Poster: Development of Wearing Practice and Common Use Errors of Mouth-Nose Coverings as well as Preference in the Choice of Masks in the Population during the COVID-19 Pandemic in Two Cities of North Rhine-Westphalia, Germany

Introduction:
The mandatory wearing of mouth-nose covers is, in addition to maintaining distance, a central component of the transmission prevention of COVID-19 and is intended to protect potential contact persons from ingesting pathogencontaining material.

Objectives:
The study examined whether the population's motivation to comply with the oral-nasal coverage requirement was higher immediately after its implementation than in the weeks that followed, as declining coronavirus disease-19 (COVID-19) case rates and the end of the initial lockdown on May 15, 2020, may have led to a decrease in risk awareness and thus noncompliance with the established behavioral rules.

Methods:
In a covert observational study in mask-required settings (public transportation and retail stores), mask types used and observed mask use errors were recorded over two time periods in a total of 9131 individuals. In addition, the importance of individual mask features, wearing behavior, and reasons for choosing current mouth-to-nose coverage, as well as attitudes toward COVID-19 protective measures, were collected in an online survey. Individuals observed in public and individuals in the online surveys represent two separate cohorts.

Results:
Over the time (07.05.–13.05.2020/12.06.–08.07.2020), the mask wear adherence increased in from 97.2% to 98.6% (p < .001). In addition, a percentage decrease in the number of people without mouth-nose cover (p < .001) and an increase in the correct mask application was observed (p = .024). In the online survey, 84% of respondents identified comfort/convenience and 81% of respondents identified fit as the most important mask attributes. The reasons for the choice of the mouth-nose cover used were heterogeneous and varied. The respondents stated that they found the wearing of a mouth-nose-covering annoying (57%) but useful (60%), but would not wear a mask if there was no mask obligation or recommendation to wear the masks (67%).

Conclusion:
Despite improvement, a high frequency of errors (31%) in wearing face masks were still observed, indicatingth e need for better clarification of the population on the correct wearing of a mask.