Effectiveness of non-pharmaceutical interventions related to social distancing on respiratory viral infectious disease outcomes: A rapid evidence-based review and meta-analysis

Abstract

Objectives: Non-pharmaceutical interventions (e.g. quarantine and isolation) are used to mitigate and control viral infectious disease, but their effectiveness has not been well studied. For COVID-19, disease control efforts will rely on non-pharmaceutical interventions until pharmaceutical interventions become widely available, while non-pharmaceutical interventions will be of continued importance thereafter. Methods: This rapid evidence-based review provides both qualitative and quantitative analyses of the effectiveness of social distancing non-pharmaceutical interventions on disease outcomes. Literature was retrieved from MEDLINE, Google Scholar, and pre-print databases ( BioRxiv.org , MedRxiv.org , and Wellcome Open Research). Results: Twenty-eight studies met inclusion criteria ( n = 28). Early, sustained, and combined application of various non-pharmaceutical interventions could mitigate and control primary outbreaks and prevent more severe secondary or tertiary outbreaks. The strategic use of non-pharmaceutical interventions decreased incidence, transmission, and/or mortality across all interventions examined. The pooled attack rates for no non-pharmaceutical intervention, single non-pharmaceutical interventions, and multiple non-pharmaceutical interventions were 42% (95% confidence interval = 30% – 55%), 29% (95% confidence interval = 23% – 36%), and 22% (95% confidence interval = 16% – 29%), respectively. Conclusion: Implementation of multiple non-pharmaceutical interventions at key decision points for public health could effectively facilitate disease mitigation and suppression until pharmaceutical interventions become available. Dynamics around R0 values, the susceptibility of certain high-risk patient groups to infection, and the probability of asymptomatic cases spreading disease should be considered.

Decreased human respiratory syncytial virus activity during the COVID-19 pandemic in Japan: an ecological time-series analysis

“…The current preliminary findings reaffirm the usefulness of the NPI measures recommended by WHO and remind us of the need and importance of educational campaigns and the practical implementation of public health policies. In particular, with a continuous circulation of COVID-19 and use of NPIs in many countries, detailed studies are critically needed to evaluate the causes of decreased respiratory infections [ 89 – 91 ]. Additionally, until viable pharmaceutical options for HRSV become available, it is important to continue to evaluate non-pharmaceutical strategies and their potential benefits.…”

Fewer non‐COVID‐19 respiratory tract infections and gastrointestinal infections during the COVID‐19 pandemic

“…Measures such as the reduction of seats in indoor spaces, social distancing, the mandatory utilization of masks, and “stay at home” campaigns have dramatically reduced interactions between people. These measures proved effective in lowering SARS‐CoV‐2 infection rates and thereby impeding the spread of the virus 1,2 . However, various other pathogens, viruses, and bacteria are transmitted from one individual to another in a similar manner 3,4 .…”

Effectiveness of Contact Tracing for Viral Disease Mitigation and Suppression: Evidence-Based Review

“…Finally, the consideration of contact tracing alone and in combination with various other interventions, as observed in the response to the COVID-19 pandemic, limits the interpretation of the causal role of contact tracing in disease mitigation. However, recent work suggests that comparisons between different permutations of NPIs may still be informative [ 52 ].…”