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Public-health measures

 

We are in the process of identifying and extracting decision-relevant information about the ‘best evidence syntheses’ for each element of the COVID-END sub-taxonomy focused on public-health measures. We will continue to add evidence syntheses to this webpage as we complete this work, and we will make adjustments on a bi-weekly basis to which evidence syntheses are profiled, and to the information made available about included reviews, as the evidence base evolves.

Broad and specific decisions Criteria for 'best evidence synthesis' Details to support relevance assessment Additional decision-relevant details Citation
Date of last search Quality (AMSTAR) rating Evidence profile              Key findings
Living evidence synthesis Type of synthesis              Type of question
Infection prevention                
  Personal protection                
    Washing hands                
                   
                   
    Wearing masks 2020-06-02  7/10 No Limited evidence from observational studies shows that face mask use may be effective at reducing respiratory virus infections, with stronger evidence from healthcare settings compared to community settings  Yes  Full review Benefits and harms Chou R, Dana T, Jungbauer R, Weeks C, McDonagh MS. Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings. Ann Intern Med. 2020 Jun 24;M20-3213.
     2020-05-03 9/11  Yes Low certainty evidence suggests large reductions in risk of  viral infections may be possible with the use of masks, with N95 or similar respirators more likely to lead to greater reductions compared to disposible surgical masks or other reusable masks  No Full review Benefits and harms Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis [published online ahead of print, 2020 Jun 1]. Lancet. 2020;S0140-6736(20)31142-9. doi:10.1016/S0140-6736(20)31142-9
    2020-04-01  9/10  No Evidence from existing trials has not found a statistically significant difference in reductions of influenza-like-illness or influenza cases when mask wearing is compared to no masks among the general population  No Full review Benefits and harms Jefferson T, Jones M, Al Ansari L, Bawazeer G, Beller E, Clark J, et al. Physical Interventions to Interrupt or Reduce the Spread of Respiratory Viruses. Part I - Face Masks, Eye Protection and Person Distancing: Systematic Review and Meta-Analysis. MedRxiv 2020.
    Wearing personal protective equipment 2020-05-03  TBD  Yes Low certainty evidence suggests N95 respirators and eye protection can lead to a reduction in viral infections No  Full review Benefits and harms Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis [published online ahead of print, 2020 Jun 1]. Lancet. 2020;S0140-6736(20)31142-9. doi:10.1016/S0140-6736(20)31142-9
    2020-04-24 6/10 No PPE use by healthcare workers including masks, gloves, gowns and eye protection has been found to be one the strongest factor associated with reduced risk of coronavirus infection, with the most consistent associations observed for masks Yes Full review Benefits and harms  Chou R, Dana T, Buckley D, Selph S, Fu R, Totten A. Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers. Ann Intern Med 2020; M20-1632
    2020-04-01 9/10 No Evidence from existing trials has not found a statistically significant difference in reductions of influenza-like-illness or influenza cases when mask wearing is compared compared to no masks among healthcare workers, and no trials have been identified No Full review Benefits and harms Jefferson T, Jones M, Al Ansari L, Bawazeer G, Beller E, Clark J, et al. Physical Interventions to Interrupt or Reduce the Spread of Respiratory Viruses. Part I - Face Masks, Eye Protection and Person Distancing: Systematic Review and Meta-Analysis. MedRxiv 2020.
    Disinfecting surfaces and facilities                
    Physical distancing 2020-05-03 TBD Yes There is evidence of moderate certainty that physical distancing of more than 1 m probably results in a large reduction in risk of viral infections  No Full review Benefits and harms Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis [published online ahead of print, 2020 Jun 1]. Lancet. 2020;S0140-6736(20)31142-9. doi:10.1016/S0140-6736(20)31142-9
    Temporal distancing                
    Public-focused behaviour-change supports                
    Health worker and essential worker-focused behaviour change supports for the above 2020-03-26 7/9 Yes The design and content of infection prevention and control guidelines, how they are communicated, and whether there is adequate organizational support, training, and access to personal protective equipment affect adherence among healthcare workers No Rapid review Other Houghton C, Meskell P, Delaney H, et al. Barriers and Facilitators to Healthcare Workers' Adherence with Infection Prevention and Control (IPC) Guidelines for Respiratory Infectious Diseases: a Rapid Qualitative Evidence Synthesis. Cochrane Database Syst Rev 2020;4(4):CD013582.
  Service Limitations                
    Essential service designations                
    Daycare, school, university and summer camp limitations                
    Recreational areas (e.g., parks) limitations                
    Religious institutions (e.g., church, mosque or synagogue)                
    Public-contact-heavy business limitations                
    Other (e.g., public contact free) business limitations                
    Service-provider protection                
    Service-user protection                
    Inspections/enforcement of the above                
  Travel limitations                
    Travel (air, ground, rail)                
    Borders                
Infection control                
  Screening                
    Targets                
    Methods 2020-04-07 4/9 No In children, the most prevalent clinical manifestations of COVID-19 are fever, cough, nasal symptoms, diarrhea, and nausea/vomiting
No Full review Other de Souza T, Nadal J, Nogueira R, Pereira R, Brandão M. Clinical Manifestations of Children with COVID-19: A Systematic Review. Pediatr Pulmonol 2020;10.
    Locations (and frequency if applicable)                
  Quarantining of exposed or potentially exposed individuals                
    Voluntary or imposed 2020-04-01 9/10 No One randomized controlled trial has found that quarantining workers during an epidemic when members of their household are infected can control the spread of influenza-like-illness, but increases their individual risk of infection
No Full review Benefits and harms Jefferson T, Jones M, Al Ansari L, Bawazeer G, Beller E, Clark J, et al. Physical Interventions to Interrupt or Reduce the Spread of Respiratory Viruses. Part I - Face Masks, Eye Protection and Person Distancing: Systematic Review and Meta-Analysis. MedRxiv 2020.
  Testing                
    Priority individuals (including their contacts)                
    Methods (including performance and quality assurance) 2020-04-06 8/10 Yes The false-negative (patients incorrectly diagnosed as not having COVID-19) rate of patients undergoing RT-PCR tests is uncertain
Yes Full review Other Arevalo-Rodriguez I, Buitrago-Garcia D, Simancas-Racines D, Zambrano-Achig P, del Campo R, Ciapponi A. False-Negative Results of Initial RT-PCR Assays for COVID-19: A Systematic Review. MedRxiv 2020.
    Locations (and frequency if applicable)                
    Speeding results                
  Isolation of suspected or confirmed cases                
  Contact tracing                
  Susceptibility tracking                
    Antibody testing                
    Antibody test usage                
Broader public-health measures                
  Risk stratification                
    Stratifying the population by risk of infection                
  Outbreak management                
    Locations (essential services or other) 2020-05-29 7/10 Yes Outbreak investigations show that long-term care facilities are more vulnerable to the COVID-19 pandemic, in terms of disease spread and mortality rate
Yes Full review Other Salcher-Konrad M, Jhass A, Naci H, Tan M, El-Tawil Y, Comas-Herrera A. COVID-19 Related Mortality and Spread of Disease in Long-Term Care: First Findings from a Living Systematic Review of Emerging Evidence. MedRxiv 2020.
  Pandemic tracking                
    Levels of re-emergence that trigger action                
  Vaccination                
    Vaccines to prevent other infections                
Future possible public-health measures                
  Vaccination (susceptibility reduction)                
    Supporting discovery of a vaccine to prevent COVID-19 (followed by its production, distribution, administration)