South Africa implemented strict lockdown regulations to reduce movement and inter-personal interactions. The WHO recommended that social distancing be practiced with other preventive behaviours including mask wearing and hand washing (World Health Organization, 2020a). Social distancing has been associated with reduced COVID-19 infections (Cowling et al., 2020 Prem et al., 2020). Social distancing refers to avoiding close physical contact with people outside one’s household, maintaining at least a metre distance from others in public places and avoiding crowded gatherings (World Health Organization, 2020a). Social distancing or ‘physical distancing’ has been a primary behavioural measure for reducing COVID-19 transmission (World Health Organization, 2020a), particularly during the early stages of the COVID-19 pandemic. Interventions and policies should take cognisance of the social determinants of health as well as culturally accepted greeting practices like hand shaking. The study identifies subgroups of individuals for whom public health interventions to improve adherence to social distancing should be prioritised and tailored. The 25–59-year olds compared to 18–24-year olds, and the White and Indian/Asian compared to the African population groups had significantly lower odds of close physical contact with others outside the home. The odds of coming into close physical contact with other people were significantly higher for males, students, and those with incorrect knowledge on physical distancing, angry attitudes about the lockdown, lack of confidence in the government response, high-risk perception, movement out of the local area, travelling to shops using public transport, households with communal water facilities and higher household size. Of the 17,586 participants, 9.2% came into close physical contact with a person outside their home by hugging, kissing, or shaking hands during the past 7 days. Simple and multiple logistic regression models examined the association between social distancing and potential explanatory variables. Adherence to social distancing was measured by self-report of having engaged in close physical contact with someone outside the home. Invitations to participate were distributed widely on local websites and social media networks, including on a data-free platform. Data was analysed from a large-scale public survey conducted in South Africa from 8 to 29 April 2020, which was administered online and telephonically. The study assessed adherence to social distancing and its associated factors during the state-implemented lockdown in South Africa. Improved understanding of factors associated with adherence to social distancing is vital for mitigating the impact of COVID-19 in South Africa. Social distancing behaviour is a primary preventive measure for reducing COVID-19 transmission.
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