The Effect of Primary School Education on Preventive Behaviours during COVID-19 in Japan

Education plays a critical role in promoting preventive behaviours against the spread of pandemics. In Japan, handwashing education in primary schools was positively correlated with preventive behaviours against COVID-19 transmission for adults in 2020, during the early stages of COVID-19. The following year, the Tokyo Olympics were held in Japan, and a state of emergency was declared several times. Public perceptions of and risks associated with the pandemic changed drastically with the emergence of COVID-19 vaccines. We re-examined whether the effect of handwashing education on preventive behaviours persisted by covering a longer period of the COVID-19 pandemic than previous studies. A total of 26 surveys were conducted nearly once a month for 30 months from March 2020 (the early stage of COVID-19) to September 2022 in Japan. By corresponding with the same individuals across surveys, we comprehensively gathered data on preventive behaviours during this period. In addition, we asked about the handwashing education they had received in their primary school. We used the data to investigate how and to what degree school education is associated with pandemic-mitigating preventive behaviours. We found that handwashing education in primary school is positively associated with behaviours such as handwashing and mask wearing as a COVID-19 preventive measure but not related to staying at home. We observed a statistically significant difference in handwashing between adults who received childhood handwashing education and those who did not. This difference persisted throughout the study period. In comparison, the difference in mask wearing between the two groups was smaller but still statistically significant. Furthermore, there was no difference in staying at home between them. Childhood hygiene education has resulted in individuals engaging in handwashing and mask wearing to cope with COVID-19. Individuals can form sustainable development-related habits through childhood education.

Effect of COVID-19 Pandemic on Awareness on Prevention of Spread of Infective Respiratory Secretions among Resident Doctors

Introduction: Respiratory infections including Coronavirus Disease-2019 (COVID-19) infection spread through droplet infections. Hence standard precautionary measures like handwashing and use of masks are essential to prevent transmission of these infections in healthcare setting. Aim: To determine the effect of COVID-19 pandemic on awareness level of resident doctors on prevention of spread of infective respiratory secretions. Materials and Methods: This cross-sectional study was conducted among two subsequent batches (year 2019-20 and 2020-21) of resident doctors at a medical college hospital, from February 2020 to September 2020. The 2019-2020 batch of resident doctors worked as residents from March 2019 to March 2020 and were considered as pre-COVID-19 batch. The 2020-2021 batch of resident doctors had their training period from April 2020 to April 2021 and were considered the COVID-19 batch. A pretested semi-structured questionnaire consisting of 14 questions to evaluate the awareness on prevention of spread of infective respiratory secretions was administered. The responses were evaluated, marks awarded and summated. Results: The response rate of pre-COVID-19 batch was 85% and that of COVID-19 batch was 86%. The mean (standard deviation) score obtained by the COVID-19 batch was 9.91 +/- 3.42 which was significant higher than that obtained by the pre-COVID-19 batch which was 7.1 +/- 1.83. The score obtained by COVID-19 batch for 11/14 questions was significantly higher compared to the pre-COVID-19 batch. Conclusion: A significant improvement was seen in the knowledge level in prevention of spread of infective respiratory secretions among resident doctors after the onset of the COVID-19 pandemic.

Rural and peri-urban households' handwashing behaviour before the COVID-19 pandemic: Implications for managing it in North-western Ghana

Good hygiene and handwashing remain important in public health, particularly in localities with low or no basic water and sanitation facilities. Using the Integrated Behavioural Model for water and hygiene, this study analysed key factors that shape handwashing behaviour and practices and the implications for managing the COVID-19 pandemic. The study was conducted using 20 rural and peri-urban communities in Ghana. Data gathered from 332 households and 20 focus group discussions indicated respondents have considerable knowledge of the significance of effective handwashing with soap, especially at critical moments. Although the practice of handwashing has been promoted in all the study communities, none of the households had a handwashing station. The respondents however argued that the absence of a handwashing station does not imply they do not wash their hands, especially at critical moments. Access to water, ability to buy soap, gender, and long hours of staying on distant farms shaped handwashing behaviour and practices. Although the study was conducted prior to the COVID-19 pandemic, the findings have substantial implications for the fight against the pandemic. Given that households are knowledgeable of the importance of handwashing, re-iterating the practice and intensifying advocacy on behavioural change, especially in the COVID-19 pandemic will reinvigorate handwashing.Copyright © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Intellectual humility predicts COVID-19 preventive practices through greater adoption of data-driven information and feelings of responsibility

