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Year : 2021  |  Volume : 12  |  Issue : 1  |  Page : 174

Non-pharmacological infection prevention and control interventions in COVID-19: What does the current evidence say?

1 IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
2 Department of Clinical Sciences, College of Pharmacy and Health Sciences; Center of Medical and Bio-Allied Health Sciences, Research, Ajman University, Ajman, United Arab Emirates
3 College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
4 Division of Community Medicine, International Medical University, Kuala Lumpur, Malaysia

Correspondence Address:
P Ravi Shankar
International Medical University, Bukit Jalil, Kuala Lumpur - 57000
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijpvm.IJPVM_604_20

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Coronavirus disease-19 (COVID-19), a major global public health emergency has significantly impacted human health and livelihoods. The pandemic continues to spread and treatments and vaccines are at different stages of development. Mass vaccination has been rolled out worldwide. This review article provides a narrative summary of the evidence on various non-pharmacological interventions (NPIs) for COVID-19 containment. The authors reviewed the evidence published by the Norwegian Institute of Public Health map of COVID-19 evidence. Additional literature was identified from PubMed and Google Scholar, preprint sites, and news media. The search terms included “Social distancing measures” and “COVID 19”, “Non-pharmacological interventions'' and “COVID 19”, “COVID-19”, “non-pharmacological interventions”, “face mask”, etc. The strength of the evidence for most studies on NPIs was 'weak to moderate' for restrictive NPIs. Ascertaining the impact of each NPI as a standalone intervention is difficult since NPIs are implemented simultaneously with other measures. Varying testing and reporting strategies across the countries and classification of deaths directly caused by COVID-19 create challenges in assessing the impact of restrictive NPIs on the case numbers and deaths. Evidence on hygiene measures such as face mask is more robust in design providing credible evidence on prevention of COVID-19 infection. Evidence from modeling studies, natural before-after studies, and anecdotal evidence from the strategies adopted by 'role model' countries suggests that continued use of NPIs is the only containment strategy until 'herd immunity' is achieved to reduce the severe disease and mortality.

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