerns,” and if one or more categories were not fulfilled, we had it rated as “major concerns.”

Data synthesis and analysis

The qualitative data was systematically reviewed and presented in accordance with the Cochrane guide line. We synthesized results from quantitative measures narratively and reported in tabular form. Because of the heterogeneity of the primary studies, quantitative analyses (meta-analysis) were not conducted.

Assessment of the certainty of the evidence

By using the GRADE approach [ 13 ], we graded the certainty of evidence for the main outcomes, reported in standard terms using tables. One of the authors conducted the certainty assessment which consists of assessments of risk of bias, indirectness, inconsistency, imprecision, and publication bias, and then, classified to one of the four categories: a high certainty (estimated effect lies close to the true effect), a moderate certainty (estimated effect is probably close to the true effect), a low certainty (estimated effect might substantially differ), and very low certainty (estimated effect is probably markedly different) from the true effect.

Studies included

The PRISMA flow diagram for the selected studies in the search process and the eligibility assessment are summarized in (Fig. 1 ). The initial electronic database search led to 1542 potentially relevant citations in the form of a title, abstract, bibliography, and full-text research. After removal of duplicates and initial screening, 125 articles were selected for further evaluation via full-text articles. Of these full-text articles, 103 articles were excluded due to the following reasons: 38 studies reported the prevention of SARS other than COVID-19; 36 have measured prevention measures other than contact tracing, screening, quarantine, and isolation; 19 had inappropriate study designs (commentaries, letters and case reports); and 10 were reviews or protocols. Thus, 22 studies [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] met the inclusion criteria and were included in the systematic review.

Flow chart for study search, selection, and screening for the review

Study characteristics

The 22 studies [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] that were retained for the final analysis were published in the period from January 15, 2020, to June 02, 2020, based on participant populations in the following countries: China ( n = 10), UK ( n = 4), USA ( n = 2), Hong Kong ( n = 2), and Netherlands, Japan, France, and Taiwan ( n = 1 from each). The included studies comprised of 9 observational [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ] and 13 modeling studies [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. With duplicates (repeated count), 3 of the studies assessed the overall prevention strategies [ 21 , 22 , 23 ], 5 assessed the effect of contact tracing [ 14 , 24 , 25 , 33 , 35 ], 2 assessed screening strategies [ 17 , 34 ], 12 assessed the effect of quarantine [ 15 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ], and 6 assessed the effect of isolation [ 17 , 25 , 26 , 31 , 33 , 35 ]. The sample sizes in the studies varied from hundreds to millions. Four studies were investigated for effect at the health facility level, while the remaining 18 studies explored at the community or national level. Survey characteristics and summary results are described in Table  1 .

Quality (risk of bias) assessment within included studies

Summaries of the risk of bias assessment of non-randomized studies and quality rating of the modeling studies are presented in Tables 2 and 3 , respectively. Two studies [ 14 , 19 ] have low bias due to confounding, eight studies have low bias in selection of participants into the study, and all studies have low bias in classification of interventions. The overall risk of bias is moderate for eight studies and serious for one study. On the other hand, we have no concern for nine modeling studies, and two studies have major concerns.

COVID-19 prevention strategies and effectiveness

The summary result is presented in Table 1 . Among the nine observational studies, three of them assessed COVID-19 transmission with the existing prevention measures at a community level in Taiwan, China, and Hong Kong [ 18 , 19 , 20 ]. The other two studies assessed the effect of escalating prevention measures at health facilities in China and Hong Kong [ 21 , 22 ], and three studies [ 15 , 16 , 17 ] assessed national- and metropolitan-based quarantine strategies and the effect of laboratory-based quarantine in the prevention of COVID-19. The last study evaluated the effect of community-based contact tracing in UK [ 14 ].

The three studies [ 18 , 19 , 20 ] that assessed the overall prevention strategies found out that integration of interventions need to be applied instead of adhering to a single intervention. Cheng [ 18 ] reported that isolating symptomatic patients alone may not be sufficient enough to contain the epidemic. Wang [ 19 ] and Law [ 20 ] also concluded that in intimate contacts the transmission is 40–60%. Preventing contact through different strategies and integration is very important.

Studies conducted on the effect of quarantine [ 15 , 16 , 17 ] found that it can have a massive preventive effect. One of the studies [ 15 ] that assessed the effect of quarantine in different populations and quarantine strategies found that it should be integrated with input population reduction (travel restriction), and the other study [ 16 ] that assessed the effects of metropolitan-wide quarantine on the Spread of COVID-19 in China found that quarantine would prevent 79.27% (75.10–83.45%) of deaths and 87.08% (84.68–89.49%) of infections. Also, the other researcher [ 17 ] evidenced that laboratory-based screenings accomplished within hours can enhance the efficiency of quarantine.

Two studies described infection control preparedness measures in health care settings of Hong Kong and China [ 21 , 22 ]. One of these studies [ 21 ] reported that infection transmission is highly increased within a short period of time and multiplicity of infection prevention strategies were recommended for prevention in health care setups. The other study [ 22 ] also concluded that practicing working shift among professionals working in facilities can be used as strategy to prevent thetransmission of COVID infection.

A study conducted by Keeling et al. [ 14 ] assessed the efficacy of contact tracing for the containment of COVID-19 in the UK. The study evaluated the contact pattern of the community and concluded that rapid contact tracing to reduce the basic reproduction number ( R 0 ) from 3.11 to 0.21 enables the outbreak to be contained. Additionally, it was found that each new case requires an average of 36 individuals to be traced, with 8.7% of cases having more than 100 close traceable contacts.

In this review, we identified 13 modeling studies [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] that assessed the effectiveness of contact tracing, screening, quarantine, and isolation for prevention of COVID-19 in different settings and groups. The simulation was done in individual or group basis and with different assumptions. Most of these studies used a model parameter from Chinese reports.

Three of these researches [ 25 , 26 , 27 ] particularly emphasized on the way how the R 0 can be reduced and the epidemic would be reduced. The simulation by Tang et al. [ 25 ] aimed to estimate the R 0 of SARS-CoV-2 and infer the required effectiveness of isolation and quarantine to contain the outbreak. Their susceptible-exposed-infected-recovered (SEIR) model estimated R 0 of 6.47 and generalized that 50% reduction of contact rate achieved by isolation and quarantine would decrease the confirmed cases by 44%; reducing contacts by 90% also can decrease the number of cases by 65%. The other researcher, Rocklov (27), by using data from the Diamond Princess Cruise ship, concluded that quarantine of passengers prevented 67% of cases and lowered the R 0 from 14.8 to 1.78. Similarly, the reduction of R 0 was achieved from quarantine [ 28 ].

In addition to these, five studies [ 24 , 28 , 30 , 31 , 35 ] which modeled the effectiveness of different public interventions consistently reported that integrated intervention is better than a single intervention. One of these research conducted in the UK [ 24 ] found that combined isolation and tracing strategies would reduce transmission more than mass testing or self-isolation alone (50–60% compared to 2–30%). The other study [ 28 ] also reported that with R 0 of 2.4, a combination of case isolation and voluntary quarantine for 3 months could prevent 31% of deaths. The others also concluded that quarantine should be strict and integrated with contact tracing, screening, and other interventions [ 30 , 31 , 35 ].

Five modeling studies also assessed the effect of quarantine [ 23 , 29 , 32 ], contact tracing [ 33 ], and screening [ 34 ]. All of the studies [ 23 , 29 , 32 ] reported that quarantine has reduced the incidence of infection and shortened the duration of the epidemic. However, the effectiveness depends on the level of integration with other strategies. Similarly, model simulations that assessed the effect of contact tracing and screening reported that the strategies are effective. However, as the report of Hellewell [ 33 ] stated, contact tracing and isolation might not contain outbreaks of COVID-19 unless very high levels of contact tracing are achieved. Similarly, the other researcher [ 34 ] reported that in a stable epidemic, under the assumption that 25% of cases are subclinical, it is estimated that arrival screening alone would detect roughly one-third of infected travelers.

This study aimed to assess the effectiveness of contact tracing, screening, and quarantine and isolation to prevent COVID-19 infection by reviewing existing literatures. The review identified and systematically synthesized the findings of 22 studies (9 observational and 13 modeling studies) [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] to bring the best available evidence that policy makers and implementers can use in the process of infection prevention interventions.

The studies consistently reported the benefit of contact tracing, screening, quarantine, and isolation in the prevention of COVID-19. The effectiveness of quarantine in particular is very high. Compared to individuals without any intervention quarantined people exposed to a confirmed case highly averted infections and deaths [ 15 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. Also, the effectiveness of quarantine increases whenever it is implemented along with other prevention measures such as isolation, contact tracing, and travel ban [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. Although, screening and contact tracing are very important to control the epidemic, early initiation, larger coverage, and integration with other programs are very important. Unless the level of contact tracing and screening is high, prevention through isolation only is very limited, as the screening programs misses 75% of cases [ 3 , 24 ].

Quarantine measures applied alone or integrated with other measures were reported to be the most effective measures [ 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. However, integration of quarantine with other public health measures increases the effectiveness and efficiency of the program [ 36 ]. Implementation of early quarantine measures makes the strategy a more cost effective one [ 28 , 30 ]. Quarantine implemented as self-quarantine and group quarantine is effective at varying levels once effectively implemented [ 28 , 32 ]. Total lockdown measures enhance the effectiveness of quarantine measures [ 15 , 16 , 17 , 18 , 19 ]. When laboratory tests are very fast, laboratory-based quarantine could be an effective in health care setups [ 17 ].

This evidence is in line with the finding of other reviews and modeling studies conducted to assess the effectiveness of these measures in the prevention of SARS, MERS, and COVID-19 [ 28 , 35 , 36 , 37 ]. As reported before, combination of case isolation and voluntary quarantine for 3 months could prevent 31% of deaths compared to any single intervention. And adding social distancing on the previous interventions on people aged 70 years or older for 4 months increases the prevention proportion of deaths to 49%. It can also reduce the reproductive number by half; hence, it can tremendously reduce the incidence of infection, reduce the period of epidemic, and enhance effectiveness of control [ 28 , 36 ].

