Effectiveness of different types and levels of social distancing measures: a scoping review of global evidence from earlier stage of COVID-19 pandemic

Kai Sing Sun; Terence See Man Lau; Eng Kiong Yeoh; Vincent Chi Ho Chung; Yin Shan Leung; Carrie Ho Kwan Yam; Chi Tim Hung

doi:10.1136/bmjopen-2021-053938

Effectiveness of different types and levels of social distancing measures: a scoping review of global evidence from earlier stage of COVID-19 pandemic

BMJ Open. 2022 Apr 11;12(4):e053938. doi: 10.1136/bmjopen-2021-053938.

Authors

Kai Sing Sun¹, Terence See Man Lau¹, Eng Kiong Yeoh², Vincent Chi Ho Chung¹, Yin Shan Leung¹, Carrie Ho Kwan Yam¹, Chi Tim Hung¹

Affiliations

¹ Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
² Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China yeoh_ek@cuhk.edu.hk.

Abstract

Objective: Social distancing is one of the main non-pharmaceutical interventions used in the control of the COVID-19 pandemic. This scoping review aims to synthesise research findings on the effectiveness of different types and levels of social distancing measures in the earlier stage of COVID-19 pandemic without the confounding effect of mass vaccination.

Design: Scoping review.

Data sources: MEDLINE, Embase, Global Health and four other databases were searched for eligible studies on social distancing for COVID-19 published from inception of the databases to 30 September 2020.

Study selection and data extraction: Effectiveness studies on social distancing between individuals, school closures, workplace/business closures, public transport restrictions and partial/full lockdown were included. Non-English articles, studies in healthcare settings or not based on empirical data were excluded.

Results: After screening 1638 abstracts and 8 additional articles from other sources, 41 studies were included for synthesis of findings. The review found that the outcomes of social distancing measures were mainly indicated by changes in R_t , incidence and mortality, along with indirect indicators such as daily contact frequency and travel distance. There was adequate empirical evidence for the effect of social distancing at the individual level, and for partial or full lockdown at the community level. However, at the level of social settings, the evidence was moderate for school closure, and was limited for workplace/business closures as single targeted interventions. There was no evidence for a separate effect of public transport restriction.

Conclusions: In the community setting, there was stronger evidence for the combined effect of different social distancing interventions than for a single intervention. As fatigue of preventive behaviours is an issue in public health agenda, future studies should analyse the risks in specific settings such as eateries and entertainment to implement and evaluate measures which are proportionate to the risk.

Keywords: COVID-19; EPIDEMIOLOGY; Infection control; Public health.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
COVID-19* / prevention & control
Communicable Disease Control
Humans
Pandemics / prevention & control
Physical Distancing
Quarantine
SARS-CoV-2