Effectiveness assessment of non-pharmaceutical interventions: lessons learned from the COVID-19 pandemic

Lison, Adrian; Banholzer, Nicolas; Sharma, Mrinank; Mindermann, Sören; Unwin, H. Juliette T.; Mishra, Swapnil; Stadler, Tanja; Bhatt, Samir; Ferguson, Neil M; Brauner, Jan Marcus; Vach, Werner

doi:10.1016/S2468-2667(23)00046-4

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Effectiveness assessment of non-pharmaceutical interventions: lessons learned from the COVID-19 pandemic

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Author(s): Adrian Lison , MSc ^* ^, ^a , Nicolas Banholzer , PhD ^b ^, ^* , Mrinank Sharma , MEng ^c ^, ^e , Sören Mindermann , MSc ^d , H Juliette T Unwin , PhD ^f , Swapnil Mishra , PhD ^g ^, ^h , Tanja Stadler , Prof, PhD ^a , Samir Bhatt , Prof, DPhil ^f ^, ^g ^, ^* , Neil M Ferguson , Prof, PhD ^f , Jan Brauner , MD ^d ^, ^e , Werner Vach , Prof, PhD ⁱ ^, ^j

Publication date (Electronic): 23 March 2023

Journal: The Lancet. Public Health

Publisher: The Author(s). Published by Elsevier Ltd.

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Abstract

Effectiveness of non-pharmaceutical interventions (NPIs), such as school closures and stay-at-home orders, during the COVID-19 pandemic has been assessed in many studies. Such assessments can inform public health policies and contribute to evidence-based choices of NPIs during subsequent waves or future epidemics. However, methodological issues and no standardised assessment practices have restricted the practical value of the existing evidence. Here, we present and discuss lessons learned from the COVID-19 pandemic and make recommendations for standardising and improving assessment, data collection, and modelling. These recommendations could contribute to reliable and policy-relevant assessments of the effectiveness of NPIs during future epidemics.

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Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe

Seth Flaxman, Swapnil Mishra, Axel Gandy … (2020)

Following the detection of the new coronavirus1 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics of coronavirus disease 2019 (COVID-19). In response, many European countries have implemented non-pharmaceutical interventions, such as the closure of schools and national lockdowns. Here we study the effect of major interventions across 11 European countries for the period from the start of the COVID-19 epidemics in February 2020 until 4 May 2020, when lockdowns started to be lifted. Our model calculates backwards from observed deaths to estimate transmission that occurred several weeks previously, allowing for the time lag between infection and death. We use partial pooling of information between countries, with both individual and shared effects on the time-varying reproduction number (Rt). Pooling allows for more information to be used, helps to overcome idiosyncrasies in the data and enables more-timely estimates. Our model relies on fixed estimates of some epidemiological parameters (such as the infection fatality rate), does not include importation or subnational variation and assumes that changes in Rt are an immediate response to interventions rather than gradual changes in behaviour. Amidst the ongoing pandemic, we rely on death data that are incomplete, show systematic biases in reporting and are subject to future consolidation. We estimate that-for all of the countries we consider here-current interventions have been sufficient to drive Rt below 1 (probability Rt < 1.0 is greater than 99%) and achieve control of the epidemic. We estimate that across all 11 countries combined, between 12 and 15 million individuals were infected with SARS-CoV-2 up to 4 May 2020, representing between 3.2% and 4.0% of the population. Our results show that major non-pharmaceutical interventions-and lockdowns in particular-have had a large effect on reducing transmission. Continued intervention should be considered to keep transmission of SARS-CoV-2 under control.

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A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker)

Thomas C. Hale, Noam Angrist, Rafael Goldszmidt … (2021)

COVID-19 has prompted unprecedented government action around the world. We introduce the Oxford COVID-19 Government Response Tracker (OxCGRT), a dataset that addresses the need for continuously updated, readily usable and comparable information on policy measures. From 1 January 2020, the data capture government policies related to closure and containment, health and economic policy for more than 180 countries, plus several countries' subnational jurisdictions. Policy responses are recorded on ordinal or continuous scales for 19 policy areas, capturing variation in degree of response. We present two motivating applications of the data, highlighting patterns in the timing of policy adoption and subsequent policy easing and reimposition, and illustrating how the data can be combined with behavioural and epidemiological indicators. This database enables researchers and policymakers to explore the empirical effects of policy responses on the spread of COVID-19 cases and deaths, as well as on economic and social welfare.

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Ranking the effectiveness of worldwide COVID-19 government interventions

Nils Haug, Lukas Geyrhofer, Alessandro Londei … (2021)

Assessing the effectiveness of non-pharmaceutical interventions (NPIs) to mitigate the spread of SARS-CoV-2 is critical to inform future preparedness response plans. Here we quantify the impact of 6,068 hierarchically coded NPIs implemented in 79 territories on the effective reproduction number, Rt, of COVID-19. We propose a modelling approach that combines four computational techniques merging statistical, inference and artificial intelligence tools. We validate our findings with two external datasets recording 42,151 additional NPIs from 226 countries. Our results indicate that a suitable combination of NPIs is necessary to curb the spread of the virus. Less disruptive and costly NPIs can be as effective as more intrusive, drastic, ones (for example, a national lockdown). Using country-specific 'what-if' scenarios, we assess how the effectiveness of NPIs depends on the local context such as timing of their adoption, opening the way for forecasting the effectiveness of future interventions.

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Author and article information

Journal

Journal ID (nlm-ta): Lancet Public Health

Journal ID (iso-abbrev): Lancet Public Health

Title: The Lancet. Public Health

Publisher: The Author(s). Published by Elsevier Ltd.

ISSN (Electronic): 2468-2667

Publication date PMC-release: 23 March 2023

Publication date (Print): April 2023

Publication date (Electronic): 23 March 2023

Volume: 8

Issue: 4

Pages: e311-e317

Affiliations

[a ]Department of Biosystems Science and Engineering, ETH Zurich, Zurich, Switzerland

[b ]Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland

[c ]Department of Statistics, University of Oxford, Oxford, UK

[d ]Department of Computer Science, University of Oxford, Oxford, UK

[e ]Future of Humanity Institute, University of Oxford, Oxford, UK

[f ]Medical Research Council Centre for Global Infectious Disease Analysis, Jameel Institute, Imperial College London, London, UK

[g ]Department of Public Health, University of Copenhagen, Copenhagen, Denmark

[h ]Saw Swee Hock School of Public Health, National University of Singapore, Singapore

[i ]Basel Academy for Quality and Research in Medicine, Basel, Switzerland

[j ]Department of Environmental Sciences, University of Basel, Basel, Switzerland

Author notes

[* ]Correspondence to: Prof Samir Bhatt, Department of Public Health, University of Copenhagen, Copenhagen DK-1353, Denmark

[*]

Contributed equally

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Publisher Item ID: S2468-2667(23)00046-4

DOI: 10.1016/S2468-2667(23)00046-4

PMC ID: 10036127

PubMed ID: 36965985

SO-VID: 122d4965-4475-45b7-a701-a8ac0c3c763c

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Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Effectiveness assessment of non-pharmaceutical interventions: lessons learned from the COVID-19 pandemic

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Novel Coronavirus Disease COVID-19

Most cited references 49

Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe

A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker)

Ranking the effectiveness of worldwide COVID-19 government interventions

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