Article type
Abstract
Background: Responses to the COVID-19 pandemic included a wide range of public health and social measures (PHSM). To inform decisions made by the public, health workforce and policy-makers, there is a need to synthesize the large volume of published research on PHSM for COVID-19. This can contribute valuable insights into the current and future understanding of the impact of PHSM on pandemic responses as well as stimulate further research in this crucial area.
Objectives: To systematically review the effectiveness and unintended health and socioeconomic consequences of PHSM aimed at reducing the scale and risk of transmission of COVID-19.
Methods: We followed Cochrane guidance about overviews of reviews and used the Epistemonikos database’s COVID-19 Living Overview of Evidence repository as a primary search source. Methodological quality was evaluated using the Measurement Tool to Assess Systematic Reviews (AMSTAR 2) checklist. The public were not involved in the study.
Results: A total of 94 reviews were included, of which 8 (9%) had “moderate” to “high” confidence ratings on the AMSTAR 2. Only 16 reviews (17%) reported applying the GRADE framework. Across the 94 reviews, the most frequently examined PHSM were personal protection (n = 18, 19%). Within multicomponent interventions, so-called “lockdown” was the most frequently examined component (n = 39, 41%). The most frequently reported outcome category was non-COVID-19-related health outcomes (n = 58, 62%). Only 5 (5%) reviews reported on socioeconomic outcomes. Findings from the moderate or high confidence reviews found low-certainty evidence that multicomponent interventions may reduce the transmission of COVID-19 in different settings. We also found very low-certainty evidence about the effectiveness of personal protection measures, travel-related control measures, and environmental measures. Unintended consequences were rarely examined by those reviews.
Conclusion: We found predominantly very low to low-certainty evidence regarding the effectiveness and unintended consequences of PHSM in controlling COVID-19 transmission. We discuss the implications for policy and research. We also highlight the importance of harnessing the power of synergy to develop better interdisciplinary collaboration, methods and tools to reduce duplications, avoid research wastes and address the highly relevant but less frequently researched questions revealed as gaps by our overview.
Objectives: To systematically review the effectiveness and unintended health and socioeconomic consequences of PHSM aimed at reducing the scale and risk of transmission of COVID-19.
Methods: We followed Cochrane guidance about overviews of reviews and used the Epistemonikos database’s COVID-19 Living Overview of Evidence repository as a primary search source. Methodological quality was evaluated using the Measurement Tool to Assess Systematic Reviews (AMSTAR 2) checklist. The public were not involved in the study.
Results: A total of 94 reviews were included, of which 8 (9%) had “moderate” to “high” confidence ratings on the AMSTAR 2. Only 16 reviews (17%) reported applying the GRADE framework. Across the 94 reviews, the most frequently examined PHSM were personal protection (n = 18, 19%). Within multicomponent interventions, so-called “lockdown” was the most frequently examined component (n = 39, 41%). The most frequently reported outcome category was non-COVID-19-related health outcomes (n = 58, 62%). Only 5 (5%) reviews reported on socioeconomic outcomes. Findings from the moderate or high confidence reviews found low-certainty evidence that multicomponent interventions may reduce the transmission of COVID-19 in different settings. We also found very low-certainty evidence about the effectiveness of personal protection measures, travel-related control measures, and environmental measures. Unintended consequences were rarely examined by those reviews.
Conclusion: We found predominantly very low to low-certainty evidence regarding the effectiveness and unintended consequences of PHSM in controlling COVID-19 transmission. We discuss the implications for policy and research. We also highlight the importance of harnessing the power of synergy to develop better interdisciplinary collaboration, methods and tools to reduce duplications, avoid research wastes and address the highly relevant but less frequently researched questions revealed as gaps by our overview.