Effective public health measures to mitigate the spread of COVID-19: a systematic review

Abstract Background In December 2019, a novel coronavirus (2019-nCoV) was recognized in Wuhan, China. It was characterised by rapid spread causing a pandemic. Multiple public health interventions have been implemented worldwide to decrease the transmission of the 2019 novel coronavirus disease (COVID-19). The objective of this systematic review is to evaluate the implemented public health interventions to control the spread of the outbreak of COVID-19. Methods: We systematically searched PubMed, Science Direct and MedRxiv for relevant articles published in English up to March 16, 2021. We included quasi experimental studies, clinical trials, cohort studies, longitudinal studies, case-control studies and interrupted time series. We included the studies that investigated the effect of the implemented public health measures to prevent and control the outbreak of 2019 novel coronavirus disease (COVID-19). Results The database search using the predefined combinations of Mesh terms found 13,497 studies of which 3595 in PubMed, 7393 in Science Direct 2509 preprints in MedRxiv. After removal of the duplicates and the critical reading only 18 articles were included in this systematic review and processed for data extraction. Conclusions Public health interventions and non-pharmaceutical measurements were effective in decreasing the transmission of COVID-19. The included studies showed that travel restrictions, borders measures, quarantine of travellers arriving from affected countries, city lockdown, restrictions of mass gathering, isolation and quarantine of confirmed cases and close contacts, social distancing measures, compulsory mask wearing, contact tracing and testing, school closures and personal protective equipment use among health workers were effective in mitigating the spread of COVID-19.

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Effectiveness of non-pharmaceutical public health interventions against COVID-19: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0260371 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0260371

Author(s):

Shabnam Iezadi ◽

Kamal Gholipour ◽

Saber Azami-Aghdash ◽

Akbar Ghiasi ◽

Aziz Rezapour ◽

...

Keyword(s):

Public Health ◽

Systematic Review ◽

Growth Rate ◽

Reproduction Number ◽

Meta Analysis ◽

Health Interventions ◽

Contact Tracing ◽

Public Health Interventions ◽

Icu Admission ◽

Daily Changes

Non-Pharmaceutical Public Health Interventions (NPHIs) have been used by different countries to control the spread of the COVID-19. Despite available evidence regarding the effectiveness of NPHSs, there is still no consensus about how policymakers can trust these results. Studies on the effectiveness of NPHSs are single studies conducted in specific communities. Therefore, they cannot individually prove if these interventions have been effective in reducing the spread of the infection and its adverse health outcomes. In this systematic review, we aimed to examine the effects of NPHIs on the COVID-19 case growth rate, death growth rate, Intensive Care Unit (ICU) admission, and reproduction number in countries, where NPHIs have been implemented. We searched relevant electronic databases, including Medline (via PubMed), Scopus, CINAHL, Web of Science, etc. from late December 2019 to February 1, 2021. The key terms were primarily drawn from Medical Subject Heading (MeSh and Emtree), literature review, and opinions of experts. Peer-reviewed quasi-experimental studies were included in the review. The PROSPERO registration number is CRD42020186855. Interventions were NPHIs categorized as lockdown, stay-at-home orders, social distancing, and other interventions (mask-wearing, contact tracing, and school closure). We used PRISMA 2020 guidance for abstracting the data and used Cochrane Effective Practice and Organization of Practice (EPOC) Risk of Bias Tool for quality appraisal of the studies. Hartung-Knapp-Sidik-Jonkman random-effects model was performed. Main outcomes included COVID-19 case growth rate (percentage daily changes), COVID-19 mortality growth rate (percentage daily changes), COVID-19 ICU admission (percentage daily changes), and COVID-19 reproduction number changes. Our search strategies in major databases yielded 12,523 results, which decreased to 7,540 articles after eliminating duplicates. Finally, 35 articles qualified to be included in the systematic review among which 23 studies were included in the meta-analysis. Although studies were from both low-income and high-income countries, the majority of them were from the United States (13 studies) and China (five studies). Results of the meta-analysis showed that adoption of NPHIs has resulted in a 4.68% (95% CI, -6.94 to -2.78) decrease in daily case growth rates, 4.8% (95 CI, -8.34 to -1.40) decrease in daily death growth rates, 1.90 (95% CI, -2.23 to -1.58) decrease in the COVID-19 reproduction number, and 16.5% (95% CI, -19.68 to -13.32) decrease in COVID-19 daily ICU admission. A few studies showed that, early enforcement of lockdown, when the incidence rate is not high, contributed to a shorter duration of lockdown and a lower increase of the case growth rate in the post-lockdown era. The majority of NPHIs had positive effects on restraining the COVID-19 spread. With the problems that remain regarding universal access to vaccines and their effectiveness and considering the drastic impact of the nationwide lockdown and other harsh restrictions on the economy and people’s life, such interventions should be mitigated by adopting other NPHIs such as mass mask-wearing, patient/suspected case isolation strategies, and contact tracing. Studies need to address the impact of NPHIs on the population’s other health problems than COVID-19.

