COVID-19 Testing and Preventive Behaviours During The Pandemic’s Onset: A Cross-sectional Study

Authors

  • Sigrid de Sousa dos Santos Professora Associada do Departamento de Medicina da Universidade Federal de São Carlos (UFSCar); São Carlos; SP; Brasil. Doutora em Medicina e Infectologista pela Universidade de São Paulo; SP; Brasil https://orcid.org/0000-0003-0366-0250
  • Carolina Toniolo Zenatti Docente e Diretora de Práticas Assistenciais da Irmandade Santa Casa de Misericórdia de São Carlos. Docente do Centro Universitário Central Paulista; UNICEP; Brasil. Doutora em Medicina pela Universidade de São Paulo; SP; Brasil. https://orcid.org/0000-0002-1956-4506
  • Professora Professora Associada do Departamento de Morfologia e Patologia e Coordenadora do Programa de Pós-Graduação em Genética Evolutiva e Biologia Molecular da Universidade Federal de São Carlos (UFSCAR); SP; Brasil. https://orcid.org/0000-0003-0571-8516
  • Crislaine Aparecida Antonio Mestre Mestre em Gestão da Clínica pela Universidade Federal de São Carlos; SP; São Carlos; SP; Brasil https://orcid.org/0000-0002-1151-8281
  • Abimael Cereda Junior Mestre em Engenharia Civil e Especialista em Geoprocessamento pela Universidade Federal de São Carlos; SP; São Carlos; SP; Brasil https://orcid.org/0000-0003-0242-7684
  • Professor Doutor em Saúde Pública pela Universidade de São Paulo e Mestre em Estatística pela Universidade de São Paulo; SP; Brasil https://orcid.org/0000-0003-2909-2052

DOI:

https://doi.org/10.36489/saudecoletiva.2025v15i97p16392-16415

Keywords:

COVID-19, cross-sectional study, health risk behaviour, communicable disease control

Abstract

Objective: This study aimed to analyze individual exposure to SARS-CoV-2 and engagement in preventive practices at the onset of the COVID-19 pandemic. Method: A population-based cross-sectional survey (Test to Care) was conducted in São Carlos, SP, Brazil, using stratified random sampling by census sectors. One adult per household was interviewed and tested for anti-SARS-CoV-2-S1 IgG antibodies. Data included demographics, comorbidities, recent symptoms, and adherence to hygiene and social distancing measures. Results: Among 3,921 participants, 91.6% reported reduced mobility. Lower adherence was associated with younger age, male sex, marital union, inhaled drug use, school-aged children at home, and lack of social benefits. Mask use was high (97.1%) but less frequent among men. One-third had flu-like symptoms; 1.1% were hospitalized. Seroprevalence was 1.74%, associated with male sex, absence of alcohol use, and previous symptoms. Case clusters were concentrated in low-income areas. Conclusion: Understanding barriers to preventive behavior is essential for guiding public health strategies and reducing vulnerabilities to respiratory infections.

Author Biographies

Carolina Toniolo Zenatti, Docente e Diretora de Práticas Assistenciais da Irmandade Santa Casa de Misericórdia de São Carlos. Docente do Centro Universitário Central Paulista; UNICEP; Brasil. Doutora em Medicina pela Universidade de São Paulo; SP; Brasil.

Professor and Director of Care Practices at Irmandade da Santa Casa de Misericórdia de São Carlos. Faculty member at Centro Universitário Central Paulista (UNICEP), Brazil. PhD in Medicine from the Universidade de São Paulo (USP), São Paulo, Brazil.

Professora, Professora Associada do Departamento de Morfologia e Patologia e Coordenadora do Programa de Pós-Graduação em Genética Evolutiva e Biologia Molecular da Universidade Federal de São Carlos (UFSCAR); SP; Brasil.

Associate Professor in the Department of Morphology and Pathology and Coordinator of the Graduate Program in Evolutionary Genetics and Molecular Biology at the Universidade Federal de São Carlos (UFSCar), SP, Brazil.