Our findings also witnessed the effectiveness of contact tracing measures used for pandemic response efforts at multiple levels of health care systems. Isolation of suspected and confirmed patients and their contact is at the heart of the prevention strategy. However, for the contact tracing to be an effective measure, it has to be integrated with other measures such as quarantine and screening. Because larger shares of individuals are asymptomatic, contact tracing may be difficult in areas where contact recording is unachievable. According to world health organization, contact tracing is also one of the most essential and effective strategies to control the epidemic [ 14 , 24 , 25 , 33 , 35 ]. Other studies also evidenced the importance of contact tracing and isolation in different settings [ 36 , 37 ].

The finding of our review revealed that screening and isolation are important measures of disease prevention [ 17 , 25 , 26 , 31 , 33 , 35 ]. Most of the researches recommend high-risk group screening and contact cases screening in a resource-limited setting. However, these programs are effective when the screening capacity is higher and contact tracing is effective. Otherwise, screening and isolation programs miss more than half of cases and may not be implemented alone [ 25 , 33 , 35 ]. Also evidences from different countries indicated that screening and isolation measures are implemented along with other measures, yet their role in the prevention of the epidemic is high [ 2 , 3 , 8 , 36 , 37 ].

This review included a wide variety of study designs (observational and model studies); hence, it failed to include meta-analysis (statistical measures). Modeled studies also assume different scenarios, where it may not be true in the general cases. Also, the review has included only publications reported in the English language and open access resources.

Conclusion and recommendation

Quarantine, contact tracing, screening, and isolation are effective measures of COVID-19 prevention, particularly whenever integrated together. In order to be more effective, quarantine should be implemented early and covers larger community. Controlling population travel will enhance the effectiveness of quarantine. Screening, contact tracing, and isolation are effective particularly in areas where contact tracing is easily attainable. Although screening is the effective measure recommended by the WHO, since the disease is asymptomatic, it may miss a larger share of the population. Therefore, this should be integrated with other preventive measures. In order to control the COVID-19 epidemic, the health care system should consider high level of contact tracing, early initiation of nationwide quarantine measures, increasing coverage of screening service, and preparing effective isolation centers.

Availability of data and materials

Please contact author for data requests.

Abbreviations

Coronavirus disease 2019

Middle East respiratory syndrome

Severe acute respiratory syndrome

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Basic reproduction number

Susceptible-exposed-infected-recovered

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How to Write About Coronavirus in a College Essay

Students can share how they navigated life during the coronavirus pandemic in a full-length essay or an optional supplement.

Writing About COVID-19 in College Essays

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Experts say students should be honest and not limit themselves to merely their experiences with the pandemic.

The global impact of COVID-19, the disease caused by the novel coronavirus, means colleges and prospective students alike are in for an admissions cycle like no other. Both face unprecedented challenges and questions as they grapple with their respective futures amid the ongoing fallout of the pandemic.

Colleges must examine applicants without the aid of standardized test scores for many – a factor that prompted many schools to go test-optional for now . Even grades, a significant component of a college application, may be hard to interpret with some high schools adopting pass-fail classes last spring due to the pandemic. Major college admissions factors are suddenly skewed.

"I can't help but think other (admissions) factors are going to matter more," says Ethan Sawyer, founder of the College Essay Guy, a website that offers free and paid essay-writing resources.

College essays and letters of recommendation , Sawyer says, are likely to carry more weight than ever in this admissions cycle. And many essays will likely focus on how the pandemic shaped students' lives throughout an often tumultuous 2020.

But before writing a college essay focused on the coronavirus, students should explore whether it's the best topic for them.

Writing About COVID-19 for a College Application

Much of daily life has been colored by the coronavirus. Virtual learning is the norm at many colleges and high schools, many extracurriculars have vanished and social lives have stalled for students complying with measures to stop the spread of COVID-19.

"For some young people, the pandemic took away what they envisioned as their senior year," says Robert Alexander, dean of admissions, financial aid and enrollment management at the University of Rochester in New York. "Maybe that's a spot on a varsity athletic team or the lead role in the fall play. And it's OK for them to mourn what should have been and what they feel like they lost, but more important is how are they making the most of the opportunities they do have?"

That question, Alexander says, is what colleges want answered if students choose to address COVID-19 in their college essay.

But the question of whether a student should write about the coronavirus is tricky. The answer depends largely on the student.

"In general, I don't think students should write about COVID-19 in their main personal statement for their application," Robin Miller, master college admissions counselor at IvyWise, a college counseling company, wrote in an email.

"Certainly, there may be exceptions to this based on a student's individual experience, but since the personal essay is the main place in the application where the student can really allow their voice to be heard and share insight into who they are as an individual, there are likely many other topics they can choose to write about that are more distinctive and unique than COVID-19," Miller says.

Opinions among admissions experts vary on whether to write about the likely popular topic of the pandemic.

"If your essay communicates something positive, unique, and compelling about you in an interesting and eloquent way, go for it," Carolyn Pippen, principal college admissions counselor at IvyWise, wrote in an email. She adds that students shouldn't be dissuaded from writing about a topic merely because it's common, noting that "topics are bound to repeat, no matter how hard we try to avoid it."

Above all, she urges honesty.

"If your experience within the context of the pandemic has been truly unique, then write about that experience, and the standing out will take care of itself," Pippen says. "If your experience has been generally the same as most other students in your context, then trying to find a unique angle can easily cross the line into exploiting a tragedy, or at least appearing as though you have."

But focusing entirely on the pandemic can limit a student to a single story and narrow who they are in an application, Sawyer says. "There are so many wonderful possibilities for what you can say about yourself outside of your experience within the pandemic."

He notes that passions, strengths, career interests and personal identity are among the multitude of essay topic options available to applicants and encourages them to probe their values to help determine the topic that matters most to them – and write about it.

That doesn't mean the pandemic experience has to be ignored if applicants feel the need to write about it.

Writing About Coronavirus in Main and Supplemental Essays

Students can choose to write a full-length college essay on the coronavirus or summarize their experience in a shorter form.

To help students explain how the pandemic affected them, The Common App has added an optional section to address this topic. Applicants have 250 words to describe their pandemic experience and the personal and academic impact of COVID-19.

"That's not a trick question, and there's no right or wrong answer," Alexander says. Colleges want to know, he adds, how students navigated the pandemic, how they prioritized their time, what responsibilities they took on and what they learned along the way.

If students can distill all of the above information into 250 words, there's likely no need to write about it in a full-length college essay, experts say. And applicants whose lives were not heavily altered by the pandemic may even choose to skip the optional COVID-19 question.

"This space is best used to discuss hardship and/or significant challenges that the student and/or the student's family experienced as a result of COVID-19 and how they have responded to those difficulties," Miller notes. Using the section to acknowledge a lack of impact, she adds, "could be perceived as trite and lacking insight, despite the good intentions of the applicant."

To guard against this lack of awareness, Sawyer encourages students to tap someone they trust to review their writing , whether it's the 250-word Common App response or the full-length essay.

Experts tend to agree that the short-form approach to this as an essay topic works better, but there are exceptions. And if a student does have a coronavirus story that he or she feels must be told, Alexander encourages the writer to be authentic in the essay.

"My advice for an essay about COVID-19 is the same as my advice about an essay for any topic – and that is, don't write what you think we want to read or hear," Alexander says. "Write what really changed you and that story that now is yours and yours alone to tell."

Sawyer urges students to ask themselves, "What's the sentence that only I can write?" He also encourages students to remember that the pandemic is only a chapter of their lives and not the whole book.

Miller, who cautions against writing a full-length essay on the coronavirus, says that if students choose to do so they should have a conversation with their high school counselor about whether that's the right move. And if students choose to proceed with COVID-19 as a topic, she says they need to be clear, detailed and insightful about what they learned and how they adapted along the way.

"Approaching the essay in this manner will provide important balance while demonstrating personal growth and vulnerability," Miller says.

Pippen encourages students to remember that they are in an unprecedented time for college admissions.

"It is important to keep in mind with all of these (admission) factors that no colleges have ever had to consider them this way in the selection process, if at all," Pippen says. "They have had very little time to calibrate their evaluations of different application components within their offices, let alone across institutions. This means that colleges will all be handling the admissions process a little bit differently, and their approaches may even evolve over the course of the admissions cycle."

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• Open access
• Published: 01 July 2020

Health-education to prevent COVID-19 in schoolchildren: a call to action

• Darren J. Gray 1   na1 ,
• Johanna Kurscheid 1   na1 ,
• Mary Lorraine Mationg 1 ,
• Gail M. Williams 2 ,
• Catherine Gordon 3 ,
• Matthew Kelly 1 ,
• Kinley Wangdi 1 &
• Donald P. McManus 3  

Infectious Diseases of Poverty volume  9 , Article number:  81 ( 2020 ) Cite this article

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There is currently considerable international debate around school closures/openings and the role of children in the transmission of coronavirus disease 2019 (COVID-19). Whilst evidence suggests that children are not impacted by COVID-19 as severely as adults, little is still known about their transmission potential, and with a lot of asymptomatic cases they may be silent transmitters (i.e. infectious without showing clinical signs of disease), albeit at a lower level than adults. In relation to this, it is somewhat concerning that in many countries children are cared for, or are often in close contact with, older individuals such as grandparents ─ the age group most at risk of acquiring serious respiratory complications resulting in death.

We emphasise that in the absence of a vaccine or an effective therapeutic drug, preventive measures such as good hygiene practices ─ hand washing, cough etiquette, disinfection of surfaces and social distancing represent the major (in fact only) weapons that we have against COVID-19. Accordingly, we stress that there is a pressing need to develop specific COVID-19 prevention messages for schoolchildren.