Preventive health practices have been crucial to mitigating viral spread during the COVID-19 pandemic. In two studies, we examined whether intellectual humility-openness to one's existing knowledge being inaccurate-related to greater engagement in preventive health practices (social distancing, handwashing, mask-wearing). In Study 1, we found that intellectually humble people were more likely to engage in COVID-19 preventive practices. Additionally, this link was driven by intellectually humble people's tendency to adopt information from data-driven sources (e.g., medical experts) and greater feelings of responsibility over the outcomes of COVID-19. In Study 2, we found support for these relationships over time (2 weeks). Additionally, Study 2 showed that the link between intellectual humility and preventive practices was driven by a greater tendency to adopt data-driven information when encountering it, rather than actively seeking out such information. These findings reveal the promising role of intellectual humility in making well-informed decisions during public health crises.

A systematic review of nudges on hand hygiene against the spread of COVID-19.

The COVID-19 pandemic has posed the greatest threat to global health over the last three years. Due to the temporary shortage of appropriate vaccines, a systematic change in human behaviour is necessary to keep the spread of the virus under control, increasing the quality of basic hygiene practices, such as systematic hand hygiene. Nudges are increasingly used in public health interventions to promote critical preventive hygiene behaviours. This review aimed to investigate the effect and the characteristics of nudges on hand hygiene, as a COVID-19 preventive measure. We systematically reviewed the relevant literature from January 2008 to November 2020. A total of 15 articles met the inclusion criteria. The findings of this review showed that most of the nudging interventions had a positive effect on hand hygiene. Nudges should be included in the existing and future public health interventions to prevent the spread of COVID-19 and future pandemics, rather than being an alternative and unconventional tool for public health policies.

Area-level deprivation and handwashing behavior during the COVID-19 pandemic: A multilevel analysis on a nationwide survey in Korea.

This study investigated the association between area deprivation level and performance of handwashing behavior during the COVID-19 pandemic in Korean adults. This study used data from the 2015 Population and Housing Census data to measure area deprivation level. The 2020 Korea Community Health Survey was used for all other variables, including hand hygiene behavior (August through November 2020). The association between area deprivation level and practice of handwashing behavior was examined using multilevel logistic regression analysis. The study population comprised 215,676 adults aged 19 years or above. Compared to the least area deprived group, the most deprived group was more likely to not wash hands after using the restroom (OR 1.43, 95% CI 1.13-1.82), after coming home (OR 1.85, 95% CI 1.43-2.39), and using soap (OR 1.55, 95% CI 1.29-1.84). The findings suggest the importance of considering area deprivation in implementing policies that promote handwashing, particularly during a pandemic.

Evaluation of Hand Washing Procedure Using Vision-Based Frame Level and Spatio-Temporal Level Data Models

Hand hygiene is obligatory for all healthcare workers and vital for patient care. During COVID-19, adequate hand washing was among recommended measures for preventing virus transmission. A general hand-washing procedure consisting several steps is recommended by World Health Organization for ensuring hand hygiene. This process can vary from person to person and human supervision for inspection would be impractical. In this study, we propose computer vision-based new methods using 12 different neural network models and 4 different data models (RGB, Point Cloud, Point Gesture Map, Projection) for the classification of 8 universally accepted hand-washing steps. These methods can also perform well under situations where the order of steps is not observed or the duration of steps are varied. Using a custom dataset, we achieved 100% accuracy with one of the models, and 94.23% average accuracy for all models. We also developed a real-time robust data acquisition technique where RGB and depth streams from Kinect 2.0 camera were utilized. Results showed that with the proposed methods and data models, efficient hand hygiene control is possible.

Factors Associated with Handwashing Behaviors During the COVID-19 Pandemic: An Analysis of the Community Health Survey in Korea.

