Narrative review of non-pharmaceutical behavioural measures for the prevention of COVID-19 (SARS-CoV-2) based on the Health-EDRM framework

Abstract

Introduction Non-pharmaceutical measures to facilitate a response to the COVID-19 pandemic, a disease caused by novel coronavirus SARS-CoV-2, are urgently needed. Using the World Health Organization (WHO) health emergency and disaster risk management (health-EDRM) framework, behavioural measures for droplet-borne communicable diseases and their enabling and limiting factors at various implementation levels were evaluated. Sources of data Keyword search was conducted in PubMed, Google Scholar, Embase, Medline, Science Direct, WHO and CDC online publication databases. Using the Oxford Centre for Evidence-Based Medicine review criteria, 10 bottom-up, non-pharmaceutical prevention measures from 104 English-language articles, which published between January 2000 and May 2020, were identified and examined. Areas of agreement Evidence-guided behavioural measures against transmission of COVID-19 in global at-risk communities were identified, including regular handwashing, wearing face masks and avoiding crowds and gatherings. Areas of concern Strong evidence-based systematic behavioural studies for COVID-19 prevention are lacking. Growing points Very limited research publications are available for non-pharmaceutical measures to facilitate pandemic response. Areas timely for research Research with strong implementation feasibility that targets resource-poor settings with low baseline health-EDRM capacity is urgently needed.

Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis

“…Substantial benefits in reducing mortality were observed in countries with universal lockdowns in place, such as Australia, New Zealand, Singapore, and China. Universal lockdowns are not, however, sustainable, and more tailored interventions need to be considered; the ones that maintain social lives and keep economies functional while protecting high risk individuals 1617. Substantial variation exists in how different countries and governments have applied public health measures,18 and it has proved a challenge for assessing the effectiveness of individual public health measures, particularly in policy decision making 19…”

Predictors of attitudes and adherence to COVID-19 public health guidelines in Western countries: a rapid review of the emerging literature

“… 4 Behavioral public health measures are crucial to curb infection rates as no curative treatment for COVID-19 is currently available and it is unclear in many jurisdictions when approved vaccines will be widely available to the general population. 5 As such, some form of these protective behaviors may be required into 2022, with risk of pandemic resurgence remaining elevated into 2024. 6 …”

Narrative Review of Primary Preventive Interventions against Water-Borne Diseases: Scientific Evidence of Health-EDRM in Contexts with Inadequate Safe Drinking Water

“…Sustainable and continuous implementation is required for all interventions to ensure maximum efficacy, and alternatives to such behavior should also be explored. Certain interventions, for example, waste management and handwashing, also exert co-benefit in reducing risks from other biological hazards under the health-EDRM framework, such as food-borne, vector-borne and droplet-borne diseases [ 111 , 112 , 113 ].…”

“…For example, the beneficial effect of handwashing with soap is consistent across various studies, but there is little evidence to support the use of alternatives, such as ash in communities where soap is not available [ 2 , 116 ]. The efficacy of such alternatives has been demonstrated in averting the transmission of droplet-borne and vector-borne, but not in waterborne diseases [ 112 , 113 ]. As almost 80% of all illnesses and deaths in low and middle-income countries are linked to poor water and sanitation conditions, further evidence-based and scientifically-rigorous studies should be conducted to better inform public health interventions in these contexts where financial and material resources are lacking [ 117 ].…”