An entertainment education intervention for schoolchildren systematically implemented in schools would be highly effective and fill this need. With such measures in place there would be greater confidence around the opening of schools.

The scant current scientific evidence suggests that coronavirus disease 2019 (COVID-19) is less severe in children than in adults and that children are more likely to be asymptomatic or have mild disease [ 1 ]. However, these observations provide no elucidation of the potential role of children in transmitting the disease.

Well-documented scientifically is the major transmission role children have had historically in the spread of respiratory infections — generally through their close interactions in schools and child-care centres. Moreover, children and teenagers aged 5–17 are considered to play the most important role in mass influenza A epidemics [ 2 ]. While the lack of severity of COVID-19 in children contrasts with that of other respiratory viruses such as influenza, similarities in the mode of transmission still exist. Recent studies have demonstrated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) does infect children; with about 50% of pediatric cases asymptomatic [ 1 ]. Consequently, they may have an important role in transmission — albeit at lower levels than adults — and could be “silent” transmitters (i.e. infectious without showing clinical signs of disease). Worryingly, in many countries it is common for children to be cared for, or be in close contact with, elderly people, for example, grandparents — the very age group most at risk of acquiring serious respiratory complications resulting in death.

In the absence of a vaccine or effective therapeutic drugs, preventive measures such as: good hygiene practices — hand washing, cough etiquette, disinfection of surfaces and social distancing represent the major weapons against COVID-19. The World Health Organization (WHO) states, “the best way to prevent and slow down transmission is to be well informed about SARS-CoV-2, the disease it causes and how it spreads” [ 3 ]. We have seen that health and hygiene campaigns, which reinforce consistent messaging and persuade people to alter their habits, are effective in reducing infection rates. To date, however, most of the messaging has targeted the general population — not children specifically. Children are able to copy parent behaviour, but are not equipped with a true understanding of why they are being asked to make changes, potentially resulting in confusion, fear and lapses in hygiene or social protocols. Development of an appropriate and engaging hygiene and social distancing education campaign targeting children is urgently needed in order to reinforce adult messages appropriately and maximise child compliance. Accordingly, we provide an overview of COVID-19-related health education/promotion messaging currently available, and posit the way forward for engaging schoolchildren.

The WHO is the main international body providing information to the public, health sector, and governments. Messaging around COVID-19 for the public incorporates: global situation updates; information on transmission; signs and symptoms of infection; prevention and control practices (i.e. good hygiene and physical distancing); and specific information for pregnant women and travelers, or those recently visiting or returning from hot spot areas. Resources for the media also explain how to relay messages regarding prevention measures. Delivery of these messages uses a variety of formats including information sheets, videos and infographics. These are available on the WHO website and their social media platforms. Advice is provided for parents on communicating with children about COVID-19. Some materials are available for schools on age-appropriate health education regarding the virus and the associated disease but messages specifically targeting children are lacking and have caused confusion and anxiety for those too young to engage with the current campaigns.

Messages similar to those provided by WHO, but with a local context, have been disseminated by the United States Centers for Disease Control (US CDC), which has a series of COVID-19 educational videos available on their website and on YouTube. In countries outside the USA, departments and ministries of health have also released similar messaging campaigns in print and multimedia formats via mass media channels and social media platforms. Specific resources are available for health professionals, including aged care providers, pathology providers and health care managers; and while there is a smattering of messages targeting young children — mainly via YouTube — there is a serious deficiency of appropriate specific resources systematically embedded in schools to provide consistent messaging for children worldwide.

Health messages that are positive, engaging, entertaining, fun and humorous, while providing accurate age-appropriate understanding are important features when targeting schoolchildren. The value of a moving image in health education was highlighted as early as 1988 in a manual published by the WHO [ 4 ], which pointed out that no other media, creates such lively interest as television. Television programs such as Sesame Street, Between the Lions, and Blue’s Clues have contributed to reinforcing positive influences in the cognitive development of young children. Cartoons also have a long history of popularity with children — highlighted by the Disney and Warner Brothers franchises — and are used to reinforce learning and interaction. As such, this entertainment-education approach has provided a highly effective forum for health education interventions targeting schoolchildren. Videos/cartoons have proven to be of great value [ 4 ]. Compared to text-based teaching videos/cartoons can reinforce desired behaviour for children as they learn through direct observation, a critical element in behaviour [ 5 ].

With the urgent need to develop specific COVID-19 prevention messages for schoolchildren it is logical to develop a cartoon video-based entertainment education approach, with a discrete, engaging and highly informative story line, emphasising correct hand washing procedures and the social distancing concept. One highly successful and proven intervention is “The Magic Glasses”, an inexpensive and engaging 12-min cartoon-based hygiene education intervention package, which is combined with classroom discussions, drawing and essay competitions, and a pamphlet (derived from the cartoon) to reinforce the health messages. The cartoon can be accessed at https://www.nejm.org/doi/full/10.1056/nejmoa1204885 . The focus of the intervention is to visually inform children about the transmission and prevention of soil-transmitted helminths; it has been rigorously tested with success in resource-poor settings across Asia including China [ 6 ], the Philippines and Vietnam; and is currently being developed for the Lower Mekong Region including its adaptation to carcinogenic liver fluke infections. To our knowledge, no such cartoon-based intervention is currently available as a preventive approach against COVID-19.

The cartoon concept enables children to identify with characters to visualise the intestinal parasitic worms and their eggs in people and the environment to reinforce the importance of good hygiene and associated health behaviours [ 5 , 6 ]. This is directly applicable to the transmission dynamics of SARS-CoV-2 — whereby virus would be visualised in people and the environment — and the associated messages for prevention. The formative research process used to develop the original “Magic Glasses” [ 7 ] would be used here to identify risk factors and drivers for behaviour change in order to translate them into the preventive messages. Key messages of such an intervention could include hand washing, care in coughing and sneezing, tissue use and disposal, physical distancing (which particularly lends itself to visual display) and what to do when feeling unwell. It also reinforces how the virus behaves to assist children’s understanding and allay fear. Readily available for systematic delivery in schools — implemented as part of the curriculum over the course of the school year — and for parents, the cartoon would be accessible via mainstream media and social media platforms (e.g. YouTube). The cartoon would also be applicable for television broadcast. Furthermore, and very importantly, utilising a scientifically validated health education intervention to disseminate COVID-19 messaging to children ensures that reliable and factual information is delivered through official channels (such as schools) to an audience who are considered to be highly vulnerable to becoming victims of misinformation or ‘infodemics’ [ 8 ].

Conclusions

Health education and promotion are important components of disease prevention activities in general, but during disease outbreaks and health emergencies, they play a key role in an active response by offering well-established tools (especially important in the absence of specific drug therapies and vaccines) to communicate and engage quickly and effectively with the public and prevent infections. Messaging specifically targeting children who may well be acting as “silent” transmitters of COVID-19 is presently lacking. A video/cartoon-based entertainment-education intervention would fill this need. This is important now during the peak of transmission and, most importantly, to reinforce and habituate good hygiene practices long-term to prevent rebound infections, given the pandemic is expected to continue for at least the remainder of 2020 if not longer if COVID-19 becomes endemic. Targeted COVID-19 messages to children will also be effective for influenza prevention and considerably help reduce COVID-19/Influenza co-morbidity; in addition, it will provide a targeted explanation to help minimise fear and anxiety in young children. With the current international debate around school closures/openings, having this preventive intervention in place in schools would contribute to mitigating the risk and provide greater confidence for schools to be open to authorities and parents alike.

Availability of data and materials

Abbreviations.

World Health Organization

Coronavirus disease 2019

Severe acute respiratory syndrome coronavirus-2

United States Centers for Disease Control

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Darren J. Gray and Johanna Kurscheid Joint first Author.

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Darren J. Gray, Johanna Kurscheid, Mary Lorraine Mationg, Matthew Kelly & Kinley Wangdi

School of Public Health, University of Queensland, Brisbane, Australia

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DJG, DPM, GMW conceived the manuscript; JK, MM, MK, CG, KW undertook the literature review; DJG, JK, DPM drafted the manuscript; All authors contributed to editing the manuscript. The author(s) read and approved the final manuscript.

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COVID-19: Prevention and control measures in community

Affiliations.

• 1 Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine,Yıldırım Beyazıt University,Ankara City Hospital, Ankara,Turkey
• 2 COVID-19 Advisory Committee of the Ministry of Health of Turkey
• PMID: 32293835
• PMCID: PMC7195988
• DOI: 10.3906/sag-2004-146

On January 30, 2020, the WHO declared the COVID-19 outbreak a public health emergency of international concern and, in March 2020, began to characterize it as a pandemic in order to emphasize the gravity of the situation and urge all countries to take action in detecting infection and preventing spread. Unfortunately, there is no medication that has been approved by the FDA, gone through controlled studies and demonstrated an effect on the virus for this global pandemic. Although there are cures for illnesses and developments made by leaps and bounds in our day, the strongest and most effective weapon that society has against this virus that is affecting not just health but also economics, politics, and social order, is the prevention of its spread. The main points in preventing the spread in society are hand hygiene, social distancing and quarantine. With increased testing capacity, detecting more COVID-19 positive patients in the community will also enable the reduction of secondary cases with stricter quarantine rules.

Keywords: COVID-19; community; prevention; quarantine; social distancing; Turkey.

This work is licensed under a Creative Commons Attribution 4.0 International License.

Publication types

• Betacoronavirus
• Communicable Disease Control / methods*
• Coronavirus Infections / prevention & control*
• Disinfection
• Hand Hygiene
• Pandemics / prevention & control*
• Personal Protective Equipment
• Pneumonia, Viral / prevention & control*

ORIGINAL RESEARCH article

Intention and practice on personal preventive measures against covid-19 among older adults in the kingdom of saudi arabia: an epidemiological study using the theory of planned behaviour.

