Preparing for a future COVID-19 wave: insights and limitations from a data-driven evaluation of non-pharmaceutical interventions in Germany

Objectives To map travel policies implemented due to COVID-19 during 2020, and conduct a mixed-methods systematic review of health effects of such policies, and related contextual factors. Design Policy mapping and systematic review Data sources and eligibility criteria for the policy mapping, we searched websites of relevant government bodies and used data from the Oxford COVID-19 Government Response Tracker for a convenient sample of 31 countries across different regions. For the systematic review, we searched Medline (Ovid), PubMed, EMBASE, the Cochrane Central Register of Controlled Trials and COVID-19 specific databases. We included randomized controlled trial, non-randomized studies, modeling studies, and qualitative studies. Two independent reviewers selected studies, abstracted data and assessed risk of bias. Results Most countries adopted a total border closure at the start of the pandemic. For the remainder of the year, partial border closure banning arrivals from some countries or regions was the most widely adopted measure, followed by mandatory quarantine and screening of travelers. The systematic search identified 69 eligible studies, including 50 modeling studies. Both observational and modeling evidence suggest that border closure may reduce the number of COVID-19 cases, disease spread across countries and between regions, and slow the progression of the outbreak. These effects are likely to be enhanced when implemented early, and when combined with measures reducing transmission rates in the community. Quarantine of travelers may decrease the number of COVID-19 cases but its effectiveness depends on compliance and enforcement and is more effective if followed by testing, especially when less than 14 day-quarantine is considered. Screening at departure and/or arrival is unlikely to detect a large proportion of cases or to delay an outbreak. Effectiveness of screening may be improved with increased sensitivity of screening tests, awareness of travelers, asymptomatic screening, and exit screening at country source. While four studies on contextual evidence found that the majority of the public is supportive of travel restrictions, they uncovered concerns about the unintended harms of those policies. Conclusion Most countries adopted full or partial border closure in response to COVID-19 in 2020. Evidence suggests positive effects on controlling the COVID-19 pandemic for border closure (particularly when implemented early), as well as quarantine of travelers (particularly with higher levels of compliance). While these positive effects are enhanced when implemented in combination with other public health measures, they are associated with concerns by the public regarding some unintended effects.

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“…We included two observational 43 44 and thirteen modeling studies 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 .…”

Section: Findings Of Included Studies On Effectiveness (N=65)mentioning

confidence: 99%

“…Lifting bordure closure in Germany resulted in minimal to no effect in increasing the daily cases over a 90-day period while lifting contact restriction policies resulted in the highest increase. 47 …”

Section: Findings Of Included Studies On Effectiveness (N=65)mentioning

confidence: 99%

Public health effects of travel-related policies on the COVID-19 pandemic: A mixed-methods systematic review

Bou-Karroum¹,

Khabsa²,

Jabbour³

et al. 2021

Journal of Infection

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“…For example, contact restriction may be an effective control measure. 17 The second aspect of control measures is whether the interregional mobility restriction can reduce the national total number of infections. Distinguishing between the short-and long term control measures is important, and the fundamental goal should be toward reducing the overall epidemic size.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12][13][14][15][16] Effective control measures that prevent spatial spread of SARS-CoV-2 are urgently demanded, and how NPIs such as travel restrictions and social distancing mitigate the epidemic must be investigated. [17][18][19][20][21][22][23][24][25][26][27] The present study aims to provide meaningful implications for combating the COVID-19 pandemic through interregional mobility restrictions.…”

Section: Introductionmentioning

confidence: 99%

Simulating the Impacts of Interregional Mobility Restriction on the Spatial Spread of COVID-19 in Japan

Kondo

2021

Preprint

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This study develops a spatial Susceptible–Exposed–Infectious–Recovered (SEIR) model that analyzes the effect of interregional mobility on the spatial spread of the coronavirus disease 2019 (COVID-19) outbreak in Japan. National and local governments have requested that residents refrain from traveling between 47 prefectures during the state of emergency. However, the extent to which restricting the interregional mobility prevents infection expansion has not been elucidated. Our spatial SEIR model describes the spatial spread pattern of COVID-19 when people commute to a prefecture where they work or study during the daytime and return to their residential prefecture at night. We assume that people are exposed to infection risk during their daytime activities. According to our simulation results, interregional mobility restriction can prevent geographical expansion of the infection. However, in prefectures with many infectious individuals, residents are exposed to higher infection risk when their mobility is restricted. Our simulation results also show that interregional mobility restriction plays a limited role in reducing the national total number of infected individuals.

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“…We found that gathering restrictions and facial coverings significantly changed the pandemic trajectory in both waves, and gathering restrictions include both gathering cancellation 29 and closure of non-essential businesses [30][31][32] . The significant effects of these measures might be due to the virus most commonly spread through droplets or aerosols among people who were in close contact 33 .…”

Section: Effect Of Integrated Covid-19 Vaccination and Npismentioning

confidence: 91%

Impacts of worldwide individual non-pharmaceutical interventions on COVID-19 transmission across waves and space

Zhang

Liu

et al. 2021

Preprint

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Worldwide governments have rapidly deployed non-pharmaceutical interventions (NPIs) to mitigate the COVID-19 pandemic, together with the large-scale rollout of vaccines since late 2020. However, the effect of these individual NPI and vaccination measures across space and time has not been sufficiently explored. By the decay ratio in the suppression of COVID-19 infections, we investigated the performance of different NPIs across waves in 133 countries, and their integration with vaccine rollouts in 63 countries as of 25 March 2021. The most effective NPIs were gathering restrictions (contributing 27.83% in the infection rate reductions), facial coverings (16.79%) and school closures (10.08%) in the first wave, and changed to facial coverings (30.04%), gathering restrictions (17.51%) and international travel restrictions (9.22%) in the second wave. The impact of NPIs had obvious spatiotemporal variations across countries by waves before vaccine rollouts, with facial coverings being one of the most effective measures consistently. Vaccinations had gradually contributed to the suppression of COVID-19 transmission, from 0.71% and 0.86% within 15 days and 30 days since Day 12 after vaccination, to 1.23% as of 25 March 2021, while NPIs still dominated the pandemic mitigation. Our findings have important implications for continued tailoring of integrated NPI or NPI-vaccination strategies against future COVID-19 waves or similar infectious diseases.

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Preparing for a future COVID-19 wave: insights and limitations from a data-driven evaluation of non-pharmaceutical interventions in Germany

Cited by 37 publications

References 19 publications

Public health effects of travel-related policies on the COVID-19 pandemic: A mixed-methods systematic review

Public health effects of travel-related policies on the COVID-19 pandemic: A mixed-methods systematic review

Simulating the Impacts of Interregional Mobility Restriction on the Spatial Spread of COVID-19 in Japan

Impacts of worldwide individual non-pharmaceutical interventions on COVID-19 transmission across waves and space

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