Impacts of public health and social measures on COVID-19 in Europe: a review and modified Delphi technique

Abstract

IntroductionThe emergence of the COVID-19 pandemic in early 2020 led countries to implement a set of public health and social measures (PHSMs) attempting to contain the spread of the SARS-CoV-2 virus. This study aims to review the existing literature regarding key results of the PHSMs that were implemented, and to identify the PHSMs considered to have most impacted the epidemiological curve of COVID-19 over the last years during different stages of the pandemic.MethodsThe PHSM under study were selected from the Oxford COVID-19 Government Response Tracker (OxCGRT), supplemented by topics presented during the Rapid Exchange Forum (REF) meetings in the scope of the Population Health Information Research Infrastructure (PHIRI) project (H2020). The evidence- based review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify which reviews have already been published about each PHSMs and their results. In addition, two modified Delphi panel surveys were conducted among subject matter experts from 30 European countries to uphold the results found.ResultsThere were 3,212 studies retrieved from PubMed, 162 full texts assessed for eligibility and 35 included in this PHSMs summary. The measures with clearest evidence on their positive impact from the evidence-based review include social distancing, hygiene measures, mask measures and testing policies. From the modified Delphi panel, the PHSMs considered most significant in the four periods analyzed were case isolation at home, face coverings, testing policy, and social distancing, respectively.DiscussionThe evidence found has significant implications for both researchers and policymakers. The study of PHSMs’ impact on COVID-19 illustrates lessons learned for future pan- and epidemics, serving as a contribution to the health systems resilience discussion. These lessons, drawn from both the available scientific evidence and the perspectives of relevant subject matter experts, should also be considered in educational and preparedness programs and activities in the public health space.

The effects of public health and social measures (PHSM) implemented during the COVID‐19 pandemic: An overview of systematic reviews

“…Two related overviews have been published since the inception of our overview [12, 13]. One focused on the effects of nonpharmacological interventions (NPIs) on the transmission of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection, but the review did not explore indirect, social, or economic impacts [12]. It was not clear how this review synthesized data or how it considered methodological limitations when interpreting findings.…”

“…Existing overviews of systematic reviews on interventions for COVID‐19 vary in their scope. Some are limited in the outcomes they consider, for example focusing only on symptoms and signs of COVID‐19 in children and adolescents [11] or on transmission‐related outcomes [12, 13]. Others have a broad focus, for example considering systematic reviews on any question related to COVID‐19 from the onset of the pandemic up to a certain date, regardless of scope or focus [10, 14].…”

The emergence of COVID-19 over-concern immediately after the cancelation of the measures adopted by the dynamic zero-COVID policy in China

“…Notably, the media's role in amplifying negative information during a pandemic, as Bagus et al (6) highlighted, could contribute to mass over-concern among the population (6). While previous studies focused on COVID-19 panic under restrictive measures (7,8), some scholars have observed an increase in COVID-19 over-concern when the Zero-COVID Policy is lifted (9). Considering the rapid transmission rate of COVID-19 and the typical recovery period for most individuals, there is a limited timeframe for conducting this study.…”

“…The previous questionnaires on the psychological impacts of the COVID-19 pandemic and zero-COVID policy in China were also reviewed (3,(11)(12)(13)(14). A person must fulfill at least five out of nine criteria, including (1) at least five physical symptoms; (2) stocking up at least five items related to protecting oneself during the COVID-19 pandemic; (3) obsessivecompulsive symptoms related to the COVID-19 pandemic; (4) illness anxiety related to the COVID-19 pandemic; (5) posttraumatic stress symptoms; (6) depression; (7) anxiety; (8) stress and (9) insomnia. The primary aim of this study was to establish the prevalence of COVID-19 over-concern in China shortly after major changes to the dynamic zero-COVID policy.…”

On the impact of mass screening for SARS-CoV-2 through self-testing in Greece

“…Of course, policymakers must carefully assess the expected positive and negative consequences of any NPI before implementing it, and studies that quantify these effects are therefore essential to improving global preparedness for future pandemics. Social distancing, hygiene measures, masking measures, and testing policies are examples of NPIs with clear evidence supporting their effectiveness in slowing the spread of SARS-CoV-2 ( 3–6 ) while also being cost-effective ( 7 ).…”