• 1 Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
• 2 College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
• 3 National Program for Community Development – Tanmiah, Riyadh, Saudi Arabia

Introduction: Older adults aged 65 years and above are among the most vulnerable to adverse outcomes and death following a COVID-19 infection. The weekly epidemiological updates by the World Health Organisation show that the continued emergence of concerning subtypes of the virus indicates that the pandemic remains a public health concern and the public should continue to comply with personal preventive measures (PPMs). This study applies the Theory of Planned Behaviour (TPB) which is rooted in the field of Public Health, Epidemiology, and Preventive Medicine to Saudi older adults to predict their health behaviour.

Methods: This behavioural epidemiological study recruited older adult participants aged 65 years of age and above. A tool which consisted of sociodemographic and health-related questions, as well as questions regarding the components of the TPB, namely, Attitude, Subjective Norm, Perceived Behavioural Control was used. Bivariate analyses, followed by unadjusted and adjusted multivariable logistic regression analyses were performed to derive odds ratios and 95% confidence intervals.

Results: The total number of participants was 502. The mean age was 70.34 years, with similar distributions between males and females. In total, 52.2% intended to practice PPMs, whereas only 48% had a good practice. Also, 56% had a favourable Attitude towards PPMs, 61.4% had a positive Subjective Norm and 39.8% had perceived they had a high control over their behaviour. Females, and high educational status were predictors for high intention to practice PPMs (OR = 1.59, 95% CI = 1.01–2.52 and OR = 2.72, 95% CI = 1.44–5.16 respectively). Further predictors included Attitudes, Subjective Norm and Perceived Behavioural Control. Results also show that intention to practice was significantly associated with a lower odd of practicing PPMs (OR = 0.06, 95% CI = 0.04–0.10).

Conclusion: Current findings highlight the need to continue with public health efforts targeting vulnerable older adults. Also, the fact that intention negatively predicted practice highlights the need for further behavioural epidemiological studies addressing the intention-behaviour gap.

Introduction

Disease prevention is crucial in various aspects of life and health. Ever since the emergence of the coronavirus disease – 2019 (COVID-19) in late December of 2019, and it being announced as a pandemic in March of 2020, over 770 million confirmed cases and almost 7 million deaths have been registered ( 1 , 2 ). This disease originates from a single-stranded RNA virus that is able to cause respiratory, gastrointestinal and central nervous system infections in its host ( 3 ). Due to the virus’s ability to rapidly spread and evolve, it remains a public health priority to this day.

Very early on, specific groups of people were understood to be at a higher risk of mortality after a COVID-19 infection. These groups include older adults aged 65 years of age and above, patients with comorbidities as well as immunocompromised patients ( 4 , 5 ). Therefore, preventive measures have been put in place, with the World Health Organisation (WHO) leading global efforts by setting up periodic bulletins with guidelines, as well as establishing the COVID-19 dashboard, and the United Nations supporting national preparedness and response plans to countries worldwide ( 1 , 6 ). During the early stages of the pandemic, and while vaccines were still under development, the primary focus was on non-pharmaceutical interventions ( 7 ). These were steps that could be taken to mitigate and control the spread of the disease, and consequently alleviate its burden and allow time to develop the much-needed vaccines and treatments.

The Kingdom of Saudi Arabia (KSA) was among the first countries to proactively implement preventive measures that were – in those early stages – considered unprecedented. For example, two months before the detection of any cases in the country, a national committee with members from different governmental agencies had been entrusted with overviewing global updates and providing recommendations in preparing for the possibility of cases locally ( 8 ). Upon the discovery of the first case, all entry points to the two holy cities of Makkah and Madinah were suspended and international flights were cancelled, shifting schools and other educational institutions to remote learning as well as nationwide curfews ( 8 , 9 ). Furthermore, health campaigns over official governmental social media accounts and text messages were streamed daily to raise public awareness and to remind everyone to abide by national preventative measures ( 8 , 10 ). These measures have greatly assisted in reducing and controlling the spread and potential further burden of the disease ( 9 ).

The Theory of Planned Behaviour (TPB) is a theory that attempts to draw the framework for predicting adherence and compliance to preventive measures ( 11 ). This theory is a conceptual model that was established in 1980 as an extension of the Theories of Reasoned Action to explain the effect of information and motivation on behaviours ( 12 ).

Even though this theory has been extensively studied in several countries, very few studies within the KSA are found, and none have studied older adults specifically and/or preventive measures in general. For example, it has been applied to dental healthcare workers to examine the factors associated with infection control behaviour ( 13 ), as well as among the general public to study their intent to receive the COVID-19 vaccine alone ( 13 , 14 ). Although on the 5th of March of 2022, all restrictions have been scraped, the continued emergence of concerning subtypes of COVID-19 and the fact that older adults remain at risk of complicated outcomes and death compounded by the lack of research on this specific vulnerable population has given rise to this research.

Therefore, this study will first provide a theoretical foundation for the TPB within the context of COVID-19, and subsequently apply the components of the theory to Saudi older adults to examine their intention to practice personal preventive measures (PPMs) as set out by the Saudi health authority guidelines. The study will also discuss the study’s findings and provide implications for public health policy.

Theoretical foundation

Several theories that attempt to predict health behaviours are available in the medical literature. These include – but are not limited to – the Health Belief Model, Technology Acceptance Model, and the TPB ( 11 , 15 , 16 ). The TPB argues that behaviour is driven by the intention to perform that particular behaviour forming what is known as the individual’s “belief structure” ( 11 ). In the case of COVID-19 preventive measures, this structure would be comprised of Attitude towards preventive measures (i.e., their perceived necessity), Subjective Norms (i.e., whether others support and perform these measures), and Perceived Behavioural Control (i.e., the extent of which the preventive measures are within the individual’s control).

The TPB is related to the science of behavioural epidemiology which has been emerging since the late 1970s ( 17 , 18 ). Behavioural epidemiology is under the umbrella of Public Health and consists mainly of two concepts, the first is to identify the epidemiological relationship between individual behaviour and disease occurrence, and the second is the epidemiological study of the actual behaviour itself ( 19 ). There is a vast literature supporting the application of this theory to predict health behaviour in general and for COVID-19 specifically ( 12 , 18 , 20 – 22 ).

Materials and methods

Study design, setting, and study participants.

This behavioural epidemiological study employed a cross-sectional design and was conducted in the Eastern region of the KSA. The study setting were community health centres where older adult participants attended routine physical examinations. Eligibility for inclusion included both male and female participants who were aged 65 years and above, and that they were clear from any neurocognitive disorders such Parkinson’s disease and dementia and were capable of communicating verbally.

Ethical considerations

The Imam Abdulrahman Bin Faisal University’s Institutional Review Board approved the study (IRB-2022-01-294). The participation was voluntary and there was no requirement to obtain personally identifiable information. Consent to participate was obtained from all participants. The study complied with the principles of the Declaration of Helsinki.

Sample size and sampling technique

The minimum required sample size was 383. This was based on a previous study in which the intention to practice PPMs was 52% ( 22 ), with a precision of 5% and at an alpha level of 0.05. The Epi info software version 7.0 was used for sample size calculations. Since the study targets a delicate population, a non-probability sampling technique was used to recruit participants.

Data collection tool and processes

The questionnaire was adapted from the WHO Survey tool and guidance and incorporated recent international literature that had also used the TPB within the context of COVID-19 ( 14 , 20 – 24 ). Since these studies were either on the general population or on specific health workers, the authors had to adapt the tool to better represent the older adults’ population who are the focus of this work. Three experts namely, a geriatrician, preventive medicine consultant and a public health consultant had reviewed the tool to check for its clarity and appropriateness. Then, a pilot study was performed on a sample of 10 participants aged 65 years and above, all questions were clear and the average time to complete the tool was 8 min.

The first set of variables in the tool included questions on sociodemographic and health-related characteristics. Also, the tool asked whether the participants knew of a previous COVID-19 infection, and if yes, the perceived severity level of that infection (mild, moderate or severe, i.e., hospitalised). The second set of variables were pertaining to the TPB. These included questions on the three main elements of the theory, namely, Attitude towards PPMs, Subjective Norm and Perceived Behavioural Control. Attitudes may be defined as the degree to which an individual holds a favourable or unfavourable assessment of a particular behaviour. Subjective Norm is the belief of whether other people within the community approve or disapprove of a particular behaviour, whereas Perceived Behavioural Control is the perceived difficulty or easiness of performing that behaviour ( 11 ). PPMs against COVID-19 may be defined as those measures that are known to protect and prevent infection and which included the following six preventive recommendations; handwashing with soap and water for a minimum of 20 s, avoid touching eyes, mouth, and nose when hands are not washed, staying at home if sick, covering mouth and nose when coughing and sneezing, physical distancing and self-isolation. Furthermore, the tool asked the participants on their intention to practice these PPMs and whether they already do so in the present time.

Data were collected through an online tool which allowed the team to share the link within themselves during the data collection period. In order to protect both the older adult participants and the team, guidelines were followed in terms of respiratory etiquette and distancing.

Measurements

The Attitude to practice PPMs was measured using the six main recommendations stated above on a five-point Likert’s scale. The mean score was computed for each participant, and those who score the overall mean and above were considered as having a good Attitude, whereas those who scored below the mean were considered to have a poor Attitude. As for Subjective Norm, it was based on two questions, namely, if you were infected with COVID-19, would you let people know? and how much do you trust the prevention information issued by the MoH? These were both measured on the five-point Likert’s scale. Similar to Attitude, participants scoring above the mean were considered to have a positive Subjective Norm and participants scoring below the mean were considered to have a negative Subjective Norm. The Perceived Behavioural Control construct was similarly computed and was based on three questions, namely, do you think COVID-19 would have a serious impact on you and your family? Are you still worried about COVID-19 and other large infectious diseases? And do you have the confidence to protect yourself and your family against COVID-19 and other large scale infectious diseases? ( 22 , 24 ).

