A new study in the BMJ suggests public health measures such as mask-wearing, universal lockdowns, and temporary closures of businesses and schools helped prevent further severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Lockdowns that are universal and mandatory quarantine measures were linked to an increase in coronavirus disease 2019 (COVID-19) cases and deaths than countries who did not implement these orders.
Study: A systematic review and meta-analysis of effectiveness of public health measures to lower covid-19, SARS/CoV-2 transmission, and death rates from covid-19. Image credit: Shutterstock/emojoez
It is possible that the further control of the COVID-19 pandemic does not rely only on high vaccination coverage and its efficacy, but as well on continued compliance with efficient and sustainable public health measures,” wrote the research team.
The researchers looked at the evidence for various measures for public health in reducing transmission of SARS-CoV-2 as well as COVID-19 deaths. They also included observational and interventional studies that examined the effectiveness of certain measures for public health (mask-wearing handwashing, hand washing, and social distancing) were in reducing the risk of contracting COVID-19 and death.
There were 72 studies that were eligible for inclusion. 35 of these studies were included in the final analysis since they measured the results of individual interventions. The studies were conducted across the globe and included, but not limited, to Asia and the United States (U.S.), Europe and the Middle East.
There was a risk of bias in several studies. Many of them had significant confounding factors likely due to the fact that the pandemic was an entirely new and exaggerating cause. There were differences in the capacity to test as well as diagnostic criteria and reporting data on COVID-19 deaths and cases. The risk of bias was most evident in studies evaluating public health interventions at the beginning of the pandemic , and in low-income neighborhoods.
PPE measures and COVID-19 risk
Three studies investigated handwashing practices among people. There were 292 people suffering from COVID-19. The results showed that handwashing resulted in 53% less COVID-19 cases when compared.
Six studies that evaluated the use of masks showed a 53% decrease in COVID-19 risk. Another study showed that wearing masks reduced the rate of transmission of SARS-CoV-2 and COVID-19-related deaths. One U.S. study found that mask-wearing decreased the risk of contracting SARS-CoV-2 by 29% in states that have mandates. Researchers did not specify which kind of masks protected against infection, but.
Infecting the home and COVID-19 risk
Only one of the 35 studies measured the effectiveness of disinfecting surfaces as well as SARS-CoV-2 transmission in household settings.
Daily use of chlorineor ethanol-based disinfectants proved to be 77 percent effective in reducing spread of CoV-2 and SARS. The study was not free of bias. Participants were not permitted to provide the concentrations of disinfectants they used.
Social distancing and COVID-19 risk
Five studies were conducted to evaluate the effectiveness of physical distancing to reduce COVID-19 risk. The pooled results showed a decrease of 25% in the risk of COVID-19 infection. However the studies all had different measurement criteria and ranged from moderate to critical bias in the data collection.
Stay-at-home efforts, COVID-19 risk
All studies that assessed the effectiveness of staying at home for risk of SARS-CoV-2 showed decreases in the transmission of viral. In one study from the United Kingdom, there was an increase of 74% in the daily number of contacts.
Two studies were conducted to measure the effectiveness of quarantine measures One study was conducted in India and the other from Saudi Arabia. In Saudi Arabia, an 8-week quarantine requirement resulted in an 4.9% decrease in COVID-19 infection. A 14-time higher risk of SARS-CoV-2 transmission was observed in Indian regions with no quarantine orders than those with strict quarantine measures.
Universal lockdowns have been reported to have reduced COVID-19-related deaths in countries that had them. A U.S. study that looked at universal lockdowns during the pandemic revealed a 11% decrease in transmission of SARS-CoV-2. In addition universal lockdowns cut down on the number of COVID-19 deaths.
COVID-19 Risk: Effects of business and school closures
Two studies investigated the impact of school closures on COVID-19 infection rates and mortality risk. One study conducted in the US found that closing schools led to the reduction of 62% in COVID-19 infections and 58% reduction in deaths due to COVID-19. Conversely, Japan’s school closing did not affect the transmission of SARS-CoV-2.
The United States saw a significant 12% decrease in transmission of SARS-CoV-2 during times when businesses were temporarily shut down. A separate U.S. study found a reduced risk of 16% in transmission.
SARS-CoV-2 risks were not affected by travel restrictions
One study examined travel restrictions in nine African countries that closed their borders in response to the pandemic. There was an increase in COVID-19 cases after the closure of the border. Border closure did not affect COVID-19 cases. However it is important to remember that the study had moderate risk of bias. The screening of travelers arriving did not help in reducing the spread of COVID-19. A study showed that when screening for fever, around 86% of infected people did not get detected.
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