Introduction: Handwashing is the most effective preventive behavior for coronavirus disease-19 (COVID-19) infection. However, research has shown the lower handwashing behaviors among Korean adults. Objectives: This study aims to analyze factors associated with handwashing as a preventive behavior for COVID-19 infection based on the health belief model (HBM) and the theory of planned behavior (TPB) behavioral theories. Methods: This secondary data analysis utilized the Community Health Survey developed by Disease Control and Prevention Agency conducted in 2020. Sampling method was stratified and targeted 900 people living in the territory of each community public health center. In total, 228,344 cases were used in the analysis. Handwashing behavior, perceived susceptibility, perceived severity, subjective norm, and influenza vaccine uptake were used in the analysis. Regression analysis using weighing strategy by stratification and domain analysis was used. Results: Less washing hand was associated with older age (B = 0.01, p < .001), males (B = 0.42, p < .001), not receiving an influenza vaccine (B = 0.09, p < .001), perceived susceptibility (B = 0.12, p < .001), subjective norm (B = 0.05, p < .001), and perceived severity (B = -0.04, p < .001). Conclusion: While perceived susceptibility and social norm had positive association, perceived severity had a negative association with handwashing. Considering the Korean culture, creating a shared norm for frequent handwashing could be beneficial to promote handwashing rather than emphasizing the disease and its consequences.

Increasing hand-hygiene compliance in clinical settings using a baby-eyes sticker

This double-blind field study tested the effectiveness of a baby-eyes image in promoting healthcare workers' hand-hygiene compliance in a hospital setting. Adults are inclined to take care of babies and aspire to be their role models;therefore, they should wash their hands thoroughly when being watched by babies. Participants were healthcare workers from the obstetrical and neonatology units of a women's hospital in Hangzhou. We recorded and coded 3,360 hours and 10,325 hand-hygiene events over a five-week period—from 16 October to 20 November 2018. Three types of stickers, depicting baby eyes, adult eyes, or flowers, were placed above handwashing basins to compare hand-hygiene behavior between the three conditions. Each condition continued for one week, and experimenters interchanged the stickers in each unit to control for the location and sequence effects. Participants in the baby-eyes condition (72.9%) were more likely to use sanitizer than those in the flowers condition (69.4%;χ2 = 9.74, p < .01, φc = 0.034). Moreover, participants in the baby-eyes condition were more likely to use sanitizer than those in the adult-eyes condition (70.8%);however, the difference only trended towards significance (χ2 = 2.38, p = .066, φc = 0.023). The mean handwashing time between the three conditions was significant (Welch's F(2, 3488.436) = 3.50, p < .05, η2 = 0.001). Washing time in the baby-eyes condition (17.41 ± 12.02) was significantly longer than in the adult-eyes condition (16.36 ± 11.47;p < .05). The presence of a baby-eyes image promoted hand-hygiene compliance in the hospital environment. This finding can be adopted to change public health behaviors. It also holds theoretical implications that enhance our understanding of how being monitored by children can enhance responsible behaviors.

Condition of water, sanitation and hygiene (WaSH) in Ghana's basic schools: Empirical evidence from Wa municipality

Access to functional water, sanitation and hygiene (WaSH) systems is a necessity for safe health and a fundamental determinant of human well-being. As a result, constant monitoring, tracking and bridging of the gaps in access to WaSH is a global public health requirement. Developing countries are currently disadvantaged in this era of the COVID-19 outbreak, particularly in the area of school-based WaSH. This study assesses the present condition and challenges hindering access to school-based WaSH in the Wa Municipality. Primary data involving 145 health teachers were sourced using survey questionnaires and supported with ocular assessment. Results show that basic schools in the Wa Municipality currently have in place some sort of WaSH facilities, thereby meeting the availability criteria to a large extent. However, these schools do not meet the remaining standards – functionality, accessibility, maintenance and quality of services, education and prac-tices. The major factors affecting the sustainable operationalisation of the school-based WaSH are poor maintenance and inadequate funding of WaSH infrastructure. The school-based WaSH in Ghana requires rapt policy attention if the quest to attain Sustainable Development Goal 6 by 2030 is to be achieved. © 2023 The Authors.