Intention to practice PPMs was measured based on the above six PPM questions, and further questions were added that included the use of antibiotics to prevent and treat COVID-19. These were measured on a Likert’s scale and those who were intending had scored above the mean. The current practicing of PPMs was a simple yes/no response. This allowed us to differentiate between the intention and actual practicing of these measures.

Data analyses

Descriptive statistics were computed as frequencies and percentages for categorical variables and means ± standard deviations for continuous variables. The study had two outcomes, the first was intention to practice PPMs and the second was the current practice. Bivariate associations were performed to study the associations between these outcomes and all elements of the TPB as well as sociodemographic and health-related characteristics. Both unadjusted and adjusted binary logistic regression analyses were performed for the two outcomes of the study to compute the Odds Ratios (ORs) and their accompanying 95% confidence intervals (CIs). The level of significance was set at 0.05. All analyses were performed in Stata Statistical Software version 15.0 (Stata Corp) ( 25 ).

Sociodemographic and health characteristics of study participants

The study included 502 participants. The mean age was 70.34 years ±5.85 years. The distribution of males and females were very similar (49 and 51% respectively). The majority of participants (44.40%) had a high school degree and only 1.60% were postgraduates. Only 2.80% reported that they once were healthcare professionals. With regards to their health status, 75.30% reported the presence of a chronic disease condition. Also, 4.60% were living alone and 45.60 of the total sample reported a “good” financial status, compared to only 2% who had reported a bad financial status.

In total, 87.30% had known people who were previously infected with COVID-19, and 42.8% had known someone who had died from it. With regards to personal history, 47.60% reported a previous COVID-19 infection, of those sub-sample of participants, 15.5% were hospitalised due to the severity of the infection ( Table 1 ).

Table 1 . Sociodemographic and health characteristics of the older adult participants.

Subjective Norm and Perceived Behavioural Control and Attitude of the study participants

The mean score for the Subject Norm was 8.44 ± 1.68 (range 2–10). In total, 61.4% had a positive Subjective Norm. As for the Perceived Behavioural Control, the mean was 8.33 ± 2.01 (range 3–13) and 39.8% perceived that they had a higher control in their behaviour. Whereas for the Attitude, the median score was 25.51 ± 4.83 (range 6–30) and 56% were found to have a favourable Attitude ( Table 2 ).

Table 2 . Attitude towards personal preventive measures against COVID-19 among older adult participants.

Likewise, along the range of the five degrees of Attitudes towards the PPMs, over half the participants (50.00 to 64.30%) strongly agreed to most of them, except for physical distancing which showed the least amount of agreement (43.60%). Physical distancing also showed a higher proportion of strong disagreement compared to other statements (05.20%).

Intention and practice on PPMs against COVID-19

The mean score for the intention to practice PPMs was 29.44 ± 8.56 (range 10–50). In total, 52.2% had intended on practicing the stated preventive measures. Along the range of the five degrees of intention, 50.8% had very likely intended to practice washing hands with soap and water for at least 20 s. Participants reported lesser percentages of being very likely intending to avoid touching eyes, mouth, and nose with unwashed hands (44.20%), as well as for using disinfectants to clean hands when soaps are unavailable (35.3%). A large proportion of participants exhibited being very unlikely to intend to use antibiotics to prevent or treat COVID-19 (62.70 and 59.40% respectively) ( Table 3 ).

Table 3 . Intention and practice of personal preventive measures against COVID-19 among older adult participants.

With regards to the actual practice of PPMs, the analysis found that the mean practice score was 15.62 ± 2.58 (range 10–20) and the proportion of participants who had good practice were 48.0%. Hand washing with soap and water for at least 20 min was reported among 80.1%, avoid touching eyes, nose, and mouth with unwashed hands was stated among 71.1%. The least commonly reported practice was using antibiotics to prevent COVID-19 (7.0%).

Factors associated with the intention to practice PPMs against COVID-19 infection

Results shows statistically significant differences in the intention to practice PPMs in relation to age, level of education, Attitude towards PPMs, Subjective Norm, and Perceived Behavioural Control ( p < 0.05). Given these results, Table 4 shows unadjusted and adjusted logistic regression analyses of participants’ characteristics in relation to intention to practice PPMs. The odds of intention were significantly lower among the ≥70-year age group, although this was not significant in the adjusted model. Sex arose as a factor where females were 59% more likely to exhibit intention to practice PPMs (95% CI = 1.0–2.52). Also, the results show that the odds of intention increased with higher education. With respect to the studied four components of the TPB, it was observed that participants who had a favourable Attitude were 4.41 times more likely intending to practice PPMs (95% CI = 2.89–6.73). Also, higher odds were seen among participants who had a positive Subjective Norm (95% CI = 1.53–3.65). Similarly, the odds of intention were 72.3% times higher among those participants with a high Perceived Behavioural Control compared to their counterparts.

Table 4 . Unadjusted and adjusted binary logistic regression analyses of older adult participants predictors of the intention to practice personal preventive measures against COVID-19 infection.

Factors associated with current practicing of PPMs

Results show that there were statistically significant differences in the current practicing of PPMs in relation to the level of education, having been a healthcare professional, Attitude towards PPMs, Subjective Norm, and Perceived Behavioural Control and the intention to practicing PPMs ( p < 0.05).

Given these results, Table 5 shows unadjusted and adjusted logistic regression analyses of participants’ characteristics in relation to the current practicing of PPMs. In the adjusted model, only three of the four components of the TPB were statistically significant. Firstly, participants with a favourable Attitude were 62.10% less likely to report practicing PPMs (95% CI = 0.22–0.63). For Perceived Behavioural Control, participants who had reported a high Control were 40% less likely to practice PPMs (95% CI =0.36–0.98). As for the intention, participants who were intending to practice PPMs were 93.4% less likely to currently practice them (95% CI = 0.04–0.10).

Table 5 . Unadjusted and adjusted binary logistic regression analyses of older adult participants predictors of the current practicing of personal preventive measures against the COVID-19 infection.

Despite all scientific evidence, epidemiologically or biologically, on the positive effects of preventive measures against COVID-19, compliance with these measures remains variable. Cultural and behavioural factors play an important role in this variability. To the best of our knowledge, this is the first study to apply the TPB to predict adherence to public health preventive measures against the COVID-19 infection in the older adults’ vulnerable population. We examined both the intention as well as the actual current practicing of PPMs. It is also important to note that the collection of the data was past the date at which the government had scraped all restrictions, hence the results presented here show the attitudes and beliefs of the participants long after the extensive health campaigns and the COVID-19 public concern. Several important findings have been found regarding the intention and practice towards PPMs among the older adult Saudi population.

In our study, we found that over half the participants had intended to practice PPMs. These figures are very similar to those of studies in parts of Africa ( 22 , 26 ), but are in stark contrast to those in the US where the national average intent to comply with four recommendations, namely, washing hands, social distancing, cough etiquette and stay at home was over 80% ( 27 ). These differences may be due to fatality differences between the two regions which may have played a role in the increased intention in the US.

Factors associated with the intention to practice PPMs against COVID-19

Our study analysed factors predicting older adults’ intention to practice PPMs. We found that females were more likely to intend to practice PPMs, and those with higher education had an even greater odd of intention. This aligns with another that showed that women, and those with higher educational attainment, were more likely to adopt preventive measures ( 28 ). Rooted within the TPB, our findings also revealed that participants with a favourable Attitude were more likely to intend to practice PPMs. This underlines the impact of personal Attitudes on health behaviours, as confirmed by multiple studies, which found that positive Attitudes towards preventive measures significantly increased their adoption ( 29 , 30 ). The role of social factors was also highlighted in our study. Participants with positive Subjective Norms were more likely to intend to practice PPMs against COVID-19, supporting the findings of a previous study which reported that positive social norms significantly influenced the uptake of preventive measures ( 31 ). Lastly, our study showed that older adults with high Perceived Behavioural Control were more likely to intend to practice PPMs against COVID-19, indicating the importance of individuals’ confidence in their ability to perform preventive behaviours. This complements the findings of a local study which found that perceived control significantly impacted the adoption of preventive measures ( 32 ). Overall, our findings confirm and expand upon existing literature, emphasizing the role of sex, education, Attitudes, social norms, and perceived control in influencing older adults’ intention to practice PPMs against COVID-19.

Factors associated with the current practice of PPMs against COVID-19

With regards to the current practicing of PPMs, we found that, among the study participants, those with a favourable Attitude towards PPMs were about two-thirds less likely to practice PPMs. This contradicts the findings of previous studies, which demonstrated a positive correlation between Attitudes towards PPMs and their adoption ( 28 , 31 ). We also found that participants who had a Perceived Behavioural Control were less likely to practice PPMs. This is in stark contrast to the findings of previous studies which highlighted that Perceived Behavioural Control was a significant predictive factor in the adoption of PPMs ( 30 , 33 ). These studies suggested that individuals who believe they have the skills and resources to perform PPMs are more likely to do so. Interestingly, our study showed that participants who reported intending to practice PPMs were almost two times less likely to actually practice PPMs against COVID-19. This divergence between intention and behaviour contradicts the findings of a Turkish study which found a strong positive correlation between intentions and subsequent behaviour, particularly around health-related actions ( 34 ). It is interesting to find that in an Ethiopian study, although those who intended to practice PPMs were more likely to actually practice it, this association was not significant in their adjusted model ( 22 ). It is important though to note that the mean age in the first study was only 38.76 years, and in the second study it was 42.67 years, whereas in our study the mean age was 70.36 years. Notably, this divergence between intention and practice is not unheard of, the intention-behaviour gap is a phrase that describes the failure of intentions to be translated into actions ( 26 ). It maybe that the older adult population as a defined group possess specific behavioural characteristics unique to all other age groups. Overall, our unexpected findings highlight a complex interaction between Attitudes, Perceived Behavioural Control, intentions, and actual behaviour in the practice of PPMs among older adults. These findings suggest that other factors might be influencing the adoption of PPMs and that further research especially in the intention-practice gap is needed to fully understand these dynamics.

