Effectiveness of non-pharmaceutical interventions in nine fields of activity to decrease SARS-CoV-2 transmission (Spain, September 2020 - May 2021)

Abstract

Background We estimated the association between the level of restriction in nine different fields of activity and SARS-CoV-2 transmissibility in Spain, from 15 September 2020 to 9 May 2021. Methods A stringency index (0 to 1) was created for mobility, social distancing, commerce, indoor and outdoor bars and restaurants, culture and leisure, worship and ceremonies, indoor and outdoor sports, for each Spanish province (n = 50) daily. The logarithmic return (LR) of the weekly percentage variation of the 7-days COVID-19 cumulative incidence was used to measure COVID-19 transmission, lagged 12 days behind the stringency index. A hierarchical multiplicative model was fitted, and the median of coefficients across provinces (with 95% bootstrap confidence intervals) was used to quantify the effect of increasing one standard deviation (1SD) in the stringency index in each field. Results Highest levels of restriction were seen in mobility, sports and restaurants, particularly indoors. The increase in restrictions overall reduced SARS-CoV-2 transmission by 22% (RR = 0.78; one-sided 95%CI: 0,0.82) in one week, with highest effects for culture and leisure 14% (0.86; 0,0.98), social distancing 13% (0.87; 0,0.95), indoor restaurants 10% (0.90; 0,0.95) and indoor sports 6% (0.94; 0,0.98). In a reduced model with seven fields, culture and leisure no longer had a significant effect while ceremonies decreased transmission by 5% (0.95; 0,0.96). Models R2 was around 70%. Conclusion Increased restrictions decreased COVID-19 transmission. Limitations include remaining collinearity between fields, and somewhat artificial quantification of qualitative restrictions, so the exact attribution of the effect to specific areas must be done with caution.

Assessment of Factories on Adherence to COVID-19 Standard Operating Procedures: A Case Study of Wakiso, Mukono, Buikwe, and Jinja Districts, Uganda

“…In a 2021 study of selected super markets in Mukono and Kampala districts, only 16.6% complied with the COVID-19 guidelines [11], while in a countrywide survey conducted during the frst outbreak phase in Uganda in 2020, a 29.0% level of compliance to SOPs was reported [9]. Tis study provided evidence of a signifcant improvement in the implementation of NPIs against COVID-19 which could probably be attributed to increased awareness of the public health implications of the outbreak that induced high vigilance among people with time [21,26,27]. Te considerably high adherence to the SOPs could have resulted from active enforcement by company owners to avoid their operations being blocked by the government due to breach of Ministry of Health set guidelines for control of COVID-19 in factories [4].…”

“…High compliance to implementation of the NPIs was however dependent on cost implications, whereby feasibly afordable interventions such as mask wearing, hand washing, and physical distancing were more emphasized [19,20,26,30]. Compliance to set SOPs was also observed to increase with people's increasing beliefs regarding perceived efectiveness and convenience of use of particular interventions at their disposal [8,27,31].…”

Effectiveness of non-pharmaceutical interventions in nine fields of activity to decrease SARS-CoV-2 transmission (Spain, September 2020–May 2021)

“…The daily stringency index for each field of activity and province can be found at the project website ( 22 ) and is summarized in the functional boxplots in Figure 2 . Static boxplots for the distribution of the median and interquartile range of the nine stringency indexes can be found in Supplementary Appendix IV .…”

“…Further, the resulting scale is being compared to NPI applied, for example, to sport activities. Decisions were taken by a panel of expert collaborators and are documented and freely available ( 22 ). Moreover, NPIs were graded from a theoretical maximum that in some cases was not achieved.…”

“…The result was one stringency index from 0 to 1 per field of activity, day and province. The codified measures and stringency indices are available at the project website ( 22 ).…”