Changes in Global Domestic Water Use Due to Handwashing for Preventing COVID-19: An Assessment

The emergence of COVID-19 has created many unanticipated changes globally, particularly in terms of the availability and use of water resources. This study aims to estimate the potential increase in global domestic water use, exclusively due to the handwashing requirement for COVID-19. To assess the potential increase in domestic water use, this study analyzed population and water use data of 175 countries. Based on WHO guidelines, the additional water required for handwashing per person per day was estimated to be 0.018 m3 and was integrated with water use and population data for the analysis. These findings reveal that if everyone washes their hands six times a day solely to prevent the spread of coronavirus, global domestic water use and total water use would increase by about 11.96% and 1.25%, respectively. Africa (23.88%), Asia (15.05%), Latin America, and the Caribbean (7.18%) are anticipated to have the most significant increases in domestic water use due to the increased handwashing. This is a concerning phenomenon because these nations are already experiencing water shortages, even before the pandemic. These results may aid these countries in achieving Sustainable Development Goal 6, by guiding stakeholders and decision-makers to take action to address the water resource management challenges posed by the unexpected rise in water use caused by events such as COVID-19.

Midwives' Risk Perception of and Preventive Behavioural Responses to COVID-19

As the novel Coronavirus disease (COVID-19) is highly contagious, application of preventive practices, such as personal protective equipment (PPE) usage and hand-washing, are crucial to prevent its spread. Evidence suggests that preventive behavioural responses to COVID-19 might be affected by risk perception. The present study aimed to assess risk perception and preventive behavioural responses among midwives and the association between them. In September 2020, a descriptive cross-sectional study was conducted in Indonesia among 421 midwives. Spearman's correlation coefficient or Spearman's rho (ρ) was used to identify the factors associated with risk perception and preventive behavioural responses as well as the correlation between risk perception and preventive practices. Generally, the midwives had a high-risk perception of COVID-19 infection. However, approximately 27% of the midwives did not always use PPE, and around 56% did not often wash their hands. Midwives who worked at health facilities had a higher level of risk perception of COVID-19 infection as well as adherence to preventive practices than those who worked at universities. A significant association was found between perception of risk severity and preventive practices (p 0.05). The healthier the midwives, the higher their level of adherence to PPE and hand-washing. Older midwives tended to use PPE at any time, while those who had a chronic disease were more likely to wash their hands for at least 20 seconds more frequently. Although the midwives had a high-risk perception of the COVID-19, it is necessary to improve their preventive practices, particularly hand hygiene. © Unisa Press 2022.

Aerosol Transmission and Control of SARS-CoV-2

One fundamental question about any novel pathogen is: how does it transmit? Answering this question will help to protect ourselves from the agent, at least until effective vaccines and antiviral therapies can be developed, especially if it is an agent of moderate to high lethality. Initially, at the start of the Coronavirus disease 2019 (COVID-19) pandemic, more emphasis was placed on handwashing rather than on droplet and aerosol transmission. Although severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2)-infected secretions such as saliva can spread the virus to hands, it became increasing evident that the virus mostly transmitted through close contact (though not necessarily touching), whilst people were breathing, talking, laughing, singing, coughing and sneezing near one another. During such respiratory activities, droplets and aerosols are produced together, and the amount of transmission due to these differentsized liquid particles will likely vary between individuals at different stages of their infection and illness. This question became even more complex as it emerged that viral transmission can occur for several days before symptom onset, and that asymptomatic cases can also shed just as much virus and potentially transmit it just as well as symptomatic cases. This chapter summarizes our understanding of how SARS-CoV-2 transmits and the infection control precautions to reduce this. © 2023 by World Scientific Publishing Co. Pte. Ltd.

Non-pharmaceutical interventions and risk of COVID-19 infection: survey of U.K. public from November 2020 - May 2021.

INTRODUCTION: Non-pharmaceutical interventions (NPIs), such as handwashing, social distancing and face mask wearing, have been widely promoted to reduce the spread of COVID-19. This study aimed to explore the relationship between self-reported use of NPIs and COVID-19 infection. METHODS: We conducted an online questionnaire study recruiting members of the UK public from November 2020 to May 2021. The association between self-reported COVID-19 illness and reported use of NPIs was explored using logistic regression and controlling for participant characteristics, month of questionnaire completion, and vaccine status. Participants who had been exposed to COVID-19 in their household in the previous 2 weeks were excluded. RESULTS: Twenty-seven thousand seven hundred fifty-eight participants were included and 2,814 (10.1%) reported having a COVID-19 infection. The odds of COVID-19 infection were reduced with use of a face covering in unadjusted (OR 0.17 (95% CI: 0.15 to 0.20) and adjusted (aOR 0.19, 95% CI 0.16 to 0.23) analyses. Social distancing (OR 0.27, 95% CI: 0.22 to 0.31; aOR 0.35, 95% CI 0.28 to 0.43) and handwashing when arriving home (OR 0.57, 95% CI 0.46 to 0.73; aOR 0.63, 95% CI: 0.48 to 0.83) also reduced the odds of COVID-19. Being in crowded places of 10-100 people (OR 1.89, 95% CI: 1.70 to 2.11; aOR 1.62, 95% CI: 1.42 to 1.85) and > 100 people (OR 2.33, 95% CI: 2.11 to 2.58; aOR 1.73, 95% CI: 1.53 to 1.97) were both associated with increased odds of COVID-19 infection. Handwashing before eating, avoiding touching the face, and cleaning things with virus on were all associated with increased odds of COVID-19 infections. CONCLUSIONS: This large observational study found evidence for strong protective effects for individuals from use of face coverings, social distancing (including avoiding crowded places) and handwashing on arriving home on developing COVID-19 infection. We also found evidence for an increased risk associated with other behaviours, possibly from recall bias.