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Prediction Models for Public Health Containment Measures on COVID-19 Using Artificial Intelligence and Machine Learning: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094499 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4499

Author(s):

Anil Babu Payedimarri ◽

Diego Concina ◽

Luigi Portinale ◽

Massimo Canonico ◽

Deborah Seys ◽

...

Keyword(s):

Public Health ◽

Artificial Intelligence ◽

Machine Learning ◽

Systematic Review ◽

Public Transportation ◽

Prediction Models ◽

Positive Impact ◽

Health Interventions ◽

Public Health Interventions ◽

Commercial Activities

Artificial Intelligence (AI) and Machine Learning (ML) have expanded their utilization in different fields of medicine. During the SARS-CoV-2 outbreak, AI and ML were also applied for the evaluation and/or implementation of public health interventions aimed to flatten the epidemiological curve. This systematic review aims to evaluate the effectiveness of the use of AI and ML when applied to public health interventions to contain the spread of SARS-CoV-2. Our findings showed that quarantine should be the best strategy for containing COVID-19. Nationwide lockdown also showed positive impact, whereas social distancing should be considered to be effective only in combination with other interventions including the closure of schools and commercial activities and the limitation of public transportation. Our findings also showed that all the interventions should be initiated early in the pandemic and continued for a sustained period. Despite the study limitation, we concluded that AI and ML could be of help for policy makers to define the strategies for containing the COVID-19 pandemic.

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A window of opportunity for intensifying testing and tracing efforts to prevent new COVID-19 outbreaks due to more transmissible variants

Canada Communicable Disease Report ◽

10.14745/ccdr.v47i78a06 ◽

2021 ◽

Vol 47 (7/8) ◽

pp. 329-338

Author(s):

Jianhong Wu ◽

Francesca Scarabel ◽

Zachary McCarthy ◽

Yanyu Xiao ◽

Nicholas H Ogden

Keyword(s):

Public Health ◽

Reproduction Number ◽

Health Interventions ◽

Contact Tracing ◽

Window Of Opportunity ◽

New Wave ◽

Public Health Interventions ◽

Contact Rates ◽

Large Outbreak ◽

Restrictive Measures

Background: When public health interventions are being loosened after several days of decline in the number of coronavirus disease 2019 (COVID-19) cases, it is of critical importance to identify potential strategies to ease restrictions while mitigating a new wave of more transmissible variants of concern (VOCs). We estimated the necessary enhancements to public health interventions for a partial reopening of the economy while avoiding the worst consequences of a new outbreak, associated with more transmissible VOCs. Methods: We used a transmission dynamics model to quantify conditions that combined public health interventions must meet to reopen the economy without a large outbreak. These conditions are those that maintain the control reproduction number below unity, while accounting for an increase in transmissibility due to VOC. Results: We identified combinations of the proportion of individuals exposed to the virus who are traced and quarantined before becoming infectious, the proportion of symptomatic individuals confirmed and isolated, and individual daily contact rates needed to ensure the control reproduction number remains below unity. Conclusion: Our analysis indicates that the success of restrictive measures including lockdown and stay-at-home orders, as reflected by a reduction in number of cases, provides a narrow window of opportunity to intensify case detection and contact tracing efforts to prevent a new wave associated with circulation of more transmissible VOCs.

