Discussion
COVID-19 has already taken a great toll on human lives and has disrupted human routines in an unprecedented manner [9]. Healthcare systems are devastated by the increasing number of cases, and the healthcare workers are exposed to the highest risk of contracting the infection. Infection prevention practices are the mainstay of minimizing the risk of transmission, helping in mitigating the spread of this pandemic. In this study, we have analyzed the preventive practices of patients presenting to an outpatient clinic for the testing for SARS-CoV-2. The self-reported compliance was statistically analyzed with the COVID-19 RT-PCR reports to observe the association between the adherence to the preventive practices and their COVID-19 test results.
There are some significant findings in this study. In the analysis of the socio-demographic features, there was no statistical correlation between the individuals' age, gender, socioeconomic status, and chances of acquiring COVID-19. Though there are conflicting reports of age and gender as risk factors for acquiring the disease, the pandemic has crossed geographical and socio-economic boundaries to infect citizens at an exponential rate [10-12]. The resident doctors were at a lower risk of contracting the infection when compared with other healthcare workers. They are the frontline workers in our hospital, being at the highest risk of exposure due to the nature of the work they use to perform, including aerosol-generating procedures, which carry the highest risk for transmission of the disease [3]. We assume that they adhered to the infection prevention practices to the maximum extent, leading to a lower incidence of COVID-19 amongst them while being present at the forefront.
The prophylactic use of hydroxychloroquine was associated with some protection level (p=0.059), which was not statistically significant. With its in-vitro effectivity against SARS-CoV-2 and good lung concentration, hydroxychloroquine is a drug candidate selected to be used as prophylaxis against COVID-19 [13-15]. But the actual protection level is still unknown, and it is to be established by larger studies. It was found in the study that the alternative medicines were effective against COVID-19 while taken as prophylaxis. These medications are considered as immunity boosters and used by a larger portion of society in this subcontinent, though the actual form of the alternative medications was not enquired of in this study. We do not conclude about the prophylactic role of these medications here as the possible reason for the apparent protection conferred by the alternative medications might lie in the fact that people exercising such measures are more conscious about other preventive practices like mask use and social distancing, which are proven to be effective in preventing the transmission of COVID-19.
The social distancing of more than six feet was found to be statistically relevant as a protective measure against COVID-19 and should be practiced at all times. There is an established role of social distancing to mitigate the spread of the disease. A systematic review had concluded that the transmission of the virus becomes significantly lower when a physical distancing of 1 meter (~ three feet) or more was maintained (n= 10,736, pooled adjusted odds ratio 0.18, 95% CI 0.09-0.38) [2]. The authors have also shown that the degree of protection improves if the distance is increased. 
It was not surprising that participants who reported to wash their hands at regular intervals while maintaining appropriate duration and who used their N-95 masks with recommended fit check were protected against this disease. The practice of hand hygiene has been strongly recommended by the World Health Organisation (WHO) both for the general public and the health care workers as a part of contact precaution against COVID-19 [3].
While analyzing the practice of using PPE and PPE kits among frontline healthcare workers (n=150), we did not find any significant statistical correlation between their use and the chances of acquiring COVID-19 except for the use of face shields, which were found to be protective. But no concluding remarks could not be made owing to the smaller sample size.
The study's major strength is that all the samples were tested by RT-PCR, which is considered the gold standard for the diagnosis of COVID-19. This study is one of the first studies from India to report a direct association with preventive practices with the COVID-19 test results.
This study design was based on telephonic interviews, which might be responsible for some degree of recall bias. There is some missing data for some of the participants, mainly due to network outages during the telephonic communications. Furthermore, it was performed in a single center involving a specific population of patients; thus, the results may not be considered a reflection of the general population's behavioral practices.
There is a considerable amount of fear associated with this disease due to its rapid spread, high transmissibility, and substantial mortality in the susceptible population. The general public is already aware of the infection prevention practices against COVID-19, which are already circulated in the news, printed, and social media. There are several numbers of studies all over the world regarding the knowledge, attitude, and practices of the general population and healthcare workers during this pandemic [16-18]. But, it has been observed in other studies that people actually fail to practice the preventive measures in a consistent manner, which is largely responsible for the progression of this pandemic [19]. Thus, religious adherence to the preventive practices by the general public and healthcare workers can help implement proper preventive strategies in the current global scenario.