PROGRESS REPORT

COVID-19 Infection Control

Public Health Discussions, Fall 2020

Saumya Kagal, Vaishnavi Kumar, Amelia Momtazzadeh, Julia Oehlers, Abhishek Soni, Juet Tan

  • Introduction

In December 2019, the COVID-19 virus was identified in Hubei, China (Lu et al., 2020). Failure to contain this virus forced the World Health Organization to declare this outbreak a global pandemic by March 11, 2020 (Vanelli and Cucinotta, 2020). Since December 30, 2019, this virus has affected over 54 million individuals, and 1.31 million deaths have been reported (“The Visual and Data,” 2020). Of these cases, the United States contributes 10.8 million infections and 245,000 deaths as of November 14, 2020 (“CDC Covid Data”, 2020). On a smaller scale, 147,000 of these reported cases come from Oklahoma. Locally, over 10,000 individuals have been affected in Cleveland County (“Oklahoma Coronavirus Cases”, 2020). 

Interestingly, individuals between the ages of 18-35 comprise 33.73% of the total number of COVID-19 cases in Oklahoma (“COVID-10: Oklahoma”, 2020). Because the virus is most prevalent in this age demographic, universities across Oklahoma have a responsibility to promote public health practices on campus to reduce this number. The University of Oklahoma’s main response to the virus was to implement social distancing measures by spacing classes at least thirty minutes apart and placing a maximum capacity for in-person classes at 40 individuals (“Phase III Return”, 2020). Additionally, the university established indoor-only mask mandates and encouraged individuals to social distance outdoors in efforts to curb the incidence rates (“Phase III Return”, 2020). 

Despite these measures, the Oklahoma COVID-19 infection rate has only increased since the start of the pandemic (“Oklahoma Coronavirus Cases”, 2020). This occurrence demands that we conduct research about the OU community’s knowledge and attitudes about the virus, using this information to implement an educational intervention. Specifically, this study investigates students’ and faculty’s opinions about the adequacy of the university’s safety measures concerning the virus and prevalence of COVID-19 cases on campus. It also examines their general knowledge of the ongoing pandemic in terms of the scale of infections and transmission mechanisms. Lastly, this study outlines the behaviors and attitudes of social distancing, masking behaviors, quarantine, and interactions with vulnerable persons. 

From our personal experiences and observations with the COVID-19 pandemic within the OU and Norman community, we determined that there might be certain misconceptions regarding the nature of the virus and healthy behaviors regarding the pandemic. After much deliberation, we decided to generate a survey to examine knowledge, beliefs, and actions regarding the pandemic. We extrapolated this information in crafting an educational intervention for the Norman community which encourages proper mask-wearing and social distancing measures. The OU/Norman community is a widespread and diverse community that would benefit from further information on the COVID-19 pandemic. Within such a large community, every member is obligated to practice safe behaviors in order to protect fellow vulnerable members of the community. Through our educational intervention, we will be able to promote healthier pandemic behaviors and hopefully correct dangerous misconceptions within our fellow students and community members. 

  • Project

In efforts to bring awareness to COVID-19, a survey covering the broad topics related to COVID-19masking behavior, knowledge of the disease, interaction with vulnerable persons alongside thoughts regarding quarantine and self-isolation was sent to the University of Oklahoma (OU) population. This survey was available for 1 week and resulted in 376 responses. Results indicated a need for COVID-19 resources and proper mask etiquette behavior awareness. We plan to implement an infographic for each of these topics and publicize them via www.ouphd.com and PHD’s social media channels. We hope our intervention will better communicate to the OU student body and the Norman community the need for change in mask behavior to stop the further spread of COVID-19. Furthermore, a copy of our findings will be sent to the provost office in hopes of making the administration aware of the need for additional education regarding both mask-wearing and social distancing behavior on campus. The compiled data regarding the COVID-19 pandemic at OU has provided a student perspective on the efforts placed by both students and the campus administration in preventing COVID-19.

  • Summary of Findings

Analysis of the survey resulted in several findings regarding attitudes and behaviors toward COVID-19 among OU students. 

Knowledge of the disease. Two-thirds of respondents underestimated the current amount of total cases (7–8 million at the time of the survey). Few respondents were aware that COVID-19’s symptoms include conf- usion, congestion, rhinitis, nausea and vomiting, or may be asymptomatic, and many incorrectly believed that COVID-19 causes sneezing. A quarter of respondents did not know the incubation time of COVID-19 (2–14 days). While respondents were generally familiar with masking technique, one-third believed that masks with exhalation valves are acceptable. OU does not permit masks with exhalation valves. Respondents’ views of susceptibility to COVID-19 declined with patient age. Only a very subtle correlation was found between the frequency at which a respondent claims to check news sources for updates and factual knowledge of COVID-19 (p = .017, ρ = −.128). Only a very subtle correlation was found between degree of caution (safe/risk-averse beliefs) and factual knowledge of COVID-19 (p < .001, ρ = .241).

