Face mask wearing during the COVID-19 pandemic: comparing perceptions in China and three European countries

Face mask recommendations are conflicting across the world during the coronavirus disease 2019 (COVID-19) pandemic. While universal face mask wearing is a useful non-pharmaceutical preventive strategy, little is known about the perception of mask wearing during a pandemic. This study aimed to examine people's face mask use in China and Europe. An online survey was conducted among residents in China, Austria, Germany, and Switzerland from the 1st to 10th of April 2020. With a convenience sampling approach, 655 valid answers were received including 267 Chinese and 388 European residents (261 from Austria, 101 from Germany, 26 from Switzerland). Self-reported face mask wearing status and related perceptions were assessed. Compared with the Europeans, Chinese participants showed a stronger pro-masking tendency. Subjective norm was an important predictor of face mask wearing in public. Wearing of face masks in the Chinese sample was also associated with risk perception as well as obedience to advice from local health authority. Discrepancies in face mask wearing suggest that targeted measures to promote face mask wearing are needed in Europe. Globally coordinated guidelines on pandemics are also warranted to face the next waves of COVID-19 and other infectious respiratory diseases.