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

AbstractObjectiveTo review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.DesignSystematic review and meta-analysis.Data sourcesMedline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World...

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Published inBMJ (Online) Vol. 375; p. e068302
Main Authors Talic, Stella, Shah, Shivangi, Wild, Holly, Gasevic, Danijela, Maharaj, Ashika, Ademi, Zanfina, Li, Xue, Xu, Wei, Mesa-Eguiagaray, Ines, Rostron, Jasmin, Theodoratou, Evropi, Zhang, Xiaomeng, Motee, Ashmika, Liew, Danny, Ilic, Dragan
Format Journal Article
LanguageEnglish
Published England British Medical Journal Publishing Group 17.11.2021
BMJ Publishing Group LTD
Subjects
Bias
Communicable Disease Control - methods
Confidence intervals
Coronaviruses
COVID-19
COVID-19 - epidemiology
COVID-19 - mortality
COVID-19 - prevention & control
COVID-19 - transmission
COVID-19 vaccines
COVID-19 Vaccines - therapeutic use
Disease transmission
Global Health
Hand Disinfection - methods
Herd immunity
Humans
Incidence
Infections
Intervention
Masks
Medical libraries
Meta-analysis
Mortality
Pandemics
Performance evaluation
Physical Distancing
Prevention
Public Health
Quarantine - methods
Reviews
SARS-CoV-2
Schools
Severe acute respiratory syndrome coronavirus 2
Systematic review
Travel
Vaccination
World Health Organization
Online AccessGet full text