Attitudes. 57% (95% CI [51.4%, 61.7%]) of respondents believed that OU’s response to the COVID-19 situation was “insufficient or inadequate.” 30% of respondents (95% CI [25.1%, 34.6%]) do not believe that COVID-19 would be a serious threat to their health, and 35% (95% CI [30.2%, 40.1%]) believe that their social interactions do not put them at risk for contracting COVID-19. 29% (95% CI [24.0%, 33.5%]) of respondents do not believe they should wear a mask when in a vehicle with friends whom they do not live with. 

Social interaction. Regarding frequency of social interaction, it is found that most respondents go grocery shopping 1–2 times per week (73%, 95% CI [68.2%, 77.5%]), meet friends 1–5 times per week (63%, 95% CI [57.6%, 67.7%]), and visit in person labs or classes 1–5 times per week (60%, 95% CI [54.7%, 65.0%]). Most respondents work or volunteer (57%, 95% CI [52.6%, 63.0%]) and eat at a restaurant (51%, 95% CI [45.5%, 55.9%]) at least once each week, but do not visit the library (71%, 95% CI [65.9%, 75.4%]), gym (72%, 95% CI [67.7%, 77.0%]), or a bar/large party (80%, 95% CI [76.2%, 84.5%]). 

Masking behavior. A majority of students (76%, 95% CI [71.6%, 80.5%]) wore cloth masks; of these, only 31% (95% CI [25.5%, 36.6%]) washed their masks daily. The CDC recommends washing cloth masks after each use (“How to Wash,” 2020). Almost all of the remaining respondents wore surgical masks or N95 respirators, and only 12% (95% CI [5.1%, 19.3%]) dispose of them immediately after taking them off. Notwithstanding this, responses regarding masking behavior are confounded by frequency of leaving home, access to laundry, and degree of mask use.

Quarantine & self-isolation. 35% (95% CI [16.3%, 52.9%]) of all respondents also stated that they would feel guilty sharing names to contact tracers. 30% (95% CI [13.0%, 48.5%]) of respondents disagreed with the statement “I am okay with possibly being put into quarantine or self-isolation.”

Interaction with vulnerable persons. Employed respondents interacted with eld- erly or immunocompromised persons sig- nificantly more often than unemployed respondents (p < .001), and 32% (95% CI [27.3%, 37.1%]) of all respondents interact with such vulnerable persons more than one time per week. Those that interacted with these vulnerable persons held a more negative view of the future of OU’s COVID-19 situation than those that did not (p < .001). 

  • Conclusion

The goal of our project is to prevent people from normalizing COVID-19 in fear that they will abandon the necessary public health measures (eg social distancing and mask wearing) needed to lower the steadily rising incidence rate.  

By creating a survey covering various aspects of COVID-19, we were able to determine common misconceptions, behaviors, and knowledge of members on OU’s campus. The key findings of the survey allowed us to tailor our intervention so that it could be effectively implemented and change behaviors and resolve current misconceptions. We decided to make infographics focusing on the topics of cloth mask hygiene, knowledge of symptoms, and promoting resources. These infographics will be posted on our social media, which can then be shared/reposted in order to reach a large audience. The other part of our intervention is to send a final report of our data to the provost office. From an administrative standpoint, this report can be a useful tool when updating campus COVID-19 guidelines, and will hopefully minimize COVID-19 infection rates.

Future Areas of Research

Future PHD consultants may want to conduct research into the OU community’s beliefs and attitudes towards vaccines and the COVID-19 vaccine in particular.

Appendix

 

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https://www.canva.com/design/DAENhrS8B0E/share/preview?token=aX_ZtvGta2YoGXzbUh4jhA&role=EDITOR&utm_content=DAENhrS8B0E&utm_campaign=designshare&utm_medium=link&utm_source=sharebutton 

Works Cited

CDC COVID Data Tracker. https://covid.cdc.gov/covid-data-tracker/ (accessed Nov 15, 2020). 

COVID-19: Oklahoma State Department of Health |. https://coronavirus.health.ok.gov/ (accessed Nov 15, 2020). 

How to Wash a Cloth Face Covering. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-to-wash-cloth-face-coverings.html (accessed Nov 15, 2020).

Lu, F. S.; Nguyen, A. T.; Link, N. B.; Lipsitch, M.; Santillana, M. Estimating the Early Outbreak Cumulative Incidence of COVID-19 in the United States: Three Complementary Approaches. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310656/ (accessed Nov 15, 2020).

Vanelli, M.; Cucinotta, D. WHO Declares COVID-19 a Pandemic. https://pubmed.ncbi.nlm.nih.gov/32191675/ (accessed Nov 15, 2020). 

Oklahoma Coronavirus Cases and Deaths. https://usafacts.org/visualizations/coronavirus-covid-19-spread-map/state/oklahoma (accessed Nov 15, 2020).

Phase III Return Plan. https://www.ou.edu/together/norman-phase-iii (accessed Nov 15, 2020).

The Visual and Data Journalism Team. Covid-19 pandemic: Tracking the global coronavirus outbreak. https://www.bbc.com/news/world-51235105 (accessed Nov 15, 2020).