Nonpharmaceutical interventions reduce the incidence and mortality of COVID-19: A study based on the survey from the International COVID-19 Research Network (ICRN)

Seung Hyun Park 1, Sung Hwi Hong 1, Kwanghyun Kim 2 3, Seung Won Lee 4, Dong Keon Yon 5, Sun Jae Jung 2 3, Ziad Abdeen 6, Ramy Abou Ghayda 7, Mohamed Lemine Cheikh Brahim Ahmed 8, Abdulwahed Al Serouri 9, Waleed Al-Herz 10, Humaid O Al-Shamsi 11, Sheeza Ali 12, Kosar Ali 13, Oidov Baatarkhuu 14, Henning Bay Nielsen 15 16, Enrico Bernini-Carri 17, Anastasiia Bondarenko 18, Ayun Cassell 19, Akway Cham 20, Melvin L K Chua 21 22 23, Sufia Dadabhai 24, Tchin Darre 25, Hayk Davtyan 26, Elena Dragioti 27, Barbora East 28, Robert Jeffrey Edwards 29, Martina Ferioli 30, Tsvetoslav Georgiev 31, Lilian A Ghandour 32, Harapan Harapan 33, Po-Ren Hsueh 34, Saad I Mallah 35, Aamer Ikram 36, Shigeru Inoue 37, Louis Jacob 38 39, Slobodan M Janković 40, Umesh Jayarajah 41, Milos Jesenak 42, Pramath Kakodkar 43, Nathan Kapata 44, Yohannes Kebede 45, Yousef Khader 46, Meron Kifle 47, David Koh 48, Višnja Kokić Maleš 49, Katarzyna Kotfis 50, Ai Koyanagi 51, James-Paul Kretchy 52, Sulaiman Lakoh 53, Jinhee Lee 54, Jun Young Lee 55, Maria da Luz Lima Mendonça 56, Lowell Ling 57, Jorge Llibre-Guerra 58, Masaki Machida 37, Richard Makurumidze 59, Ziad A Memish 60, Ivan Mendoza 61, Sergey Moiseev 62, Thomas Nadasdy 63, Chen Nahshon 64, Silvio A Ñamendys-Silva 65, Blaise Nguendo Yongsi 66, Amalea Dulcene Nicolasora 67, Zhamilya Nugmanova 68, Hans Oh 69, Atte Oksanen 70, Oluwatomi Owopetu 71, Zeynep Ozge Ozguler 72, Konstantinos Parperis 73, Gonzalo Emanuel Perez 74, Krit Pongpirul 75, Marius Rademaker 76, Nemanja Radojevic 77, Anna Roca 78, Alfonso J Rodriguez-Morales 79 80 81, Enver Roshi 82, Khwaja Mir Islam Saeed 83, Ranjit Sah 84, Boris Sakakushev 85 86 87, Dina E Sallam 88, Brijesh Sathian 89, Patrick Schober 90, P Shaik Syed Ali 12, Zoran Simonović 91, Tanu Singhal 92, Natia Skhvitaridze 93, Marco Solmi 94 95 96 97, Kannan Subbaram 12, Kalthoum Tizaoui 98, John Thato Tlhakanelo 99, Julio Torales 100, Junior Smith Torres-Roman 101, Dimitrios Tsartsalis 102, Jadamba Tsolmon 103, Duarte Nuno Vieira 104, Sandro G Viveiros Rosa 105, Guy Wanghi 106, Uwe Wollina 107, Ren-He Xu 108, Lin Yang 109, Kashif Zia 110, Muharem Zildzic 111, Jae Il Shin 112, Lee Smith 113

Affiliations

02 January 2023

-

doi: 10.1002/jmv.28354

Abstract

The recently emerged novel coronavirus, "severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)," caused a highly contagious disease called coronavirus disease 2019 (COVID-19). It has severely damaged the world's most developed countries and has turned into a major threat for low- and middle-income countries. Since its emergence in late 2019, medical interventions have been substantial, and most countries relied on public health measures collectively known as nonpharmaceutical interventions (NPIs). We aimed to centralize the accumulative knowledge of NPIs against COVID-19 for each country under one worldwide consortium. International COVID-19 Research Network collaborators developed a cross-sectional online survey to assess the implications of NPIs and sanitary supply on the incidence and mortality of COVID-19. The survey was conducted between January 1 and February 1, 2021, and participants from 92 countries/territories completed it. The association between NPIs, sanitation supplies, and incidence and mortality were examined by multivariate regression, with the log-transformed value of population as an offset value. The majority of countries/territories applied several preventive strategies, including social distancing (100.0%), quarantine (100.0%), isolation (98.9%), and school closure (97.8%). Individual-level preventive measures such as personal hygiene (100.0%) and wearing facial masks (94.6% at hospitals; 93.5% at mass transportation; 91.3% in mass gathering facilities) were also frequently applied. Quarantine at a designated place was negatively associated with incidence and mortality compared to home quarantine. Isolation at a designated place was also associated with reduced mortality compared to home isolation. Recommendations to use sanitizer for personal hygiene reduced incidence compared to the recommendation to use soap. Deprivation of masks was associated with increased incidence. Higher incidence and mortality were found in countries/territories with higher economic levels. Mask deprivation was pervasive regardless of economic level. NPIs against COVID-19 such as using sanitizer, quarantine, and isolation can decrease the incidence and mortality of COVID-19.

