Effectiveness of social distancing measures and lockdowns for reducing transmission of COVID-19 in non-healthcare, community-based settings

Abstract

Social distancing measures (SDMs) are community-level interventions that aim to reduce person-to-person contacts in the community. SDMs were a major part of the responses first to contain, then to mitigate, the spread of SARS-CoV-2 in the community. Common SDMs included limiting the size of gatherings, closing schools and/or workplaces, implementing work-from-home arrangements, or more stringent restrictions such as lockdowns. This systematic review summarized the evidence for the effectiveness of nine SDMs. Almost all of the studies included were observational in nature, which meant that there were intrinsic risks of bias that could have been avoided were conditions randomly assigned to study participants. There were no instances where only one form of SDM had been in place in a particular setting during the study period, making it challenging to estimate the separate effect of each intervention. The more stringent SDMs such as stay-at-home orders, restrictions on mass gatherings and closures were estimated to be most effective at reducing SARS-CoV-2 transmission. Most studies included in this review suggested that combinations of SDMs successfully slowed or even stopped SARS-CoV-2 transmission in the community. However, individual effects and optimal combinations of interventions, as well as the optimal timing for particular measures, require further investigation. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.

Incidence of new-onset hypertension before, during, and after the COVID-19 pandemic: a 7-year longitudinal cohort study in a large population

“…The pandemic crisis has caused great unrest in society and unprecedented changes in lifestyle, work, and social interactions [ 48 ]. The implementation of policies such as social distancing and the closure of gathering and interaction centers such as parks, cafes, schools, universities, etc., has had certain social consequences [ 49 ]. The adoption of smart work modalities by many industries and institutions may have exerted deleterious effect on health outcomes according to the results of a recently published paper which has demonstrated that after adjusting for sex, age, education, smoking, drinking, and body mass index, individuals who mostly sat at work had a 16% higher all-cause mortality risk, and a 34% increased mortality risk from cardiovascular disease compared with those who were mostly non-sitting at work [ 50 ], although the prevalence of arterial hypertension remained unchanged.…”

Influenza mortality as an indicator of the effectiveness of public health interventions and their impact on United States COVID mortality

“…Furthermore, almost every intervention has, at some point, been declared ineffective, including masking, 7,8 routine testing, 9 school closures, 10 and business "lockdowns". 11,12 Meta-analyses of studies of the efficacy of individual NPIs have tended to find beneficial effects [13][14][15] with a few prominent exceptions. 7,8 Closures of businesses and schools, limits on social gathering, travel restrictions, social distancing rules, masking mandates, and other NPI's act in concert to reduce the transmission of respiratory infections.…”