Adherence to respiratory disease prevention and control measures in Spain after COVID-19

Abstract Background During the COVID-19 pandemic, there was high adherence to preventive measures such as handwashing, mask use, and maintaining a social distance. However, it is unclear whether these have remained habitual five years later. This study aims to assess the current adherence of the Spanish population to the main non-pharmaceutical measures and to examine potential differences by sex and age. Methods An online cross-sectional survey was conducted in a representative sample of the Spanish population (n = 1,000) in September 2024. Participants were asked about their general use of various preventive measures. Additionally, they were asked about their behaviour if they had experienced symptoms of a respiratory illness, whether they had gone out while symptomatic; and, if so, their mask use. Differences by age, and sex were analysed using t-student and Chi-square test. Results The average age of the participants was 49.5 years, and 51% were women. A total of 46% reported frequently or always washing their hands after coughing, 89% before eating, 87% after using the toilet, and 74% upon arriving home. In all cases, the mean age of those who practiced frequent hand hygiene was significantly higher (p ≤ 0.05). In contrast, participants who reported frequently or always sneezing into their elbow (32%) were younger (mean: 46.3 years) than those who never or almost never did so (mean: 50.3 years) (p = 0.001). Among the 442 individuals who experienced symptoms of a respiratory illness, 15% reported visiting vulnerable individuals, and 63% of those did so without a mask. Additionally, 86% (n = 158) of symptomatic individuals reported going out. Of these, 52% wore a mask when visiting a doctor; 18% when going to work and 12% when attending a social event. No statistically significant differences were found by sex. Conclusions It is essential to strengthen public health messaging to promote consistent preventive behaviours, particularly when experiencing respiratory symptoms.