Government-imposed social distancing, as well as self-imposed prevention measures such as hand washing and mask-wearing, can help mitigate and delay a COVID-19 pandemic, according to a new study, highlighting the importance of disease awareness and information dissemination.

The coronavirus disease COVID-19 caused by the novel coronavirus has spread to nearly every country in the world since it first emerged in China in December. Confronted with an epidemic, public health officials in different countries are seeking recommendations on how to delay and/or flatten its peak.

Alexandra Teslya of University Medical Center Utrecht and her team developed a transmission model to evaluate the impact of self-imposed measures (handwashing, mask-wearing, and social distancing) due to awareness of COVID-19 and of short-term government-imposed social distancing on the epidemic dynamics.

If a population quickly becomes aware of the coronavirus and effective prevention measures, self-imposed prevention measures can both diminish and postpone the peak number of cases, the model showed, arguing that a large epidemic can be prevented if the efficacy of these measures exceeds 50%.

The number of cases can also be delayed even by a slow change of behavior of the public, but when this happens the peak in cases isn’t delayed, according to the model. Meanwhile, if the government imposes social distancing measures but no one takes additional protective steps, the peak can be delayed but not reduced in cases.

A three-month intervention by the government would delay the peak by, at most, seven months, the study found. If government-imposed physical distancing is combined with disease awareness and personal steps, the height of the peak could be reduced, even after government-imposed social distancing orders were lifted.

“Moreover, the effect of combinations of self-imposed measures is additive,” the researchers wrote. “In practical terms, it means that SARS-CoV-2 will not cause a large outbreak in a country where 90% of the population adopts handwashing and social distancing that are 25% efficacious.”

The analysis was limited by a set of factors. It didn’t take into account demographics and the imperfect isolation of people who have Covid-19, which means they can infect others that care for them at home or in a healthcare facility. The model also didn’t consider the possibility of reinfection with the virus.

For the authors, the findings show the importance of the government spending time and resources on educating the public about how the virus spreads and highlighting the importance of social-distance, handwashing and mask-wearing. The study didn’t differentiate between mandating some of these behaviors or encouraging them.

“We stress the importance of disease awareness in controlling the ongoing epidemic and recommend that, in addition to policies on social distancing, governments and public health institutions mobilize people to adopt self-imposed measures with proven efficacy in order to successfully tackle COVID-19,” they wrote.

The study was published in the journal PLOS Medicine.