Crislaine Aparecida Antonio Mestre, Mestre em Gestão da Clínica pela Universidade Federal de São Carlos; SP; São Carlos; SP; Brasil

Master’s Degree in Clinical Management from the FUniversidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.

Abimael Cereda Junior, Mestre em Engenharia Civil e Especialista em Geoprocessamento pela Universidade Federal de São Carlos; SP; São Carlos; SP; Brasil

Master’s Degree in Civil Engineering and Specialist in Geoprocessing from the Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.

Professor, Doutor em Saúde Pública pela Universidade de São Paulo e Mestre em Estatística pela Universidade de São Paulo; SP; Brasil

PhD in Public Health and Master’s Degree in Statistics from the Universidade de São Paulo (USP), São Paulo, Brazil.

References

Khosravizadeh O, Ahadinezhad B, Maleki A, Najafpour Z, Golmohammadi R. Social distance capacity to control the COVID-19 pandemic: A systematic review on time series analysis. Vol. 33, International Journal of Risk and Safety in Medicine. 2022. DOI: https://doi.org/10.3233/JRS-210037

Abouk R, Heydari B. The Immediate Effect of COVID-19 Policies on Social-Distancing Behavior in the United States. Public Health Reports. 2021;136(2). DOI: https://doi.org/10.1177/0033354920976575

Yen-Hao Chu I, Alam P, Larson HJ, Lin L. Social consequences of mass quarantine during epidemics: A systematic review with implications for the COVID-19 response. Vol. 27, Journal of Travel Medicine. 2020. DOI: https://doi.org/10.1093/jtm/taaa192

Bonaccorsi G, Pierri F, Cinelli M, Flori A, Galeazzi A, Porcelli F, et al. Economic and social consequences of human mobility restrictions under COVID-19. Proc Natl Acad Sci U S A. 2020;117(27). DOI: https://doi.org/10.1073/pnas.2007658117

Flanagan EW, Beyl RA, Fearnbach SN, Altazan AD, Martin CK, Redman LM. The Impact of COVID-19 Stay-At-Home Orders on Health Behaviors in Adults. Obesity. 2021;29(2). DOI: https://doi.org/10.1002/oby.23066

Miller AP, Mugamba S, Bulamba RM, Kyasanku E, Nkale J, Nalugoda F, et al. Exploring the impact of COVID-19 on women’s alcohol use, mental health, and experiences of intimate partner violence in Wakiso, Uganda. PLoS One. 2022;17(2 February). DOI: https://doi.org/10.1371/journal.pone.0263827

Silubonde-Moyana TM, Draper CE, Norris SA. Effectiveness of behavioural interventions to influence COVID-19 outcomes: A scoping review. Prev Med (Baltim). 2023 Jul;172:107499. DOI: https://doi.org/10.1016/j.ypmed.2023.107499

Warszawski J, Beaumont AL, Seng R, de Lamballerie X, Rahib D, Lydié N, et al. Prevalence of SARS-Cov-2 antibodies and living conditions: the French national random population-based EPICOV cohort. BMC Infect Dis. 2022;22(1). DOI: https://doi.org/10.1186/s12879-021-06973-0

Figueiredo AM de, Figueiredo DCMM de, Gomes LB, Massuda A, Gil-García E, Vianna RP de T, et al. Social determinants of health and COVID-19 infection in Brazil: an analysis of the pandemic. Rev Bras Enferm. 2020;73. DOI: https://doi.org/10.1590/0034-7167-2020-0673

Bau N, Khanna G, Low C, Shah M, Sharmin S, Voena A. Women’s well-being during a pandemic and its containment. J Dev Econ. 2022;156. DOI: https://doi.org/10.1016/j.jdeveco.2022.102839

Ravindran S, Shah M. Unintended consequences of lockdowns, COVID-19 and the Shadow Pandemic in India. Nat Hum Behav. 2023; DOI: https://doi.org/10.1038/s41562-022-01513-5

