Facemasks: Perceptions and use in an ED population during COVID-19

Study Objective: Facemask use is associated with reduced
transmission of SARS-CoV-2. Most surveys assessing perceptions
and practices of mask use miss the most vulnerable racial, ethnic, and
socio-economic populations. These same populations have suffered
disproportionate impacts from the pandemic. The purpose of this study was
to assess beliefs, access, and practices of mask wearing across 15 urban
emergency department (ED) populations.  Methods: This
was a secondary analysis of a cross-sectional study of ED patients from
December 2020 to March 2021 at 15 geographically diverse, safety net EDs
across the US. The primary outcome was frequency of mask use outside the
home and around others. Other outcome measures included having enough
masks and difficulty obtaining them. Results: Of 2,575 patients
approached, 2,301 (89%) agreed to participate; nine had missing data
pertaining to the primary outcome, leaving 2,292 included in the final
analysis. A total of 79% of respondents reported wearing masks “all of the
time” and 96% reported wearing masks over half the time. Subjects with
PCPs were more likely to report wearing masks over half the time compared
to those without PCPs (97% vs 92%). Individuals experiencing homelessness
were less likely to wear a mask over half the time compared to those who
were housed (81% vs 96%). Conclusions: Study participants
reported high rates of facemask use. Respondents who did not have PCPs and
those who were homeless were less likely to report wearing a mask over
half the time and more likely to report barriers in obtaining masks. The
ED may serve a critical role in education regarding, and provision of,
masks for vulnerable populations.