Masks and Social Distancing work, say 8 in 10 families who have escaped COVID in the last 2 years

April 14, 2022, New Delhi: In what has been one of its kind exercise, LocalCircles in the last 30 days has gone back to people of India to learn what has worked and what hasn’t with evading the COVID infection. While a relatively large percentage of the population did not get symptomatic infection post the 2nd wave, that changed after the Omicron spread. With very high transmission rates and it being highly infectious, the cases of Omicron spread rapidly in India from last December till the end of January, infecting nearly 1 in 2 households. While most people who had symptoms did not get even tested and took basic medication that is used to manage symptoms of cold, sore throat and fever, for a very small percent though, the Omicron symptoms stayed for a prolonged period and some of them still have a few persisting conditions. India, since early February, has experienced a steady decline in COVID cases with the test positivity rate (TPR) below 1%, and nearly 1000 reported cases a day. Though the availability of RAT tests has impacted daily reported COVID numbers, most citizens may not have tested for COVID, impacting the overall number of positive cases being reported since early March. As a result, starting from the beginning of April, atleast half of the states have removed the mask mandates and those that have it are simply not enforcing it. The Prime Minister last weekend told Indians to take precautions, saying that COVID has not gone away and is changing forms.

The World Health Organisation (WHO) has raised an alarm regarding rising COVID cases globally despite testing levels dropping significantly. Many countries in Europe like France, the United Kingdom, Germany, Netherlands and those in Asia like Hong Kong, South Korea, Vietnam and China are experiencing a huge surge in cases. The surges around the world are being driven by BA.2 variants, its sub-lineages like BA.2.2, the Omicron XE mutant, which is a BA.1 and BA.2 recombinant. China now has over 50 million people in lockdown, including those at major business centers like Shenzhen and Shanghai with the highest daily cases being reported, reminding the world of January 2020, when the initial surge was reported in Wuhan, China. The Center for Disease Control in China has issued a stark warning on Deltacron, citing that the worst as no recombination events involving large genomic fragments (like “Deltacron”) have been found in SARS-CoV-2 before. This week, BA.4 and BA.5 variants of Omicron have been added by WHO to its monitoring list. Scientists have reported that BA.4 has a 63% growth advantage over BA.2 and BA.5 has 84% growth advantage over BA.2. Both BA.4 and BA.5 also have the L452R pathogenic mutation which is also found in the Delta variant leading to concerns if these sub-variants can potentially be both highly transmissible and severe. BA.4 and BA.5 have just started rising in South Africa, the first country to report Omicron BA.1 in November last year and the one to experience the first Omicron surge.

In India, the Genomics Consortium (INSACOG) has reported 16 cases of BA.2+S:I1221T or the BA.2.2 sub-lineage of Omicron, which caused the recent surge in Hong Kong. Further, over 560 cases of Deltacron, a combination of Delta and Omicron variants, have also been reported in India in the last week of March. With 5-6 new variants being found in different parts of the world and all commercial flights to India operational, and complacency among Indians to wear a mask and follows social distancing rules, the big question many are asking is, what is next and will we see a 4th COVID wave soon? In the recent LocalCircles survey, 9 in 10 surveyed said that most people in their area/district/city are either not carrying a mask anymore, or not wearing it or not wearing it properly basically indicating that the mask compliance percentage in India is in single digits.

To understand what has worked for people in staying protected from COVID and what hasn’t and whether masking and social distancing have actually been of help, LocalCircles has conducted a unique survey over the last one month. The survey attempts to broadly understand the extent of families that have had 1 or more individuals who got infected with COVID over the past 2 years. It also tries to understand from citizens who have not been infected by COVID in the last 2 years about COVID norms they followed to avoid getting infected by the virus. It then asked citizens who had been infected by COVID about what they could have done to not get infected by the virus.

The objective of this study is to understand what works and create awareness among the larger citizenry and quantify the role of masking, social distancing and ensuring air ventilation in indoor spaces in the last 2 years when COVID risk was present. The survey received more than 29,000 responses from citizens across 345 districts of India. 61% respondents were men while 39% respondents were women. 45% respondents were from tier 1, 31% from tier 2 and 24% respondents were from tier 3, 4 and rural districts.

