COVID-19 facial covering during outdoor recreation reflects historical disease prevalence and culture above and beyond governmental measures – A study in 53 countries

The COVID-19 pandemic severely influenced human behavior due to governmental restrictions. In addition to administrative restrictions, other factors, like historical disease prevalence and culture might impact on recent behavior. The parasite stress theory of values and sociality predicts an influence of historical diseases on human culture and may be of important influence on current human behavioral responses towards the pandemic. To address the influence on behavior, we studied mask use in outdoor recreationists (N = 4863) from 53 cultures. Studying outdoor recreationists is advantageous because people have at least some choices over their mask use, and it is less strictly controlled. We hypothesize that pathogen prevalence and cultural values of a society predict mask usage above and beyond the simplistic explanation of the strength of the governmental pandemic-related restrictions. Our results indicate that societal variables, especially individualism, contribute to the mask use during leisure activities, with people from more individualistic societies reporting lesser mask usage. Further, historic pathogen prevalence has a significant influence on mask use, even when controlling for the stringency measures of the government, HDI and population density. Zoonotic disease richness, however, did not receive significance. A mediation model showed that historical pathogen prevalence had an indirect effect on mask use, via the two pathways collectivism-individualism and governmental regulations. The total effect size of pathogen prevalence on mask use was 0.61, and with 0.24 as direct, and 0.37 indirect effects. Our data fit into the parasite stress theory of values and sociality. Our results provide evidence that the governmental decisions and restrictions themselves are influenced by the historical pathogens.