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Review Question - QID 216229

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QID 216229 (Type "216229" in App Search)
Researchers are investigating the efficacy of mask-wearing on community transmission of the common cold, which is a self-limited condition. A governmental mask-wearing mandate was recently instituted based on studies showing that mask-wearing reduces transmission of various respiratory viruses from symptomatic and asymptomatic individuals to non-infected people, as measured by nasal swabs. The researchers have obtained prevalence and incidence data for the 3 months prior to the implementation of the mask-wearing mandate. The present study involves the measurement of prevalence and incidence of common cold infection over the 3 months following implementation of the mandate. Based on the evidence provided, what would be the expected change in prevalence and incidence (See Figure A)?
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  • A

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Based on the evidence provided, mask-wearing reduces viral transmission and would reduce both the total number of infected people and the number of new cases of infection over time. These are known as prevalence and incidence, respectively.

Disease prevalence is defined as the total number of cases divided by the total number of individuals in a given population. Prevalence is typically reported as either a percentage or as the number of cases per a set unit of the population (e.g., 25 cases per 100,000 people). Disease incidence is defined as the number of new cases divided by the number of at-risk individuals in a given population over a defined period of time. Incidence is typically reported as the number of new cases per people at risk per unit time. For example, a population of 10,000 individuals with 2,000 infected individuals at baseline (8,000 people at risk) and 2,000 new cases over the following month has an incidence of 2,000 cases per 8,000 person-months, assuming negligible re-infection rates.

Figure A shows the answer choices.

Incorrect Answers:
Answer 1: No change in prevalence and decrease in incidence is incorrect because prevalence should decrease as fewer individuals become infected and those who are infected resolve their infections after the mandate is implemented. Incidence can decrease with no change in prevalence if reduced incidence is paired with increased disease survival at a rate such that these opposing effects offset each other.

Answer 2: Increase in prevalence and increase in incidence is incorrect because the mask-wearing mandate should reduce both the total number of cases and the number of new cases in the population. Increase in prevalence and increase in incidence may occur when new screening or diagnostic tests improve the rate of disease detection without improving survival.

Answer 3: Increase in prevalence and decrease in incidence is incorrect because the mask-wearing mandate should decrease the prevalence as infected individuals resolve their infection and are replaced by ever lower numbers of new cases. Increase in prevalence and decrease in incidence may occur when new advances both help prevent disease and prolong survival.

Answer 4: Decrease in prevalence and increase in incidence is incorrect because mask-wearing decreases transmission rates, thereby preventing new cases. Decrease in prevalence and increase in incidence may occur if a disease becomes more virulent and lethal.

Bullet Summary:
Preventive measures decrease both the prevalence and incidence of disease.

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