BRASIL. IBGE. ESTIMATIVAS DA POPULAÇÃO RESIDENTE NO BRASIL E UNIDADES DA FEDERAÇÃO COM DATA DE REFERÊNCIA EM 1o DE JULHO DE 2019 [Internet]. 2020 [cited 2023 Jul 18]. Available from: https://ftp.ibge.gov.br/Estimativas_de_Populacao/Estimativas_2019/estimativa_dou_2019.pdf

BRASIL. IBGE/DGC/CETE. Malha de Setores Censitários 2010/ sp_setores_censitarios.zip/ sp/ setores_censitarios_shp/ censo_2010/ malhas_de_setores_censitarios__divisoes_intramunicipais/ malhas_territoriais/ organizacao_do_territorio/ Downloads. https://www.ibge.gov.br/geociencias/downloads-geociencias.html. 2022.

Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. Vol. 95, Journal of Biomedical Informatics. 2019. DOI: https://doi.org/10.1016/j.jbi.2019.103208

Okba NMA, Müller MA, Li W, Wang C, Geurtsvankessel CH, Corman VM, et al. Severe Acute Respiratory Syndrome Coronavirus 2-Specific Antibody Responses in Coronavirus Disease Patients. Emerg Infect Dis. 2020;26(7). DOI: https://doi.org/10.3201/eid2607.200841

Tang MS, Hock KG, Logsdon NM, Hayes JE, Gronowski AM, Anderson NW, et al. Clinical Performance of Two SARS-CoV-2 Serologic Assays. Clin Chem. 2020;66(8). DOI: https://doi.org/10.1093/clinchem/hvaa120

Pluss O, Campbell H, Pezzi L, Morales I, Roell Y, Quandelacy TM, et al. Limitations introduced by a low participation rate of SARS-CoV-2 seroprevalence data. Vol. 52, International journal of epidemiology. 2023. DOI: https://doi.org/10.1093/ije/dyac178

Berra TZ, Alves YM, Popolin MAP, da Costa FBP, Tavares RBV, Tártaro AF, et al. The COVID-19 pandemic in Brazil: space-time approach of cases, deaths, and vaccination coverage (February 2020 – April 2024). BMC Infect Dis. 2024 Jul 18;24(1):704. DOI: https://doi.org/10.1186/s12879-024-09598-1

Zhang Y, Wu G, Chen S, Ju X, Yimaer W, Zhang W, et al. A review on COVID-19 transmission, epidemiological features, prevention and vaccination. Medical Review. 2022;2(1). DOI: https://doi.org/10.1515/mr-2021-0023

Lee MJ, Snell LB, Douthwaite ST, Fidler S, Fitzgerald N, Goodwin L, et al. Clinical outcomes of patients with and without HIV hospitalized with COVID-19 in England during the early stages of the pandemic: a matched retrospective multi-centre analysis (RECEDE-C19 study). HIV Med. 2022;23(2). DOI: https://doi.org/10.1111/hiv.13174

Da Silva SJR, Do Nascimento JCF, Germano Mendes RP, Guarines KM, Targino Alves Da Silva C, Da Silva PG, et al. Two Years into the COVID-19 Pandemic: Lessons Learned. Vol. 8, ACS Infectious Diseases. 2022. DOI: https://doi.org/10.1021/acsinfecdis.2c00204

Haider N, Osman AY, Gadzekpo A, Akipede GO, Asogun D, Ansumana R, et al. Lockdown measures in response to COVID-19 in nine sub-Saharan African countries. Vol. 5, BMJ Global Health. 2020. DOI: https://doi.org/10.1101/2020.07.09.20149054

Naseer S, Khalid S, Parveen S, Abbass K, Song H, Achim MV. COVID-19 outbreak: Impact on global economy. Vol. 10, Frontiers in Public Health. 2023. DOI: https://doi.org/10.3389/fpubh.2022.1009393

Faria de Moura Villela E, López RVM, Sato APS, de Oliveira FM, Waldman EA, Van den Bergh R, et al. COVID-19 outbreak in Brazil: adherence to national preventive measures and impact on people’s lives, an online survey. BMC Public Health. 2021 Dec 18;21(1):152. DOI: https://doi.org/10.1186/s12889-021-10222-z