Promoting Community Health and Understanding of Science Topics by Reading Graphic-Style Stories Aloud Together.

Limited health literacy and access to engaging, relevant, understandable health promotion and disease prevention materials are barriers to achieving and maintaining health. The We-Engage-4-Health program co-created the graphic-style story "Foamy Soap Fun" with community members to reinforce the importance of the primary preventive strategy-handwashing-in limiting spread of COVID-19. Pre/postsurveys were administered, and a modified focus group was conducted to learn community participants' preferences for reading stories (aloud together and/or silently to themselves), versus reading typical health promotion information sheets. Three themes were identified related to reading the story aloud: increased enthusiasm, increased attentiveness, and improved interpretation skills, vocabulary, and information processing skills. Educational constructs included: empathy with the story's characters, engagement with previous health experiences, enthusiasm with sharing health information, and explanation of complex health topics. This study supports the value of graphic-style stories in helping communities to better understand the science behind health topics.

Water, Sanitation and Hygiene (WASH) in Japanese elementary schools: Current conditions and practices.

BACKGROUND: Water, sanitation, and hygiene (WASH) is the foundation for preventing infectious diseases, as the current COVID-19 pandemic has shown. WASH is essential for school health, yet there have been very few papers published on WASH in Japanese schools. The objective of this review is to describe the current conditions and practices in Japanese elementary schools using an international framework for WASH in schools and identify implications for handwashing promotion in other areas. METHODS: This research was based primarily on a literature review. Information on common WASH practices was also collected through an international workshop attended by school health experts. RESULTS: There is a rigorous legal foundation for ensuring the physical infrastructure and quality control of a safe water supply in Japanese schools. Water quality is monitored regularly by Yogo teachers and school pharmacists. Strategic locations and an abundance of water supply infrastructure facilitate handwashing behavior. Hygiene promotion activities by Yogo teachers and student's health committees play a major role in increasing awareness, while health education classes provide minimal but necessary knowledge on handwashing with soap. Flush toilets are the standard, but there is still a demand for improvement of toilet facilities. Children's participation in daily cleaning of school toilets contributes to students understanding the importance of cleanliness. CONCLUSIONS: Drawing from the Japanese example, WASH in schools' interventions are suggested to include laws and policies, a designated teacher, and children's participation to sustain both infrastructure and hygiene promotion.

WHAT COVID TAUGHT US ABOUT HEALTH

The article discuses the suggestions by various leading scientists to remain healthy during pandemic. It is reported by Eric Feigl Ding, chief of the Covid risk task force at the New England Complex Systems Institute that Vitamin D plays a crucial role in immune health. It is further reported that to prevent chronic illnesses one should eat well, be active, should avoid tobacco, and be moderate with alcohol.

Mask-Wearing and Handwashing Behaviors of Chinese Rural Residents during the Pandemic of COVID-19: A Cross-Sectional Survey.

