Public health measures for covid-19

Paul P Glasziou, Susan Michie, Atle Fretheim

Research output: Contribution to journalEditorialResearch

23 Citations (Scopus)


Although the pandemic has seen remarkable trials for vaccines and drug treatments, much less has been done to evaluate the effects of public health and social measures (PHSMs)1; also known as non-pharmaceutical interventions (NPIs) or behavioural, environmental, social, and systems interventions (BESSIs).1 A linked systematic review of public health measures for covid-192 by Talic and colleagues (doi:10.1136/BMJ-2021-068302) found just one randomised controlled trial—of mask wearing—among 35 eligible studies that could provide estimates on the effectiveness of individual interventions.3 The 34 observational studies comprised 14 natural experiments or quasi-experiments and nine cohort, two case-control, and nine cross sectional studies—from Asia (n=11), the United States (n=9), Europe (n=7), and elsewhere (n=8). Combined, these studies suggested relative reductions in incidence of 25% (relative risk 0.75, 95% confidence interval 0.59 to 0.95) for physical distancing, 53% (0.47, 0.29 to 0.75) for mask wearing, and 53% (0.47, 0.19 to 1.12) for handwashing. The handwashing finding is somewhat surprising, and at odds with evidence that the predominant route of transmission is through inhalation rather than fomites.4
Original languageEnglish
Article numbern2729
Number of pages2
JournalBMJ (Clinical research ed.)
Publication statusPublished - 18 Nov 2021


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