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Abstract AbstractObjectiveTo review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.DesignSystematic review and meta-analysis.Data sourcesMedline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints).Eligibility criteria for study selectionObservational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.Main outcome measuresThe main outcome measure was incidence of covid-19. Secondary outcomes included SARS-CoV-2 transmission and covid-19 mortality.Data synthesisDerSimonian Laird random effects meta-analysis was performed to investigate the effect of mask wearing, handwashing, and physical distancing measures on incidence of covid-19. Pooled effect estimates with corresponding 95% confidence intervals were computed, and heterogeneity among studies was assessed using Cochran’s Q test and the I2 metrics, with two tailed P values.Results72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a “package of interventions.” Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I2=12%), mask wearing (0.47, 0.29 to 0.75, I2=84%), and physical distancing (0.75, 0.59 to 0.95, I2=87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively.ConclusionsThis systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination.Systematic review registrationPROSPERO CRD42020178692.
AbstractList To review the evidence on the 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. Medline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints). Observational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. The main outcome measure was incidence of covid-19. Secondary outcomes included SARS-CoV-2 transmission and covid-19 mortality. DerSimonian Laird random effects meta-analysis was performed to investigate the effect of mask wearing, handwashing, and physical distancing measures on incidence of covid-19. Pooled effect estimates with corresponding 95% confidence intervals were computed, and heterogeneity among studies was assessed using Cochran's Q test and the I metrics, with two tailed P values. 72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a "package of interventions." Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I =12%), mask wearing (0.47, 0.29 to 0.75, I =84%), and physical distancing (0.75, 0.59 to 0.95, I =87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively. This systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination. PROSPERO CRD42020178692.
To review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.OBJECTIVETo review the evidence on the 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.DESIGNSystematic review and meta-analysis.Medline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints).DATA SOURCESMedline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints).Observational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.ELIGIBILITY CRITERIA FOR STUDY SELECTIONObservational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.The main outcome measure was incidence of covid-19. Secondary outcomes included SARS-CoV-2 transmission and covid-19 mortality.MAIN OUTCOME MEASURESThe main outcome measure was incidence of covid-19. Secondary outcomes included SARS-CoV-2 transmission and covid-19 mortality.DerSimonian Laird random effects meta-analysis was performed to investigate the effect of mask wearing, handwashing, and physical distancing measures on incidence of covid-19. Pooled effect estimates with corresponding 95% confidence intervals were computed, and heterogeneity among studies was assessed using Cochran's Q test and the I2 metrics, with two tailed P values.DATA SYNTHESISDerSimonian Laird random effects meta-analysis was performed to investigate the effect of mask wearing, handwashing, and physical distancing measures on incidence of covid-19. Pooled effect estimates with corresponding 95% confidence intervals were computed, and heterogeneity among studies was assessed using Cochran's Q test and the I2 metrics, with two tailed P values.72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a "package of interventions." Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I2=12%), mask wearing (0.47, 0.29 to 0.75, I2=84%), and physical distancing (0.75, 0.59 to 0.95, I2=87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively.RESULTS72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a "package of interventions." Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I2=12%), mask wearing (0.47, 0.29 to 0.75, I2=84%), and physical distancing (0.75, 0.59 to 0.95, I2=87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively.This systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination.CONCLUSIONSThis systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination.PROSPERO CRD42020178692.SYSTEMATIC REVIEW REGISTRATIONPROSPERO CRD42020178692.
ObjectiveTo review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.DesignSystematic review and meta-analysis.Data sourcesMedline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints).Eligibility criteria for study selectionObservational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.Main outcome measuresThe main outcome measure was incidence of covid-19. Secondary outcomes included SARS-CoV-2 transmission and covid-19 mortality.Data synthesisDerSimonian Laird random effects meta-analysis was performed to investigate the effect of mask wearing, handwashing, and physical distancing measures on incidence of covid-19. Pooled effect estimates with corresponding 95% confidence intervals were computed, and heterogeneity among studies was assessed using Cochran’s Q test and the I2 metrics, with two tailed P values.Results72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a “package of interventions.” Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I2=12%), mask wearing (0.47, 0.29 to 0.75, I2=84%), and physical distancing (0.75, 0.59 to 0.95, I2=87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively.ConclusionsThis systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination.Systematic review registrationPROSPERO CRD42020178692.
AbstractObjectiveTo review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.DesignSystematic review and meta-analysis.Data sourcesMedline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and World Health Organization COVID-19 database (preprints).Eligibility criteria for study selectionObservational and interventional studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.Main outcome measuresThe main outcome measure was incidence of covid-19. Secondary outcomes included SARS-CoV-2 transmission and covid-19 mortality.Data synthesisDerSimonian Laird random effects meta-analysis was performed to investigate the effect of mask wearing, handwashing, and physical distancing measures on incidence of covid-19. Pooled effect estimates with corresponding 95% confidence intervals were computed, and heterogeneity among studies was assessed using Cochran’s Q test and the I2 metrics, with two tailed P values.Results72 studies met the inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures as a “package of interventions.” Eight of 35 studies were included in the meta-analysis, which indicated a reduction in incidence of covid-19 associated with handwashing (relative risk 0.47, 95% confidence interval 0.19 to 1.12, I2=12%), mask wearing (0.47, 0.29 to 0.75, I2=84%), and physical distancing (0.75, 0.59 to 0.95, I2=87%). Owing to heterogeneity of the studies, meta-analysis was not possible for the outcomes of quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces. The effects of these interventions were synthesised descriptively.ConclusionsThis systematic review and meta-analysis suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of covid-19 vaccination.Systematic review registrationPROSPERO CRD42020178692.
Author Ilic, Dragan
Motee, Ashmika
Zhang, Xiaomeng
Talic, Stella
Mesa-Eguiagaray, Ines
Shah, Shivangi
Gasevic, Danijela
Xu, Wei
Rostron, Jasmin
Wild, Holly
Liew, Danny
Maharaj, Ashika
Li, Xue
Theodoratou, Evropi
Ademi, Zanfina
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  givenname: Stella
  orcidid: 0000-0001-7739-3381
  surname: Talic
  fullname: Talic, Stella
  email: stella.talic@monash.edu
  organization: Monash Outcomes Research and health Economics (MORE) Unit, Monash University, VIC, Australia
– sequence: 2
  givenname: Shivangi
  surname: Shah
  fullname: Shah, Shivangi
  organization: School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
– sequence: 3
  givenname: Holly
  surname: Wild
  fullname: Wild, Holly
  organization: Torrens University, VIC, Australia
– sequence: 4
  givenname: Danijela
  surname: Gasevic
  fullname: Gasevic, Danijela
  organization: Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
– sequence: 5
  givenname: Ashika
  surname: Maharaj
  fullname: Maharaj, Ashika
  organization: School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
– sequence: 6
  givenname: Zanfina
  surname: Ademi
  fullname: Ademi, Zanfina
  organization: Monash Outcomes Research and health Economics (MORE) Unit, Monash University, VIC, Australia
– sequence: 7
  givenname: Xue
  surname: Li
  fullname: Li, Xue
  organization: School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
– sequence: 8
  givenname: Wei
  surname: Xu
  fullname: Xu, Wei
  organization: Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
– sequence: 9
  givenname: Ines
  surname: Mesa-Eguiagaray
  fullname: Mesa-Eguiagaray, Ines
  organization: Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
– sequence: 10
  givenname: Jasmin
  surname: Rostron
  fullname: Rostron, Jasmin
  organization: Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
– sequence: 11
  givenname: Evropi
  surname: Theodoratou
  fullname: Theodoratou, Evropi
  organization: Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
– sequence: 12
  givenname: Xiaomeng
  surname: Zhang
  fullname: Zhang, Xiaomeng
  organization: Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
– sequence: 13
  givenname: Ashmika
  surname: Motee
  fullname: Motee, Ashmika
  organization: Centre for Global Health, The Usher Institute, University of Edinburgh, Edinburgh, UK
– sequence: 14
  givenname: Danny
  surname: Liew
  fullname: Liew, Danny
  organization: Monash Outcomes Research and health Economics (MORE) Unit, Monash University, VIC, Australia
– sequence: 15
  givenname: Dragan
  surname: Ilic
  fullname: Ilic, Dragan
  organization: School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004 VIC, Australia
BackLink https://www.ncbi.nlm.nih.gov/pubmed/34789505$$D View this record in MEDLINE/PubMed
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34916225 - BMJ. 2021 Dec 16;375:n3050. doi: 10.1136/bmj.n3050
34862160 - BMJ. 2021 Dec 3;375:n2997. doi: 10.1136/bmj.n2997
34789507 - BMJ. 2021 Nov 17;375:n2729. doi: 10.1136/bmj.n2729
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Snippet AbstractObjectiveTo review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and...
To review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality....
ObjectiveTo review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19...
To review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19...
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SubjectTerms Bias
Communicable Disease Control - methods
Confidence intervals
Coronaviruses
COVID-19
COVID-19 - epidemiology
COVID-19 - mortality
COVID-19 - prevention & control
COVID-19 - transmission
COVID-19 vaccines
COVID-19 Vaccines - therapeutic use
Disease transmission
Global Health
Hand Disinfection - methods
Herd immunity
Humans
Incidence
Infections
Intervention
Masks
Medical libraries
Meta-analysis
Mortality
Pandemics
Performance evaluation
Physical Distancing
Prevention
Public Health
Quarantine - methods
Reviews
SARS-CoV-2
Schools
Severe acute respiratory syndrome coronavirus 2
Systematic review
Travel
Vaccination
World Health Organization
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Title 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
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https://www.ncbi.nlm.nih.gov/pubmed/34789505
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