Implications and future directions

Although literature focusing on the role of the TPB during the pandemic is flourishing, there is a lack of research focusing on the older adult population. The current finding in that intention does not necessarily mean practice is extremely important to investigate in further epidemiological studies for this particular vulnerable population. Public health agencies within the KSA should continue its efforts to raise awareness through communication plans regarding the importance of adopting these preventive measures even long after lifting all restrictions. These communication plans should incorporate the role of friends and family especially since social constructs have been found to be associated with adoption of preventive measures. Furthermore, epidemiologists should further conduct behavioural epidemiological studies that would further suggest practical recommendations for public health agencies and health authorities in the KSA. Funded national surveys managed by experienced epidemiologists would be particularly helpful in order to reach sample sizes of sufficient and generally representative quality. Also, given the current focus on the practice of Family and primary care physicians, particularly with the expansion in preventive clinics, the role of these healthcare practitioners is crucial in increasing both awareness and promoting the health of older adults and other vulnerable groups.

Strengths and limitations

This is the first study to apply the TPB to the older adult population in the KSA within the context of preventive measures against COVID-19. However, the cross-sectional nature and the fact that both the intention and the actual practice were taken at the same time does not allow for any temporal associations to be made. Furthermore, the non-probability sampling technique, albeit consciously chosen due to the sensitive nature of our population, limits the generalisability of our results.

This study has shown that long after lifting all restrictions against COVID-19 in the KSA, a little over half the older adult participants intend to practice PPMs. It also showed that females, participants with a higher education level, those with a favourable Attitude towards preventive measures, positive Subjective Norm and high Perceived Behavioural Control exhibited a higher odd of intending to practice PPMs. Most importantly, that intending to practice does not necessarily mean actual practicing. We recommend that public health agencies, health authorities and primary care physicians in the country to continue the efforts to raise awareness of proper preventive measures through customised communication plans. Also, the role of epidemiologists in terms of behavioural epidemiological studies should not be neglected.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics statement

The studies involving humans were approved by Institutional review board of Imam Abdulrahman Bin Faisal University (IRB-2022-01-294). The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

Author contributions

RA: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing. AmA: Conceptualization, Data curation, Project administration, Validation, Visualization, Writing – original draft, Writing – review & editing. LA: Conceptualization, Data curation, Methodology, Validation, Visualization, Writing – original draft, Writing – review & editing. SA: Conceptualization, Data curation, Methodology, Validation, Visualization, Writing – original draft, Writing – review & editing. ZA: Conceptualization, Data curation, Methodology, Validation, Visualization, Writing – original draft, Writing – review & editing. HA: Conceptualization, Data curation, Methodology, Validation, Visualization, Writing – original draft, Writing – review & editing. FA: Conceptualization, Data curation, Methodology, Validation, Visualization, Writing – original draft, Writing – review & editing. MA-S: Conceptualization, Data curation, Methodology, Validation, Visualization, Writing – original draft, Writing – review & editing. NoA: Conceptualization, Formal analysis, Methodology, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing. MS: Formal analysis, Investigation, Methodology, Project administration, Supervision, Writing – original draft, Writing – review & editing. AsA: Conceptualization, Formal analysis, Project administration, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing. NiA: Conceptualization, Formal analysis, Methodology, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing.

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Acknowledgments

The authors would like to thank all individuals who have kindly agreed to participate in this research.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The reviewer OA declared a shared affiliation with the authors to the handling editor at the time of review.

Publisher’s note

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19. Mason, JO, and Powell, KE. Physical activity, behavioral epidemiology, and public health. Public Health Rep . (1985) 100:113–5.

20. Adiyoso, W, and Wilopo,. Social distancing intentions to reduce the spread of COVID-19: the extended theory of planned behavior. BMC Public Health . (2021) 21:1836. doi: 10.1186/s12889-021-11884-5

21. Tran, QA, HTT, N, Bui, TV, Tran, NT, Nguyen, NT, Nguyen, TT, et al. Factors associated with the intention to participate in coronavirus disease 2019 frontline prevention activities among nursing students in Vietnam: an application of the theory of planned behavior. Front Public Health . (2021) 9:699079. doi: 10.3389/fpubh.2021.699079

22. Andarge, E, Fikadu, T, Temesgen, R, Shegaze, M, Feleke, T, Haile, F, et al. Intention and practice on personal preventive measures against the COVID-19 pandemic among adults with chronic conditions in southern Ethiopia: a survey using the theory of planned behavior. J Multidiscip Healthc . (2020) 13:1863–77. doi: 10.2147/jmdh.S284707

23. WHO. Survey tool and guidance. Rapid, simple, flexible behavioural insights on COVID-19. Monitoring knowledge, risk perceptions, preventive behaviours and trust to inform pandemic outbreak response . Geneva: World Health Organisation (2020).

24. Zhang, X, Wang, F, Zhu, C, and Wang, Z. Willingness to self-isolate when facing a pandemic risk: model, empirical test, and policy recommendations. Int J Environ Res Public Health . (2019) 17. doi: 10.3390/ijerph17010197

25. StataCorp. Stata statistical software: release 16 . College Station, TX: StataCorp LLC (2019).

26. Faries, MD. Why we don’t “just do it”: understanding the intention-behavior gap in lifestyle medicine. Am J Lifestyle Med . (2016) 10:322–9. doi: 10.1177/1559827616638017

27. Lennon, RP, Sakya, SM, Miller, EL, Snyder, B, Yaman, T, Zgierska, AE, et al. Public intent to comply with COVID-19 public health recommendations. Health Lit Res Pract . (2020) 4:e161–5. doi: 10.3928/24748307-20200708-01

28. Al-Hanawi, MK, Angawi, K, Alshareef, N, Qattan, AMN, Helmy, HZ, Abudawood, Y, et al. Knowledge, attitude and practice toward COVID-19 among the public in the Kingdom of Saudi Arabia: a cross-sectional study. Front Public Health . (2020) 8:217. doi: 10.3389/fpubh.2020.00217

29. Hao, F, Wang, B, Tan, W, Husain, SF, McIntyre, RS, Tang, X, et al. Attitudes toward COVID-19 vaccination and willingness to pay: comparison of people with and without mental disorders in China. BJPsych Open . (2021) 7:e146. doi: 10.1192/bjo.2021.979

30. Clark, C, Davila, A, Regis, M, and Kraus, S. Predictors of COVID-19 voluntary compliance behaviors: an international investigation. Glob Transit . (2020) 2:76–82. doi: 10.1016/j.glt.2020.06.003

31. Zhong, B-L, Luo, W, Li, H-M, Zhang, Q-Q, Liu, X-G, Li, W-T, et al. Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey. Int J Biol Sci . (2020) 16:1745–52. doi: 10.7150/ijbs.45221

32. Alqahtani, MMJ, Arnout, BA, Fadhel, FH, and Sufyan, NSS. Risk perceptions of COVID-19 and its impact on precautionary behavior: a qualitative study. Patient Educ Couns . (2021) 104:1860–7. doi: 10.1016/j.pec.2021.02.025

33. Bish, A, and Michie, S. Demographic and attitudinal determinants of protective behaviours during a pandemic: a review. Br J Health Psychol . (2010) 15:797–824. doi: 10.1348/135910710X485826

34. Yıldırım, M, and Güler, A. COVID-19 severity, self-efficacy, knowledge, preventive behaviors, and mental health in Turkey. Death Stud . (2022) 46:979–86. doi: 10.1080/07481187.2020.1793434

Keywords: public health, epidemiology, Theory of Planned Behaviour, older adults, COVID-19

Citation: AlOmar RS, AlHarbi AS, Abu Abdullah LA, Almuqbil SM, Albahrani ZS, Aldar HM, Alzouri FS, Al-Shiban MA, AlShamlan NA, Shafey MM, AlAbdulKader AM and Alotaibi NS (2023) Intention and practice on personal preventive measures against COVID-19 among older adults in the Kingdom of Saudi Arabia: an epidemiological study using the Theory of Planned Behaviour. Front. Public Health . 11:1315443. doi: 10.3389/fpubh.2023.1315443

Received: 10 October 2023; Accepted: 20 November 2023; Published: 14 December 2023.

Reviewed by:

Copyright © 2023 AlOmar, AlHarbi, Abu Abdullah, Almuqbil, Albahrani, Aldar, Alzouri, Al-Shiban, AlShamlan, Shafey, AlAbdulKader and Alotaibi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Reem S. AlOmar, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Persuasive Essay Guide

Persuasive Essay About Covid19

How to Write a Persuasive Essay About Covid19 | Examples & Tips

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Are you looking to write a persuasive essay about the Covid-19 pandemic?

Writing a compelling and informative essay about this global crisis can be challenging. It requires researching the latest information, understanding the facts, and presenting your argument persuasively.

But don’t worry! with some guidance from experts, you’ll be able to write an effective and persuasive essay about Covid-19.

In this blog post, we’ll outline the basics of writing a persuasive essay . We’ll provide clear examples, helpful tips, and essential information for crafting your own persuasive piece on Covid-19.

Read on to get started on your essay.