OBJECTIVE: To understand mask-wearing and handwashing behaviors of Chinese rural residents during the COVID-19 pandemic and to analyze the associated factors. METHODS: This study used a multi-stage random sampling method to conduct a cross-sectional questionnaire survey during the period of July to December of 2021, in six counties located in Shandong, Shanxi, and Yunnan provinces representing the eastern, central, and western regions of China, respectively. A total of 3864 villagers were surveyed with a questionnaire, and 3832 valid questionnaires were finally analyzed. Descriptive statistics and logistic regression analysis were used for statistical analysis. RESULTS: Around ninety-four percent (93.6%) of rural residents reported mask-wearing during the COVID-19 pandemic, but only 44.5% of them could replace masks in time. Multivariate logistic regression analysis showed that those who were female, aged 15-59, had an education level of high school and above, were divorced/widowed, worked as farmers (workers), or were rural residents in Shandong Province were more likely to wear masks. Furthermore, those who were female, aged 15-59, had an education level of high school and above, were unmarried and married, were business and service workers, or were rural residents in Shandong and Shanxi Province replaced masks more timely. Around seventy percent (69.7%) of rural residents reported using soap when washing their hands, but only 38.0% of rural residents could wash their hands properly. Multivariate logistic regression analysis showed that rural residents who were aged 35-59, had an education of high school and above, or lived in Shandong Province and Shanxi Province were more likely to wash their hands with soap. Those who were aged 15-59, had an education of high school and above, worked as farmers (workers), were employees of governmental departments and retirees, were business and service workers, or were students had higher proper handwashing rates. CONCLUSION: During the COVID-19 pandemic, the proportion of Chinese rural residents wearing masks reached 93.6%, but only 44.5% were able to replace masks in time, gender, age, education level, marital status, occupation, and living place had an impact on mask-wearing. The proportion of Chinese rural residents who could wash hands with soap reached 69.7%, but only 38.0% could wash their hands properly. Age and education level were influencing factors for both washing-hand with soap and proper handwashing.

Handwashing knowledge, attitudes, and practices in Ghana.

Introduction: Handwashing has been recognized as a convenient, effective, and cost-effective means of preventing communicable diseases. However, many people overlook the importance of handwashing when engaging in activities that require handwashing due to various factors. The objectives of this study were to assess the level of handwashing knowledge, attitudes, and practices and determine their relationships and how they are affected by sex, educational background, and age. Methods: A cross-sectional survey was conducted among 636 respondents who received and completed an online questionnaire that was disseminated to the contacts of the researchers via WhatsApp, Email, LinkedIn, and Facebook. Respondents were presented with several statements to assess their handwashing knowledge, attitudes, and practices. Results: Overall, 82.2% of respondents had good knowledge, 91% had a positive attitude, and 48.4% adhered to good handwashing practices. Having a high school level of education (OR = 0.193, p = 0.034.), (OR = 0.145, p = 0.000) and (OR = 0.448, p = 0.049) decreased the likelihood of having good knowledge, positive attitudes, and good practices than in persons with tertiary level education. Predictors of good handwashing practices were knowledge (OR = 1.059, p = 0.37) and attitude (OR = 1.095, p = 0.000). These results suggest that having a higher level of education could increase a person's knowledge and attitude, which in turn enhances the likelihood that the person would adhere to most handwashing and hand hygiene practices. Conclusions: Enhancing people's handwashing practices requires positive attitudes and good knowledge about handwashing. These need to be complemented by enhanced access to handwashing facilities and innovative measures to enforce and encourage compliance.

A tipping point of spreading viruses: Estimating the risk of household contact transmission of COVID-19

COVID-19 infection has been reported to be caused by droplet and contact infection. This paper proposes a model that visualizes the risk of contact infection to family members when viruses spread to various items at home. Behavior data after returning home are extracted from a questionnaire-based survey of home behavior to design the agent-based model. The data tables of contact behavior are created, including the room-to-room transfer probability table, the conditional probability table, and the contact probability table. The material transfer efficiency table is also created by measuring the virus transmission rate after contact with droplets in a virus experiment laboratory. In the experiment, the synthetic agent created from the acquired data probabilistically performs movement and contact behavior after returning home and reproduces the state in which the virus attached to the hand or belongings, when going out, propagates to objects at home. Next, we examine the risk of a second family member returning home. As a result, virus-attached contacts within around 30 minutes after returning home are widely confirmed around the entrance and kitchen, suggesting the effectiveness of early hand-washing behavior. And the experiment shows that even if the first person returning home disinfects their hands inside the entrance, the virus remains in a part of the entrance, and the virus is spread inside the room by the second person returning home. Copyright © 2023 Kurahashi, Mukai, Sekine, Nakajima, Otake, Sugiyama, Takizawa and Kakizawa.