Assessment of Behavior and Attitude of Academic Community During Covid-19 Contingency

The survey about the behavior and attitude of an academy community was carried out to know their preventive measures and response caused by SARS-CoV-2 infection. In the period between March 26 and May 31, 2020, data from “Survey on the Follow-up of the Community of the Medical Faculty” were collected using Lime Survey version 4.2.5 in the CIPPS Survey Service. The use of mouth and face mask in the respondents barely exceeded 70%. 10% of the respondents have chronic diseases such as hypertension and obesity. 95% reported constant hygienic measure of hand-wash with soap and water, while more than 94% have respected physical-space distance. 20% of the survey population showed respiratory symptoms, which fell to 5% in the last 9 weeks. The most frequently reported symptoms were headache, cough, odynophagia, rhinorrhea, asthenia, anosmia and symptoms associated with respiratory tract. Less than 1% required medical attention, using non-steroid anti-inflammatory drugs. The analysis of the academic community survey depicts the importance of community discipline and the interest in collective health. The dissemination of useful information to prevent infections such as the use of mouth and face masks, physical-space distance and direct medical orientation guidance should continue to be strengthened.


Introduction
Airway infections are the cause of more than 4 million deaths a year and approximately 40% of them are produced by viral infections Troeger [1]. Acute respiratory diseases produced by viruses have a great impact and importance for global public health. Severe acute respiratory syndrome (SARS) is a respiratory disease provoked by a coronavirus, named SARS-CoV-associated coronavirus. In 2003, the World Health Organization (WHO) [2] reported an accumulated 8,439 infected people by SARS-CoV with a toll of 812 deaths. The outbreak, which started in China spread to 30 countries and was successfully suppressed, thanks to timely detection measures and isolation of cases WHO [3]. From this moment on, the possible future transmissions of the virus were announced. Likewise, 26, 2020, a staggering number of confirmed cases have risen to 9,683,414 infected people worldwide, with a toll of 491,095 deaths.
On the same date, in Mexico, 202,951 confirmed cases with a total of 25,060 deaths were reported J Hopkins [5].
Based on the virulence and the speed of spread, a vehement call was made to the health ministries of all the affected countries around the world to reinforce measures for the control of SARS-CoV-2, which, with no existing specific treatment, should be but also to cover the needed resources which the protocol to mitigate the spread of a pandemics demands, by actively searching for contacts with confirmatory tests. The purpose of containment measures is to suspend or impede the development of crowding activities and encourage social-distancing, closure of schools as well as non-essential businesses and commerce Mitigation [6].
In this health emergency, it is difficult to foresee which are the most effective measures and how to implement them in order to reduce the number of infected cases. For this, estimations with mathematical models has been formulated and applied in the observation of the behavior of the contagion or spread of the infection with social-distancing measures. A study performed in Singapore, one of the countries with less number of deaths and confirmed cases associated with SARS-CoV-2, showed a simulation of 100 infected cases in 80 days in different scenarios J Hopkins [5].
In the first scenario, there was no intervention and data on infected cases registered a total of 279,000 people which corresponds to 7.4% of the population. In the second scenario with the population in quarantine, the result of confirmed case was 15,000. In the third simulation with closure of schools and remote working, the number of contagion was 10,000 cases on day 80. In the fourth scenario, involving the combination of the aforementioned measures, the confirmed cases were 1,800 on day 80 Koo et al. [7]. Another study carried out with EnerPol platform in Swiss population including interventions such as closure of schools, activities, limitation of public transport and social distancing from February 22 to April 11, reported that 42% of the population were infected without government intervention compared to 1% of the population infected with timely intervention Reza et al. [8].
The objective of the present work was to evaluate the behavior and attitude of the students and staffs of the Faculty of Medicine

Results
In Table 1, the number of people who responded the survey in the period between March 26, 2020 and May 31, 2020 are shown. In the Table 2, the demographic characteristics of the respondents can be observed. Figure 2 shows the age distribution of the members of FacMed community and the people who live in it. In the first week of confinement, 19.9% of the respondents had to leave their house and during the rest of the confinement, this exit from home came down. (Table 3) shows the percentage of the community that left home during the confinement. For the first three recommendations of the WHO such as constant hand-wash with water and soap, quarantine keeping and the use of mouth mask, the answered of the respondents were complete obeisance to the recommendation. (Table 4) describes the rest of the sanitary measures that the community implemented to avoid the spread of COVID-19. Of the people who had to leave their houses, the answers given were mainly for work and for shopping for food and the transport means used were mainly buses. The rest of the reasons and the transport means used are shown in Table 5. Most of the symptoms were reported in the first week of confinement, while the percentage of this situation reported in the following weeks were progressively lower than the first week. In Table 6, the percentage of the community that presented respiratory symptoms are shown. Cough and headache were the main symptoms reported in the survey. The rest of the symptoms observed are outlined in Table 7. Regarding the approaches adopted for symptom treatment, less than 5% of the study population required some kind of medical attention. The drugs used are listed in Table 8.    Change of shoes on returning to the house 66.9 Change of clothes on returning to the house 54.5 Use of masks or glasses 11 Change of clothes and shoes on returning to the house 10.7 Use of gloves 9.9 None of the measures 0.3

Discussion
In this work, we analyze some of the measures, for instance spite of the fact that the health authorities of many countries such as Mexico exempted companies with non-essential activities to work from home, a factor observed that impede strict fulfillment of the confinement is work. This fact goes hand in hand with the use of any kind of transport means to get to the work. We consider that for the containment of the disease, these two factors are crucial determinant. In countries like New Zealand, Singapore and Germany, the use of public transport was restricted at the beginning of confirmed cases Medrxiv [11]. In our study, of the activities that impede the people to keep the confinement, the most important was work. A total of 59.50% of these people used public transport.
In Mexico, the beginning of changes in mobility in strategic points in public transport started in April Semovi (2020), a time when the accumulated average confirmed cases was 11,600 J Hopkins [5]. In this study, we observed that the fulfillment of the recommendations  movie theaters, bars, gyms and other non-essential activities. These measures were maintained until June 1 when partial return to the new-lifestyle-reality was declared. Two weeks after, a daily average confirmed case of 1,091 was registered J Hopkins [5].

Conclusion
The emergency of SARS-CoV-2 [23] in different countries and its serious effect on health of the population led to physical-distance decision-making as one of the most effective strategies to avoid the transmission of the virus. To assess the scope of the measures implemented, it was necessary the use of any standard assessment tool and the most easy-to-perform adequate tool is a survey as the one analyzed in this work. The FacMed survey shows the discipline of her community and her interest for collective health [24][25].
The dissemination of useful information to prevent infections such as the use of a mouth and face mask, physical distancing and direct medical orientation phone lines and others should continue to be re-enforced.