Li L, Taeihagh A, Tan SY. A scoping review of the impacts of COVID-19 physical distancing measures on vulnerable population groups. Nat Commun. 2023;14(1). DOI: https://doi.org/10.1038/s41467-023-36267-9

Correia RF, da Costa ACC, Moore DCBC, Gomes Junior SC, de Oliveira MPC, Zuma MCC, et al. SARS-CoV-2 seroprevalence and social inequalities in different subgroups of healthcare workers in Rio de Janeiro, Brazil. The Lancet Regional Health - Americas. 2022;7. DOI: https://doi.org/10.1016/j.lana.2021.100170

Venugopal U, Jilani N, Rabah S, Shariff MA, Jawed M, Mendez Batres A, et al. SARS-CoV-2 seroprevalence among health care workers in a New York City hospital: A cross-sectional analysis during the COVID-19 pandemic. International Journal of Infectious Diseases. 2021;102. DOI: https://doi.org/10.1016/j.ijid.2020.10.036

Bryan A, Tatem K, Diuguid-Gerber J, Cooke C, Romanoff A, Choudhury N, et al. Cross-sectional study evaluating the seroprevalence of SARS-CoV-2 antibodies among healthcare workers and factors associated with exposure during the first wave of the COVID-19 pandemic in New York. BMJ Open. 2021;11(11). DOI: https://doi.org/10.1136/bmjopen-2021-053158

Taylor S, Paluszek MM, Rachor GS, McKay D, Asmundson GJG. Substance use and abuse, COVID-19-related distress, and disregard for social distancing: A network analysis. Addictive Behaviors. 2021;114. DOI: https://doi.org/10.1016/j.addbeh.2020.106754

Kulkarni D, Nundy M, McSwiggan E, Adams E, Dozier M, Hartnup K, et al. To what extent is alcohol consumption in social gatherings associated with observance of COVID-19 restrictions? A rapid review. Vol. 12, Journal of global health. 2022. DOI: https://doi.org/10.7189/jogh.12.13001

Tjaden AH, Edelstein SL, Ahmed N, Calamari L, Dantuluri KL, Gibbs M, et al. Association between COVID-19 and consistent mask wearing during contact with others outside the household—A nested case–control analysis, November 2020–October 2021. Influenza Other Respir Viruses. 2023;17(1). DOI: https://doi.org/10.1111/irv.13080

Looi KH. Explicating gender disparity in wearing face masks during the COVID-19 pandemic. BMC Public Health. 2022;22(1). DOI: https://doi.org/10.1186/s12889-022-14630-7

Bergman NK, Fishman R. Correlations of mobility and Covid-19 transmission in global data. PLoS One. 2023;18(7 July). DOI: https://doi.org/10.1371/journal.pone.0279484

Moura HF, von Diemen L, Bulzing RA, Meyer J, Grabovac I, López-Sánchez GF, et al. Alcohol use in self-isolation during the COVID-19 pandemic: a cross-sectional survey in Brazil. Trends Psychiatry Psychother. 2023;45. DOI: https://doi.org/10.47626/2237-6089-2021-0337

Barron GC, Laryea-Adjei G, Vike-Freiberga V, Abubakar I, Dakkak H, Devakumar D, et al. Safeguarding people living in vulnerable conditions in the COVID-19 era through universal health coverage and social protection. Vol. 7, The Lancet Public Health. 2022. DOI: https://doi.org/10.1016/S2468-2667(21)00235-8

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Published

2025-07-01

How to Cite

Santos, S. de S. dos, Zenatti, C. T., Anibal, F. F., Mestre, C. A. A., Junior, A. C., & Oishi, J. (2025). COVID-19 Testing and Preventive Behaviours During The Pandemic’s Onset: A Cross-sectional Study. Sa´úde Coletiva (Barueri), 15(97), 16392–16415. https://doi.org/10.36489/saudecoletiva.2025v15i97p16392-16415

Issue

Vol. 15 No. 97 (2025)

Section

Original Article