• 1. Steps to Write a Persuasive Essay About Covid-19
• 2. Examples of Persuasive Essay About Covid19
• 3. Examples of Persuasive Essay About Covid-19 Vaccine
• 4. Examples of Persuasive Essay About Covid-19 Integration
• 5. Examples of Argumentative Essay About Covid 19
• 6. Examples of Persuasive Speeches About Covid-19
• 7. Tips to Write a Persuasive Essay About Covid-19
• 8. Common Topics for a Persuasive Essay on COVID-19 

Steps to Write a Persuasive Essay About Covid-19

Here are the steps to help you write a persuasive essay on this topic, along with an example essay:

Step 1: Choose a Specific Thesis Statement

Your thesis statement should clearly state your position on a specific aspect of COVID-19. It should be debatable and clear. For example:

Step 2: Research and Gather Information

Collect reliable and up-to-date information from reputable sources to support your thesis statement. This may include statistics, expert opinions, and scientific studies. For instance:

• COVID-19 vaccination effectiveness data
• Information on vaccine mandates in different countries
• Expert statements from health organizations like the WHO or CDC

Step 3: Outline Your Essay

Create a clear and organized outline to structure your essay. A persuasive essay typically follows this structure:

• Introduction
• Background Information
• Body Paragraphs (with supporting evidence)
• Counterarguments (addressing opposing views)

Step 4: Write the Introduction

In the introduction, grab your reader's attention and present your thesis statement. For example:

Step 5: Provide Background Information

Offer context and background information to help your readers understand the issue better. For instance:

Step 6: Develop Body Paragraphs

Each body paragraph should present a single point or piece of evidence that supports your thesis statement. Use clear topic sentences, evidence, and analysis. Here's an example:

Step 7: Address Counterarguments

Acknowledge opposing viewpoints and refute them with strong counterarguments. This demonstrates that you've considered different perspectives. For example:

Step 8: Write the Conclusion

Summarize your main points and restate your thesis statement in the conclusion. End with a strong call to action or thought-provoking statement. For instance:

Step 9: Revise and Proofread

Edit your essay for clarity, coherence, grammar, and spelling errors. Ensure that your argument flows logically.

Step 10: Cite Your Sources

Include proper citations and a bibliography page to give credit to your sources.

Remember to adjust your approach and arguments based on your target audience and the specific angle you want to take in your persuasive essay about COVID-19.

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Examples of Persuasive Essay About Covid19

When writing a persuasive essay about the Covid-19 pandemic, it’s important to consider how you want to present your argument. To help you get started, here are some example essays for you to read:

Check out some more PDF examples below:

Persuasive Essay About Covid-19 Pandemic

Sample Of Persuasive Essay About Covid-19

Persuasive Essay About Covid-19 In The Philippines - Example

If you're in search of a compelling persuasive essay on business, don't miss out on our “ persuasive essay about business ” blog!

Examples of Persuasive Essay About Covid-19 Vaccine

Covid19 vaccines are one of the ways to prevent the spread of Covid-19, but they have been a source of controversy. Different sides argue about the benefits or dangers of the new vaccines. Whatever your point of view is, writing a persuasive essay about it is a good way of organizing your thoughts and persuading others.

A persuasive essay about the Covid-19 vaccine could consider the benefits of getting vaccinated as well as the potential side effects.

Below are some examples of persuasive essays on getting vaccinated for Covid-19.

Covid19 Vaccine Persuasive Essay

Persuasive Essay on Covid Vaccines

Interested in thought-provoking discussions on abortion? Read our persuasive essay about abortion blog to eplore arguments!

Examples of Persuasive Essay About Covid-19 Integration

Covid19 has drastically changed the way people interact in schools, markets, and workplaces. In short, it has affected all aspects of life. However, people have started to learn to live with Covid19.

Writing a persuasive essay about it shouldn't be stressful. Read the sample essay below to get idea for your own essay about Covid19 integration.

Persuasive Essay About Working From Home During Covid19

Searching for the topic of Online Education? Our persuasive essay about online education is a must-read.

Examples of Argumentative Essay About Covid 19

Covid-19 has been an ever-evolving issue, with new developments and discoveries being made on a daily basis.

Writing an argumentative essay about such an issue is both interesting and challenging. It allows you to evaluate different aspects of the pandemic, as well as consider potential solutions.

Here are some examples of argumentative essays on Covid19.

Argumentative Essay About Covid19 Sample

Argumentative Essay About Covid19 With Introduction Body and Conclusion

Looking for a persuasive take on the topic of smoking? You'll find it all related arguments in out Persuasive Essay About Smoking blog!

Examples of Persuasive Speeches About Covid-19

Do you need to prepare a speech about Covid19 and need examples? We have them for you!

Persuasive speeches about Covid-19 can provide the audience with valuable insights on how to best handle the pandemic. They can be used to advocate for specific changes in policies or simply raise awareness about the virus.

Check out some examples of persuasive speeches on Covid-19:

Persuasive Speech About Covid-19 Example

Persuasive Speech About Vaccine For Covid-19

You can also read persuasive essay examples on other topics to master your persuasive techniques!

Tips to Write a Persuasive Essay About Covid-19

Writing a persuasive essay about COVID-19 requires a thoughtful approach to present your arguments effectively. 

Here are some tips to help you craft a compelling persuasive essay on this topic:

Choose a Specific Angle

Start by narrowing down your focus. COVID-19 is a broad topic, so selecting a specific aspect or issue related to it will make your essay more persuasive and manageable. For example, you could focus on vaccination, public health measures, the economic impact, or misinformation.

Provide Credible Sources 

Support your arguments with credible sources such as scientific studies, government reports, and reputable news outlets. Reliable sources enhance the credibility of your essay.

Use Persuasive Language

Employ persuasive techniques, such as ethos (establishing credibility), pathos (appealing to emotions), and logos (using logic and evidence). Use vivid examples and anecdotes to make your points relatable.

Organize Your Essay

Structure your essay involves creating a persuasive essay outline and establishing a logical flow from one point to the next. Each paragraph should focus on a single point, and transitions between paragraphs should be smooth and logical.

Emphasize Benefits

Highlight the benefits of your proposed actions or viewpoints. Explain how your suggestions can improve public health, safety, or well-being. Make it clear why your audience should support your position.

Use Visuals -H3

Incorporate graphs, charts, and statistics when applicable. Visual aids can reinforce your arguments and make complex data more accessible to your readers.

Call to Action

End your essay with a strong call to action. Encourage your readers to take a specific step or consider your viewpoint. Make it clear what you want them to do or think after reading your essay.

Revise and Edit

Proofread your essay for grammar, spelling, and clarity. Make sure your arguments are well-structured and that your writing flows smoothly.

Seek Feedback 

Have someone else read your essay to get feedback. They may offer valuable insights and help you identify areas where your persuasive techniques can be improved.

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Common Topics for a Persuasive Essay on COVID-19 

Here are some persuasive essay topics on COVID-19:

• The Importance of Vaccination Mandates for COVID-19 Control
• Balancing Public Health and Personal Freedom During a Pandemic
• The Economic Impact of Lockdowns vs. Public Health Benefits
• The Role of Misinformation in Fueling Vaccine Hesitancy
• Remote Learning vs. In-Person Education: What's Best for Students?
• The Ethics of Vaccine Distribution: Prioritizing Vulnerable Populations
• The Mental Health Crisis Amidst the COVID-19 Pandemic
• The Long-Term Effects of COVID-19 on Healthcare Systems
• Global Cooperation vs. Vaccine Nationalism in Fighting the Pandemic
• The Future of Telemedicine: Expanding Healthcare Access Post-COVID-19

In search of more inspiring topics for your next persuasive essay? Our persuasive essay topics blog has plenty of ideas!

To sum it up,

You have read good sample essays and got some helpful tips. You now have the tools you needed to write a persuasive essay about Covid-19. So don't let the doubts stop you, start writing!

If you need professional writing help, don't worry! We've got that for you as well.

MyPerfectWords.com is a professional essay writing service that can help you craft an excellent persuasive essay on Covid-19. Our experienced essay writer will create a well-structured, insightful paper in no time!

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Frequently Asked Questions

Are there any ethical considerations when writing a persuasive essay about covid-19.

Yes, there are ethical considerations when writing a persuasive essay about COVID-19. It's essential to ensure the information is accurate, not contribute to misinformation, and be sensitive to the pandemic's impact on individuals and communities. Additionally, respecting diverse viewpoints and emphasizing public health benefits can promote ethical communication.

What impact does COVID-19 have on society?

The impact of COVID-19 on society is far-reaching. It has led to job and economic losses, an increase in stress and mental health disorders, and changes in education systems. It has also had a negative effect on social interactions, as people have been asked to limit their contact with others.

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Examining persuasive message type to encourage staying at home during the COVID-19 pandemic and social lockdown: A randomized controlled study in Japan

• • We examined persuasive message types in terms of a narrator encouraging self-restraint.
• • Messages from a governor, an expert, a physician, a patient, and a resident were compared.
• • The message from a physician increased intention to stay at home the most.
• • The physician’s message conveyed the crisis of collapse of the medical system.

Behavioral change is the only prevention against the COVID-19 pandemic until vaccines become available. This is the first study to examine the most persuasive message type in terms of narrator difference in encouraging people to stay at home during the COVID-19 pandemic and social lockdown.

Participants (n = 1,980) were randomly assigned to five intervention messages (from a governor, a public health expert, a physician, a patient, and a resident of an outbreak area) and a control message. Intention to stay at home before and after reading messages was assessed. A one-way ANOVA with Tukey’s or Games–Howell test was conducted.

Compared with other messages, the message from a physician significantly increased participants’ intention to stay at home in areas with high numbers of people infected (versus a governor, p  = .002; an expert, p  = .023; a resident, p  = .004).

The message from a physician―which conveyed the crisis of overwhelmed hospitals and consequent risk of people being unable to receive treatment―increased the intent to stay at home the most.

Practice implications

Health professionals and media operatives may be able to encourage people to stay at home by disseminating the physicians’ messages through media and the internet.

