Red Flag: Even with Omicron detected, 1 in 3 Indians continue to refrain from carrying a mask when stepping out of home

December 4, 2021, New Delhi: Earlier this week, the Ministry of Health and Family Welfare announced that 2 cases of the Omicron variant were found in Bangalore. Also, COVID positive samples of over a dozen travellers are being genome tested across labs in India for the Omicron variant. The variant, which has scientists and epidemiologists around the world raising red flags was categorised as a “variant of concern” by the World Health Organisation earlier this week after it was identified in 3 countries. Within a week, Omicron has been detected in over 40 countries around the world with all major nations included.

The latest data suggests that the variant has between 30-50 mutations and likely a 500% transmission advantage over the base or alpha variant of COVID. The Union Health Ministry has alerted all states and Union territories to be alert and to increase testing and monitoring with special guidelines being implemented for screening and testing of international passengers. Most experts continue to remain uncertain about the efficacy of the vaccine against the new variant leaving the use of mask and social distancing as the only and absolute preventative measure. The WHO has also asked countries to take preventative measures like hand hygiene, physical distancing, improving ventilation and wearing well-fitted masks.

There has been an introduction of several kinds of masks since the beginning of the pandemic. However, medical experts have suggested that most provide limited protection from COVID. Data released by the American Conference of Governmental Industrial Hygienists (ACGIH) states that the time required to reach an infectious dose for an individual from an infected individual is if both are wearing an N-95 mask and are 6 feet apart is 1667 hours of exposure for the Alpha variant of SARS-COV2. If the N-95 mask is well fitted in both cases, the research indicates that it requires 677 hours of exposure to reach an infectious dose. However, the time required to reach an infectious dose for an individual from an infected individual if neither is wearing a mask is 10 minutes of exposure. The time required increases to 14 minutes with the vulnerable person wearing a cloth mask, 20 minutes with a surgical mask, 50 minutes with an N-95 mask and 16.7 hours if the vulnerable person is wearing a well-fitted N-95 mask when the infectious person is not wearing a mask. Since the Omicron variant is believed to be more transmissible, the time taken to expose an individual from the infected person could be much lower. Thus, it is extremely important for citizens to wear masks at all times and ensuring that the mask used provides protection against the new variant.

With almost 125 crore vaccine doses administered in India, and cases dropping to below 10,000 new cases a day, citizens surely have let their guard down. Mask compliance has declined significantly as indicated by a previous survey conducted by LocalCircles in November 2021, which revealed that mask compliance hit new lows during the festive season, with only 2% of citizens saying mask compliance is effective in their area or district. To understand if the situation has changed post the Omicron being detected in India, LocalCircles conducted another extensive survey to understand how citizens rate mask compliance in their area, district or city. The survey received more than 25,000 responses from citizens residing in 364 districts of India. 69% respondents were men while 31% respondents were women. 41% respondents were from tier 1, 30% from tier 2 and 29% respondents were from tier 3, 4 and rural districts.

Mask compliance drops drastically with only 2% now saying people in their area/city/district are complying well

The first question in the survey asked citizens, “With the new variant getting identified and cases rising in other parts of the world, how are people in your city/district/area now complying to wearing mask norms?” In response, 8% of citizens said that there is no compliance at all. Breaking down the poll, 19% said that 0-30% people are compliant, 32% said 30-60% people are compliant and 39% said 60-90% people are compliant. Only 2% citizens said people in their area/city/district are complying well. This question in the survey received 8,633 responses.

Despite Omicron variant being detected in India, only 2% Indians say mask compliance is effective in their city/district/area

Mask compliance has seen a decline since cases started to decline post the 2nd wave of the pandemic. In a survey conducted by LocalCircles in April 2021, only 29% citizens rated mask compliance in their city/district/area as high. This percentage further dropped to 12% in September 2021. During the festive season, with shopping and socialising on in the country, mask compliance dropped drastically to only 2% in November 2021. Percentage of citizens rating mask compliance as high in their city/area/district remains low at 2% despite the threat of Omicron variant in December 2021.

1 in 3 Indians say most people in their city/district/area are not carrying a mask when stepping out of home

There remains high uncertainty about the Omicron variant, with scientists and epidemiologists suggesting it is likely 5X more transmissible and studies are still being conducted to understand the efficacy of the existing vaccines against it. Mask compliance according to them remains the absolute top defense against it. Taking cognisance, the next question asked citizens the current status of people in regard to mask compliance in their city/district/area. In response, 34% said most people don’t even have a mask with them now and 23% said most have a mask with them but don’t wear it at all. There were also 38% of citizens who said that most have a mask but don’t wear it properly. Only 5% said most have a mask and wear it properly. On an aggregate basis, 1 in 3 Indians is not even carrying a mask when they step out of their house. This question in the survey 8,413 responses.

2 in 3 Indians are wearing cloth masks that provide limited protection from COVID

While there has been an introduction of many kinds of masks since the pandemic started in 2020, experts suggest that N-95 or KN-95 masks are now a necessity with surgical masks providing limited protection and cloth masks providing near-zero protection. This guidance has evolved from early 2020 when any mask was acceptable to now as it has been proven that the virus is airborne and hence masks with high levels of protection are a must. To understand what Indians are currently using, citizens were asked about what is the kind of mask that they see people in their city/district/area wearing most often. In response, 21% said that people in their city/district/area wear surgical disposable masks (the blue one). 8% said “N-95 Mask” and 3% each said “KN-95 or W-95 Mask” and “others.” “N-95 Mask with valve” while another 1% couldn’t say. The majority of the citizens, a whopping 63% said cloth mask. The finding of the poll suggests that 2 in 3 Indians are wearing cloth masks that provide limited protection from COVID. This question in the survey received 8,779 responses.

In summary, mask compliance remains at its lowest in the country despite the Omicron variant being detected in India, with only 2% now saying people in their area/city/district are complying well. Further, the survey revealed that 1 in 3 Indians say most people in their city/district/ area are not even carrying a mask when stepping out of the home. The need of the hour is to educate the public on the effectiveness of masks as 2 in 3 Indians are still wearing cloth masks that provide limited protection from COVID. What this means is that if Omicron starts spreading in India, the population is highly vulnerable because of the poor mask discipline and whatever time people are wearing masks, the majority of them wear one that doesn’t provide adequate protection. It is critical that the Central Government, State Governments and District Administrations introduce all possible mechanisms to create awareness about mask compliance in light of the Omicron variant and enforce necessary penalties to drive this compliance.

Survey Demographics

The survey received more than 25,000 responses from citizens residing in 364 districts of India. 69% respondents were men while 31% respondents were women. 41% respondents were from tier 1, 30% from tier 2 and 29% respondents were from tier 3, 4 and rural districts. The survey was conducted via LocalCircles platform and all participants are validated citizens who had to be registered with LocalCircles to participate