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Community Health Worker Training Curricula and Intervention Outcomes in African American and Latinx Communities: A Systematic Review

Health Education & Behavior ◽

10.1177/1090198120959326 ◽

2020 ◽

pp. 109019812095932

Author(s):

Leslie B. Adams ◽

Jennifer Richmond ◽

Sable N. Watson ◽

Crystal W. Cené ◽

Rachel Urrutia ◽

...

Keyword(s):

Public Health ◽

African American ◽

Community Health ◽

Health Workers ◽

Health Interventions ◽

Intervention Effectiveness ◽

Racially Diverse ◽

Public Health Interventions ◽

Worker Training ◽

Key Stakeholders

In recent years, community health workers (CHWs) have emerged as key stakeholders in implementing community-based public health interventions in racially diverse contexts. Yet little is known about the extent to which CHW training curriculums influence intervention effectiveness in marginalized racial and ethnic minority communities. This review summarizes evidence on the relationship between CHW training curricula and intervention outcomes conducted among African American and Latinx populations. We conducted a literature search of intervention studies that focused on CHW public health interventions in African American and Latinx populations using PubMed, PsycINFO, ERIC, CINAHL, EMBASE, and Web of Science databases. Included studies were quantitative, qualitative, and mixed methods studies employed to conduct outcome (e.g., blood pressure and HbA1c) and process evaluations (e.g., knowledge and self-efficacy) of CHW-led interventions. Out of 3,295 articles from the database search, 36 articles met our inclusion criteria. Overall, the strength of evidence linking specific CHW training curricula components to primary intervention health outcomes was weak, and no studies directly linked outcomes to specific characteristics of CHW training. Studies that described training related to didactic sessions or classified as high intensity reported higher percentages of positive outcomes compared to other CHW training features. These findings suggest that CHW training may positively influence intervention effectiveness but additional research using more robust methodological approaches is needed to clarify these relationships.

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A systematic review of economic evaluations of public health interventions targeting alcohol, tobacco, illicit drug use and problematic gambling: Using a case study to assess transferability

Health Policy ◽

10.1016/j.healthpol.2020.09.002 ◽

2021 ◽

Vol 125 (1) ◽

pp. 54-74

Author(s):

Camilla Nystrand ◽

Mihretab Gebreslassie ◽

Richard Ssegonja ◽

Inna Feldman ◽

Filipa Sampaio

Keyword(s):

Public Health ◽

Systematic Review ◽

Drug Use ◽

Illicit Drug ◽

Illicit Drug Use ◽

Health Interventions ◽

Economic Evaluations ◽

Public Health Interventions ◽

Problematic Gambling

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Public Health or Clinical Ethics: Thinking beyond Borders

Ethics & International Affairs ◽

10.1111/j.1747-7093.2002.tb00395.x ◽

2002 ◽

Vol 16 (2) ◽

pp. 35-45 ◽

Cited By ~ 46

Author(s):

Onora O'Neill

Keyword(s):

Public Health ◽

Medical Ethics ◽

Clinical Medicine ◽

Clinical Care ◽

Effective Means ◽

Cost Effective ◽

Health Interventions ◽

Individual Autonomy ◽

Public Health Interventions ◽

Health Measures

Most work in medical ethics across the last twenty-five years has centered on the ethics of clinical medicine. Even work on health and justice has, in the main, been concerned with the just distribution of (access to) clinical care for individual patients. By contrast, the ethics of public health has been widely neglected. This neglect is surprising, given that public health interventions are often the most effective (and most cost-effective) means of improving health in rich and poor societies alike.In this essay I explore two sources of contemporary neglect of public health ethics. One source of neglect is that contemporary medical ethics has been preoccupied—in my view damagingly preoccupied—with the autonomy of individual patients. Yet individual autonomy can hardly be a guiding ethical principle for public health measures, since many of them must be uniform and compulsory if they are to be effective. A second source of neglect is that contemporary political philosophy has been preoccupied—in my view damagingly preoccupied—with the requirements for justice within states or societies, and (until very recently) has hardly discussed justice across borders. Yet public health problems often cross borders, and public health interventions have to measure up to the problems they address.

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