Effectiveness of non-pharmaceutical interventions as implemented in the UK during the COVID-19 pandemic: a rapid review
Ashcroft T., Mcswiggan E., Agyei-Manu E., Nundy M., Atkins N., Kirkwood JR., Ben Salem Machiri M., Vardhan V., Lee B., Kubat E., Ravishankar S., Krishan P., De Silva U., Iyahen EO., Rostron J., Zawiejska A., Ogarrio K., Harikar M., Chishty S., Mureyi D., Evans B., Duval D., Carville S., Brini S., Hill J., Qureshi M., Simmons Z., Lyell I., Kavoi T., Dozier M., Curry G., Ordóñez-Mena JM., De Lusignan S., Sheikh A., Theodoratou E., McQuillan R.
Background: Although non-pharmaceutical inventions (NPIs) were used globally to control the spread of COVID-19, their effectiveness remains uncertain. We aimed to assess the evidence on NPIs as implemented in the UK, to allow public health bodies to prepare for future pandemics. Methods: We used rapid systematic methods (search date: January 2024) to identify, critically appraise and synthesize interventional, observational and modelling studies reporting on NPI effectiveness in the UK. Results: Eighty-five modelling, nine observational and three interventional studies were included. Modelling studies had multiple quality issues; six of the 12 non-modelling studies were high quality. The best available evidence was for test and release strategies for case contacts (moderate certainty), which was suggestive of a protective effect. Although evidence for school-related NPIs and universal lockdown was also suggestive of a protective effect, this evidence was considered low certainty. Evidence certainty for the remaining NPIs was very low or inconclusive. Conclusion: The validity and reliability of evidence on the effectiveness of NPIs as implemented in the UK during the COVID-19 pandemic is weak. To improve evidence generation and support decision-making during future pandemics or other public health emergencies, it is essential to build evaluation into the design of public health interventions.