The trajectory of COVID-19 pandemic and handwashing adherence: findings from 14 countries

Abstract Background The COVID-19 pandemic has affected people’s engagement in health behaviors, especially those that protect individuals from SARS-CoV-2 transmission, such as handwashing/sanitizing. This study investigated whether adherence to the World Health Organization’s (WHO) handwashing guidelines (the outcome variable) was associated with trajectory of pandemic, measured by following 6 indicators: (i) number new cases morbidity/mortality (a country-level mean calculated for 14 days prior data collection), (ii) total accumulated since onset and (iii) changes recent difference between previous compared recorded 14–28 earlier). Methods observational (#NCT04367337) enrolled 6064 adults residing Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, Switzerland. Data on across 8 situations (indicated WHO guidelines) were collected via an online survey (March–July 2020). Individual-level matched date- country-specific values indices obtained daily reports. Results Multilevel regression models indicated a negative association both accumulation morbidity ( B = −.041, SE .013, p .013) mortality −.036, .014 .002) handwashing. Higher levels COVID-related related lower adherence. However, increases .014, .007, .035) .022, .009, .015) higher Analyses controlled participants’ COVID-19-related situation (their exposure information about handwashing, being healthcare professional), sociodemographic characteristics (gender, age, marital status), variables (strictness containment policies, human development index). explained 14–20% variance Conclusions To better explain protective behaviors future research should account indicators pandemic. Trial registration Clinical Trials.Gov, # NCT04367337