Water use behaviors and water access in intermittent and continuous water supply areas during the COVID-19 pandemic

More than one billion people worldwide receive intermittent water supply (IWS), in which water is delivered through a pipe network for fewer than 24 h/day, which limits the quantity and accessibility of water. During the COVID-19 pandemic, stay-at-home orders and efforts to limit contact with others can affect water access for those with unreliable home water supplies. We explored whether water service delivery and household water-use behaviors changed during the COVID-19 pandemic in Hubballi-Dharwad, India, and whether they differed if households had IWS or continuous (24x7) water supply through a longitudinal household survey in 2020-2021. Few perceived differences in water service delivery or water access were observed, although one-quarter of all households reported insufficient water for handwashing, suggesting an increased demand for water that was not satisfied. Many households with 24x7 reported water outages, necessitating the use of alternative water sources. These findings suggest that water demand at home increased and households with IWS and 24x7 both lacked access to sufficient water. Our findings indicate that water insecurity negatively affected households' ability to adhere to protective public health measures during the COVID-19 pandemic and highlight the importance of access to uninterrupted, on-premise water during public health emergencies.