Keywords: COVID-19; isolation; mask; nonpharmacologic interventions; quarantine; sanitizer.

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References

 

  1. Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720.
  2. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20(5):533-534.
  3. Andrews N, Stowe J, Kirsebom F, et al. Covid-19 vaccine effectiveness against the Omicron (B. 1.1. 529) variant. N Engl J Med. 2022;386(16):1532-1546.
  4. Cowling BJ, Ali ST, Ng TWY, et al. Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health. 2020;5(5):e279-e288.
  5. Davies NG, Kucharski AJ, Eggo RM, et al. Effects of non-pharmaceutical interventions on COVID-19 cases, deaths, and demand for hospital services in the UK: a modelling study. Lancet Public Health. 2020;5(7):e375-e385.
  6. Figueiredo A, Daponte Codina AD, de Figueiredo DCMM, et al. Impact of lockdown on COVID-19 incidence and mortality in China: an interrupted time series study. Bull World Health Organ. 2020;25:56.
  7. Flaxman S, Mishra S, Gandy A, et al. Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe. Nature. 2020;584:257-261.
  8. Islam N, Sharp SJ, Chowell G, et al. Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries. BMJ. 2020;370:m2743.
  9. Ji D, Fan L, Li X, Ramakrishna S. Addressing the worldwide shortages of face masks. BMC Mater. 2020;2(1):9.
  10. Kai D, Goldstein G-P, Morgunov A, Nangalia V, Rotkirch A. Universal masking is urgent in the COVID-19 pandemic: SEIR and agent based models, empirical validation, policy recommendations. arXiv. Preprint. 2020. 200413553.
  11. Ahmed F, Ahmed N, Pissarides C, Stiglitz J. Why inequality could spread COVID-19. Lancet Public Health. 2020;5(5):e240.
  12. Karanikolos M, Heino P, McKee M, Stuckler D, Legido-Quigley H. Effects of the global financial crisis on health in high-income oecd countries: a narrative review. Int J Health Serv. 2016;46(2):208-240.
  13. Hanefeld J, Mayhew S, Legido-Quigley H, et al. Towards an understanding of resilience: responding to health systems shocks. Health Policy Plan. 2018;33(3):355-367.
  14. Bo Y, Guo C, Lin C, et al. Effectiveness of non-pharmaceutical interventions on COVID-19 transmission in 190 countries from 23 January to 13 April 2020. Int J Infect Dis. 2021;102:247-253.
  15. Lai S, Ruktanonchai NW, Zhou L, et al. Effect of non-pharmaceutical interventions to contain COVID-19 in China. Nature. 2020;585(7825):410-413.
  16. Min K-D, Kang H, Lee J-Y, Jeon S, Cho S. Estimating the effectiveness of non-pharmaceutical interventions on COVID-19 control in Korea. J Korean Med Sci. 2020;35(35):e321.
  17. Roser M, Ritchie H, Ortiz-Ospina E, Hasell J. Coronavirus pandemic (COVID-19). Our World in Data; 2020:4.
  18. Population. Worldometer. 2022. Accessed February 26, 2022.https://www.worldometers.info/population/
  19. World Bank list of economies (June 2020). World Bank. 2020. Accessed February 26, 2022. https://databank.worldbank.org/data/download/site-content/CLASS.xls
  20. Countries. Global Health Data Exchange. 2022. Accessed February 26, 2022. http://ghdx.healthdata.org/countries
  21. Lee SW. Methods for testing statistical differences between groups in medical research: statistical standard and guideline of Life Cycle Committee. Life Cycle. 2022;2:2.
  22. Lee SW. Regression analysis for continuous independent variables in medical research: statistical standard and guideline of Life Cycle Committee. Life Cycle. 2022;2:2.
  23. Wang Z, He T, Zhu L, Sheng H, Huang S, Hu J. Active quarantine measures are the primary means to reduce the fatality rate of COVID-19. Bull World Health Organ. Published online March 20, 2020.
  24. Figueiredo AM, Codina AD, Figueiredo D, Saez M, León AC. Impact of lockdown on COVID-19 incidence and mortality in China: an interrupted time series study. Bull World Health Organ. Published online April 06, 2020.
  25. Siedner MJ, Harling G, Reynolds Z, et al. Social distancing to slow the US COVID-19 epidemic: longitudinal pretest-posttest comparison group study. PLoS Med. 2020;17(8):e1003244.