57% Indian families have had 1 or more individuals testing COVID positive in the last 2 years (1st, 2nd or 3rd wave)

The first question in the survey asked citizens, “How many individuals in your home have had COVID in the last 24 months (1st, 2nd or 3rd wave)? In response, 12% of citizens said “1 of us”, 14% said “2 of us” and 6% said “3 of us”, 12% said “4 of us”, and 13% said “5 or more of us”. 41% of citizens said “None of us have had it yet” while 2% couldn’t say. On an aggregate basis, 57% of Indian families have had 1 or more individuals testing COVID positive in the last 2 years, or duing the 1st, 2nd or 3rd waves of the pandemic. This question in the survey received 10,200 responses.

8 in 10 families who did not have any family member get infected with COVID in the last 2 years say they minimised social contact during the wave, and diligently followed masking and social distancing norms

The next question asked citizens, “If you are among the families that did not have any member at home getting infected during the last 2 years (1st, 2nd and 3rd wave), what all did you do to escape COVID?” In response, 27% of families said they “(1) Minimised social contact and followed masking and social distancing protocol when COVID waves came”, 7% said, “(2) Maintained an active and healthy lifestyle during this period” and 3% said “(3) During waves only met people outdoors or when meeting indoors ensured good air ventilation”. Breaking down the poll, there were 23% of citizens who said they followed “1 &2” practices from aforementioned options. 7% said “1&3” and 23% said “1, 2 & 3”. Only 7% of families said they “Didn’t do much of the above but got lucky” and 3% said “Did other things not listed here”. On an aggregate basis, 8 in 10 families that did not have any family member get infected with COVID in the last 2 years say they minimised social contact during the wave, and diligently followed masking and social distancing norms. This question in the survey received 9,985 responses.

Disciplines followed by those who did not get infected by COVID in the last 2 years during the 3 waves

If responses by those citizens who did not get infected in the last 2 years are analysed in the order of priority, 80% said they “Minimised social contact and followed masking and social distancing protocols when COVID waves came”, 53% “Maintained an active and healthy lifestyle during the same period”, and 33% said that they “Only met people outdoors or ensured good air ventilation when they met indoors”.

74% of families that had 1 or more family members getting infected with COVID in the last 2 years say they could have avoided it by minimising social contact and following masking and social distancing norms during the 3 waves

The next question asked citizens, “If you are among the families that have 1 or more members at home getting infected from COVID during the last 2 years (1st, 2nd and 3rd wave), what all do you think you could have done to prevent it?” In response, 24% of citizens said, “(1) Minimise social contact and diligently follow masking and social distancing protocols when COVID waves came”, 13% said “(2) Maintain an active and healthy lifestyle during this period”. None of the respondents said “(3) During waves should have only met people outdoors or when meeting indoors ensured good air ventilation”. 31% said they could’ve followed all “1, 2 & 3” COVID protocols from the aforementioned options. 19% said “1 & 2”. 7% of citizens said “Couldn’t have done any of the above and prevent contracting the infection” while 6% citizens said “Did not do other things not listed here that led to us contracting the infection”. On an aggregate basis, 74% of families that had 1 or more family members getting infected with COVID in the last 2 years say they could have avoided it by minimising social contact and following masking and social distancing norms during the 3 waves of the COVID pandemic. This question in the survey received 9,360 responses.

Disciplines not followed by those who got infected by COVID in the last 2 years during the 3 waves

If the responses given by those infected with COVID are evaluated in the order of priority, 74% said they did not “Minimise social contact and follow mask and social distancing protocol when the COVID waves came”. Further, 63% said they did not “Maintain an active and healthy lifestyle in the past 2 years”, and 31% said they should have “Only met people outdoors or when meeting indoors ensured good air ventilation”.

Effective masking, social distancing and indoor air ventilation remain the best protection against COVID. This is evident by the findings of the survey as 8 in 10 families that did not have any family member get infected with COVID in the last 2 years say they minimised social contact and diligently followed masking and social distancing norms during the 3 waves. However, among those who had family members infected, 74% say they could have avoided infection by minimising social contact and following masking and social distancing norms during the 3 waves. Following masking and social distancing norms are the two most important actions that every Indian must follow. The recent move by several states of India to remove the mask mandate is highly risky as it signals the end of the pandemic to the masses. If a 4th wave does arrive, it will find India with high vulnerability and with the habit of masking going away, the virus could spread rather quickly. Instead, the need of the hour is to initiate a “Mask for All program” such that every citizen has a few high-quality masks like N95, KN95, etc. available to them.

LocalCircles will escalate the findings of this study with key stakeholders in the Central and State Governments such that public awareness can be created on masking and social distancing including reconsideration of bringing back the mask mandates so the public knows that COVID is still out there, changing forms like the Prime Minister said and caution is still the need of the hour.