1. Introduction

The outbreak of the coronavirus disease 2019 (COVID-19) has emerged as the largest global pandemic ever experienced [ 1 ]. Experts have proposed that social lockdown will lead to improvements such as controlling the increase in the number of infected individuals and preventing a huge burden on the healthcare system [ [2] , [3] , [4] ]. Governments of many countries across the world have declared local and national social lockdown [ 4 , 5 ]. In April 2020, the Japanese government declared a state of emergency, which allows prefectural governors to request residents to refrain from unnecessary and nonurgent outings from home [ 6 ]. However, despite such governor declarations, people in various countries have resisted and disregarded calls to stay at home [ [7] , [8] , [9] ]. Because social lockdown is the only existing weapon for prevention of the pandemic until vaccines becomes available to treat COVID-19, behavioral change in individuals regarding staying at home is crucial [ 3 , 4 ]. Many news articles about COVID-19 are published daily by the mass media and over the internet. Such articles convey messages from governors, public health experts, physicians, COVID-19 patients, and residents of outbreak areas, encouraging people to stay at home. This is the first study to examine which narrator’s message is most persuasive in encouraging people to do so during the COVID-19 pandemic and social lockdown.

2.1. Participants and design

Participants were recruited from people registered in a survey company database in Japan. The eligibility criterion was men and women aged 18–69 years. Exclusion criteria were individuals who answered screening questions by stating: that they cannot go out because of illness or disability; that they have been diagnosed with a mental illness; or/and that they or their family members have been infected with COVID-19. A total of 1,980 participants completed the survey from May 9–11, 2020, when the state of emergency covered all prefectures in Japan. Participants were included according to the population composition ratio in Japan nationwide by gender, age, and residential area. Participants were randomly assigned either to a group that received an intervention message (i.e., from a governor, a public health expert, a physician, a patient, and a resident of the outbreak area) or to one that received a control message. The study was registered as a University Hospital Medical Information Network Clinical Trials Registry (number: UMIN000040286) on May 1, 2020. The methods of the present study adhered to CONSORT guidelines. The protocol was approved by the ethical review committee at the Graduate School of Medicine, University of Tokyo (number: 2020032NI). All participants gave written informed consent in accordance with the Declaration of Helsinki.

2.2. Intervention and control messages

We searched news articles about COVID-19 using Yahoo! JAPAN News ( https://news.yahoo.co.jp ), the largest Japanese news portal site. We also searched videos posted by residents of outbreak areas such as New York using YouTube ( https://www.youtube.com/user/YouTubeJapan ). By referring to these articles and videos, we created five intervention messages from a governor, a public health expert, a physician, a patient, and a resident of an outbreak area. The content of each message encouraged readers to stay at home. We included threat and coping messages in each intervention message based on protection motivation theory (PMT) [ 10 , 11 ]. Appendix A shows the five intervention messages used in this study, translated into English for this report. For a control message we obtained textual information about bruxism from the website of the Ministry of Health, Labour and Welfare ( https://www.e-healthnet.mhlw.go.jp/ ).

2.3. Measures

The primary outcome was intention to stay at home. The secondary outcomes were PMT constructs (i.e., perceived severity, vulnerability, response efficacy, and self-efficacy). Participants responded to two or three questions for each measure (see Appendix B ). These measures were adapted and modified from previous studies [ [12] , [13] , [14] , [15] ]. All primary and secondary outcomes were measured before and after the participants read intervention or control messages, and mean scores were calculated. Higher scores indicated greater intention and perception. All participants were asked for their sociodemographic information before they read intervention or control messages.

2.4. Sample size

Based on the effect size in a previous randomized controlled study [ 16 ], we estimated a small effect size (Cohen’s d  = .20) in the current study. We conducted a power analysis at an alpha error rate of .05 (two-tailed) and a beta error rate of .20. The power analysis indicated that 330 participants were required in each of the intervention and control groups.

2.5. Statistical analysis

A one-way analysis of variance (ANOVA) was conducted with the absolute change in mean values for each measure before and after intervention as the dependent variable and the group assignment as the independent variable. For multiple comparisons, Tukey’s test was conducted on significant main effects where appropriate. The Games–Howell test was performed when the assumption of homogeneity of variances was not satisfied. Additionally, we conducted subgroup analyses including only participants who lived in 13 “specified warning prefectures,” where the number of infected individuals showed a marked increase [ 17 ]. A p value of <.05 was considered significant in all statistical tests. All statistical analyses were performed using IBM SPSS Statistics for Windows, Version 21.0 (IBM, Armonk, NY, USA).

Table 1 shows the participants’ characteristics. Table 2 , Table 3 present a comparison among the five intervention groups using one-way ANOVA and multiple comparisons when including all prefectures and only participants who lived in the specified warning prefectures, respectively. More significant differences between intervention messages were found in the specified warning prefectures compared with all prefectures. In Table 3 , the Games–Howell test indicates that the message from a physician increased participants’ intention to stay at home significantly more than other narrators’ messages (versus a governor, p  = .002; an expert, p  = .023; a resident, p  = .004). Multiple comparisons demonstrated that the message from a physician increased participants’ perceived severity (versus a governor, p  = .015), response efficacy (versus a resident, p  = .014), and self-efficacy (versus a governor, p  = .022; a patient, p  = .009) significantly more than other narrators’ messages.

Participants’ sociodemographic information.

Comparison of amount of change before and after intervention among groups when including all prefectures (N = 1,980).

Comparison of amount of change before and after intervention among groups when including only the “specified warning prefectures” (N = 1,274).

4. Discussion and conclusion

4.1. discussion.

As Appendix A shows, the message from a physician specifically communicated the critical situation of hospitals being overwhelmed and the consequent risk of people being unable to receive treatment. Depiction of the crisis of overwhelmed hospitals may have evoked heightened sensation that elicited sensory, affective, and arousal responses in recipients. Social lockdown presumably evoked psychological reactance in many individuals [ 18 ]. Psychological reactance is considered one of the factors that impedes individuals’ staying at home during a pandemic [ 18 ]. Studies of psychological reactance have indicated that heightened sensation is the feature of a message that reduces psychological reactance [ 19 , 20 ]. Additionally, in Japan recommendations by physicians have a strong influence on individuals’ decision making owing to the remnants of paternalism in the patient–physician relationship [ 21 ]. These may constitute the reasons for the message from a physician generating the greatest impact on recipients’ protection motivation.

Public health professionals, governors, media professionals, and other influencers should use messages from physicians and disseminate relevant articles through the media and social networking services to encourage people to stay at home. It is important that health professionals and media have a network and collaborate with one another [ 22 ]. To build relationships and provide reliable resources, health professionals are expected to hold press conferences and study meetings with journalists. Through such networking, journalists can acquire accurate information in dealing with the pandemic, such as using messages from physicians to encourage people to stay at home. Consequently, journalists should disseminate such messages. It is also important that governments, municipalities, medical associations, and other public institutions convey messages from physicians and that the media effectively spread those messages. Owing to the advances of Web 2.0 [ 23 ], health professionals’ grassroots communication with journalists and citizens via social media may provide opportunities for many people to access persuasive messages from physicians.

4.1.1. Limitations

First, the content of the intervention messages in this study may not represent voices of all governors, public health experts, physicians, patients, and residents of outbreak areas. Second, it is not clear from this study which sentences in the intervention message made the most impact on recipients and why. Third, this study assessed intention rather than actual behavior. Finally, it is unclear as to what extent the present findings are generalizable to populations other than the Japanese participants in this study.

4.2. Conclusion

In areas with high numbers of infected people, the message from a physician, which conveyed the crisis of hospitals being overwhelmed and the consequent risk of people being unable to receive treatment, increased the intention to stay at home to a greater extent than other messages from a governor, a public health expert, a patient with COVID-19, and a resident of an outbreak area.

4.3. Practice implications

Governors, health professionals, and media professionals may be able to encourage people to stay at home by disseminating the physicians’ messages through media such as television and newspapers as well as social networking services on the internet.

This work was supported by the Japan Society for the Promotion of Science KAKENHI (grant number 19K10615).

CRediT authorship contribution statement

Tsuyoshi Okuhara: Conceptualization, Methodology, Formal analysis, Investigation, Writing - original draft, Funding acquisition. Hiroko Okada: Methodology, Investigation, Writing - review & editing. Takahiro Kiuchi: Supervision, Writing - review & editing.

Declaration of Competing Interest

The authors declare that there is no conflict of interest.

Acknowledgement

We thank Hugh McGonigle, from Edanz Group ( https://en-author-services.edanzgroup.com/ac ), for editing a draft of the manuscript.

Appendix A. 

Intervention: the message from a governor.

The following is a message from the governor of your local area.

Please avoid leaving your house as much as possible.

Staying at home can save lives and prevent the spread of infection.

Intervention: The message from an expert

The following is a message from an infectious disease control expert.

Intervention: The message from a physician

The following is a message from an emergency medical care doctor.

Intervention: The message from a patient

The following is a message from a patient who is infected with the novel coronavirus.

Intervention: The message from a resident

The following is a message from an individual who lives in an area where an outbreak of novel coronavirus has occurred.

A control message

According to the traditional definition, grinding one’s teeth is when somebody makes a sound by strongly grinding the teeth together, usually unconsciously or while asleep. Nowadays, it is often referred to as ‘teeth grinding,’ a term which also covers various actions that we do while awake.

Whether you are sleeping or awake, the non-functional biting habit of grinding one’s teeth dynamically or statically, or clenching one’s teeth, can also be referred to as bruxism (sleep bruxism if it occurs at night). Bruxism can be categorized into the movements of: sliding the upper and lower teeth together like mortar and pestle (grinding); firmly and statically engaging the upper and lower teeth (clenching); and dynamically bringing the upper and lower teeth together with a tap (tapping).

Bruxism is difficult to diagnose, as it often has no noticeable symptoms. Stress and dentition are thought to be causes of bruxism, but it is currently unclear and future research is anticipated.

Splint therapy, which involves the use of a mouthpiece as an artificial plastic covering on one’s teeth, and cognitive behavioral therapy are being researched as treatments for bruxism.

Appendix B. 

All questions above were on a scale of 1–6, ranging from “extremely unlikely” to “unlikely,” “a little unlikely,” “a little likely,” “likely,” and “extremely likely.”