  26. Flu pandemic mitigation: quarantine and isolation. Global Security.org. Accessed April 9, 2022. www.globalsecurity.org/security/ops/hsc-scen-3_flu-pandemic-quarantine.htm
  27. Lohiniva A-L, Dub T, Hagberg L, Nohynek H. Learning about COVID-19-related stigma, quarantine and isolation experiences in Finland. PLoS One. 2021;16(4):e0247962.
  28. Lee E, Chen Y-Y, McDonald M, O'Neill E. Dynamic response systems of healthcare mask production to COVID-19: a case study of Korea. Systems. 2020;8(2):18.
  29. Lu H, Yao D, Yip J, Kan C-W, Guo H. Addressing COVID-19 spread: development of reliable testing system for mask reuse. Aerosol Air Qual Res. 2020;20(11):2309-2317.
  30. Ma QX, Shan H, Zhang CM, et al. Decontamination of face masks with steam for mask reuse in fighting the pandemic COVID-19: experimental supports. J Med Virol. 2020;92(10):1971-1974.
  31. Noti JD, Lindsley WG, Blachere FM, et al. Detection of infectious influenza virus in cough aerosols generated in a simulated patient examination room. Clin Infect Dis. 2012;54(11):1569-1577.
  32. Tirupathi R, Bharathidasan K, Palabindala V, Salim SA, Al-Tawfiq JA. Comprehensive review of mask utility and challenges during the COVID-19 pandemic. Infez Med. 2020;28(suppl 1):57-63.
  33. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
  34. Chan JF-W, Yuan S, Kok K-H, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514-523.
  35. World Health Organization. Modes of Transmission of Virus Causing COVID-19: Implications for IPC Precaution Recommendations. World Health Organization; 2021.
  36. Wang J, Du G. COVID-19 may transmit through aerosol. Ir J Med Sci (1971). 2020;189(4):1143-1144.
  37. Asadi S, Bouvier N, Wexler AS, Ristenpart WD. The Coronavirus Pandemic and Aerosols: Does COVID-19 Transmit via Expiratory Particles? Vol 54. Taylor & Francis; 2020:635-638.
  38. Setti L, Passarini F, De Gennaro G, et al. Airborne transmission route of COVID-19: why 2 meters/6 feet of inter-personal distance could not be enough. Int J Environ Res Public Health. 2020;17(8):2932.
  39. Q&A for consumers|hand sanitizers and COVID-19. (CDC) CfDCaP. Accessed August 13, 2022. https://www.fda.gov/drugs/information-drug-class/qa-consumers-hand-sanit…
  40. Jing JLJ, Pei Yi T, Bose RJC, McCarthy JR, Tharmalingam N, Madheswaran T. Hand sanitizers: a review on formulation aspects, adverse effects, and regulations. Int J Environ Res Public Health. 2020;17(9):3326.
  41. Lin Q, Lim JYC, Xue K, et al. Sanitizing agents for virus inactivation and disinfection. View. 2020;1(2):e16.
  42. Kariwa H, Fujii N, Takashima I. Inactivation of SARS coronavirus by means of povidone-iodine, physical conditions and chemical reagents. Dermatology. 2006;212(suppl. 1):119-123.
  43. Casadevall A, Pirofski L. Host-pathogen interactions: basic concepts of microbial commensalism, colonization, infection, and disease. Infect Immun. 2000;68(12):6511-6518.
  44. Howard J, Huang A, Li Z, et al. An evidence review of face masks against COVID-19. Proc Natl Acad Sci USA. 2021;118(4):e2014564118.
  45. Mack A, Choffnes ER, Sparling PF, Hamburg MA, Lemon SM. Ethical and Legal Considerations in Mitigating Pandemic Disease: Workshop Summary. National Academies Press; 2007.
  46.  
    1. Larremore DB, Wilder B, Lester E, et al. Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening. Sci Adv. 2021;7(1):eabd5393.
  47. Rosolanka R, Henao-Martinez AF, Pisney L, Franco-Paredes C, Krsak M. COVID-19: a review of current knowledge regarding exposure, quarantine, isolation and other preventive measures. Ther Adv Infect Dis. 2021;8:204993612110320.
  48.  
    1. Mallapaty S. Where did Omicron Come From? Three Key Theories. Nature Publishing Group; 2022.
  49. Hanefeld J, Powell-Jackson T, Balabanova D. Understanding and measuring quality of care: dealing with complexity. Bull World Health Organ. 2017;95(5):368-374.
  50. David Williams O, Yung KC, Grépin KA. The failure of private health services: COVID-19 induced crises in low-and middle-income country (LMIC) health systems. Global Public Health. 2021;16:1320-1333.

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