Keeping people safe: Understanding COVID-19 Protective Behaviours at Large Social Events

Background

As the world gradually reopened in 2021, the UK faced the challenge of reintroducing mass gatherings while ensuring public safety in the wake of the COVID-19 pandemic. The Welsh Government, keen on understanding how people would adhere to personal protective measures in these settings, conducted a study during two ‘mass’ events: the Tafwyl Music Festival and a business conference at the Celtic Manor Resort. The study aimed to observe the real-world application of protective behaviours like social distancing and mask-wearing and to identify factors that influenced adherence.

Woman picking out fruit wearing mask — Credit:Photo by Anna Shvets: https://www.pexels.com/photo/woman-wearing-face-mask-3902732/

Our Approach

We approached this study with a comprehensive plan to observe and analyse behaviour in a structured manner:

Defining the Problem: The central issue was the potential for large gatherings to act as catalysts for COVID-19 transmission. Understanding the behavioural factors of attendees as they adhered to protective measures in various contexts within these events was crucial to mitigating this risk.
Identifying Key Behavioural Drivers and Barriers: The study focused on understanding how factors such as the physical environment, social norms, and the progression of time during an event influenced protective behaviours. We used these observations to pinpoint what encouraged or hindered adherence.
Designing Observational Studies: Trained observers were deployed to monitor behaviour discreetly throughout the events. Observations were systematically recorded in different contexts, such as during entry and exit, at seating areas, and in queues, to capture a comprehensive picture of adherence to protective measures.

- Social Distancing: At the Tafwyl Music Festival, adherence to social distancing was highest when attendees were seated at their designated tables, with 91% of attendees maintaining the recommended distance. However, this adherence plummeted during entry and exit phases, where crowding was more likely. Similarly, at the Celtic Manor conference, 95% of attendees maintained social distancing during lunch, but this dropped to just 18% when moving between rooms.
- Mask-Wearing: Mask usage was generally high but varied by context. At Tafwyl, mask adherence was 99% upon entry but fell to 50% when attendees were queuing to enter and exit the event. At the Celtic Manor, mask adherence was consistently higher, likely due to the professional setting and stricter enforcement.

- Event Layout and Design: The physical environment played a crucial role in maintaining or disrupting protective behaviours. At Tafwyl, the lack of floor markings and visible signage in high-traffic areas like toilet queues led to lower adherence to social distancing. Conversely, the structured environment at Celtic Manor, with floor markings and designated pathways, helped maintain higher levels of adherence, though some breaches still occurred in less monitored areas.
- Noise Levels: High noise levels at Tafwyl often led attendees to remove their masks to communicate more effectively, particularly in crowded areas where distancing was also compromised.

- Staff Behaviour: The study found that staff behaviour significantly influenced attendee adherence. At Tafwyl, while staff were consistent in wearing masks (100% adherence), their adherence to social distancing was notably lower, particularly among volunteers who frequently interacted closely with attendees. This inconsistent behaviour likely contributed to similar lapses among attendees.
- Social Norms: Observers noted that when a minority of attendees breached protective measures, such as moving around without masks or crowding in lines, it often led to a ripple effect where others followed suit. This was particularly evident in the Celtic Manor conference, where one group of attendees consistently breached distancing guidelines, leading to lower adherence among others in the same group.

Figure 1. Adherence rates to social distancing and wearing face coverings over the duration of the Tafwyl event.

Discussion

Based on the detailed observations and analyses, several targeted strategies were developed to improve adherence to protective behaviours in future events:

- Signage and Floor Markings: Clear, visible signage and strategically placed floor markings should be a standard feature at all events. These environmental cues help guide attendees in maintaining social distancing and remind them of the importance of mask-wearing, especially in high-traffic areas like entry points, restrooms, and refreshment zones.
- Structured Movement: Event organizers should design pathways and movement flows that minimize crowding. For example, staggered entry and exit times, one-way pathways, and clearly marked queuing systems can help maintain physical distancing.

- Consistency in Protective Behaviours: All event staff, particularly volunteers, should be trained to model protective behaviours consistently. This includes maintaining social distancing, wearing masks correctly, and intervening promptly when breaches occur. Training should emphasize the role of staff as role models, whose behaviour directly influences attendee actions.
- Active Stewarding: Deploying stewards who actively monitor and guide attendees, particularly in less structured areas like queues and during transitions between event phases, can help maintain adherence to protective measures.

- Pre-Event Messaging: Clear communication before the event, including guidelines on expected behaviours and the importance of adherence to protective measures, can set the tone for compliance. This can be reinforced with reminders during the event, using both live announcements and digital messages.
- Positive Reinforcement: Acknowledging and praising adherence to protective measures during the event can reinforce positive behaviour. For example, live announcements highlighting groups that are maintaining social distancing or wearing masks correctly can encourage others to follow suit.

- Monitoring Behaviour Over Time: Observers noted that adherence to protective behaviours tended to decrease as events progressed, likely due to fatigue or reduced vigilance. To counteract this, event organizers should plan for increased monitoring and reinforcement of protective measures during the later stages of an event, particularly as attendees become more relaxed.
- Managing High-Risk Areas: Special attention should be given to areas where breaches are most likely, such as entry and exit points. Increasing staff presence and signage in these areas can help maintain adherence to protective measures.

Data image for Situational Behaviour Support

Figure 2. Situational strategies to support COVID-19-safe behaviours.

Read the full manuscript here

Further Steps

To build on the findings of this study, further research and interventions could focus on:

Behavioural Interventions in Different Settings: Expanding observations to different types of events and settings to see how context-specific factors influence behaviour. This could include varying event sizes, indoor versus outdoor settings, and different cultural contexts.
Long-Term Monitoring: Establishing long-term monitoring of adherence to protective behaviours at events over time, particularly as public attitudes toward COVID-19 evolve and new variants emerge.
Integration of Technology: Exploring the use of technology, such as mobile apps or wearable devices, to monitor and encourage adherence to protective behaviours in real-time. For example, apps could provide reminders to wear masks or maintain distance based on proximity to others.

Conclusion

The COVID-19 pandemic has had profound physical and mental health impacts, often comparable to post-traumatic stress disorder. Effectively reducing transmission rates across various levels of disease prevalence is crucial for future public health. Historical insights, like those from the Spanish Flu pandemic, highlight that poor risk literacy, the inherently social nature of humans, and the unconscious drivers of behaviour are significant barriers to preventing disease spread. Our findings align with these insights, underscoring the need for greater appreciation and integration of behavioural science in policymaking.

To address these challenges, it's essential to invest in behavioural science to inform policies, interventions, and communication strategies early on. Toolkits like the Behaviour Change Wheel, EAST, and MINDSPACE offer frameworks for designing behaviourally informed strategies that can help bridge the gap between intention and action in public health behaviours.

As the Royal Society's reviews on non-pharmaceutical interventions during COVID-19 suggest, measures like social distancing can be effective, but further research is needed to optimize environmental controls. Moreover, while government communication strategies have been generally effective, future research should focus on directly measuring observable behaviours in real-world settings to better understand the nuances of individual actions and refine interventions accordingly.

This approach will be critical not just for managing ongoing public health challenges but also for preparing for future scenarios where mass behaviour change is required.