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Nonpharmaceutical interventions reduce the incidence and mortality of COVID-19: A study based on the survey from the International COVID-19 Research Network (ICRN)

. 2023 Feb ; 95 (2) : e28354.

Language English Country United States Media print

Document type Journal Article

The recently emerged novel coronavirus, "severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)," caused a highly contagious disease called coronavirus disease 2019 (COVID-19). It has severely damaged the world's most developed countries and has turned into a major threat for low- and middle-income countries. Since its emergence in late 2019, medical interventions have been substantial, and most countries relied on public health measures collectively known as nonpharmaceutical interventions (NPIs). We aimed to centralize the accumulative knowledge of NPIs against COVID-19 for each country under one worldwide consortium. International COVID-19 Research Network collaborators developed a cross-sectional online survey to assess the implications of NPIs and sanitary supply on the incidence and mortality of COVID-19. The survey was conducted between January 1 and February 1, 2021, and participants from 92 countries/territories completed it. The association between NPIs, sanitation supplies, and incidence and mortality were examined by multivariate regression, with the log-transformed value of population as an offset value. The majority of countries/territories applied several preventive strategies, including social distancing (100.0%), quarantine (100.0%), isolation (98.9%), and school closure (97.8%). Individual-level preventive measures such as personal hygiene (100.0%) and wearing facial masks (94.6% at hospitals; 93.5% at mass transportation; 91.3% in mass gathering facilities) were also frequently applied. Quarantine at a designated place was negatively associated with incidence and mortality compared to home quarantine. Isolation at a designated place was also associated with reduced mortality compared to home isolation. Recommendations to use sanitizer for personal hygiene reduced incidence compared to the recommendation to use soap. Deprivation of masks was associated with increased incidence. Higher incidence and mortality were found in countries/territories with higher economic levels. Mask deprivation was pervasive regardless of economic level. NPIs against COVID-19 such as using sanitizer, quarantine, and isolation can decrease the incidence and mortality of COVID-19.

1st Department of Internal Medicine Medical University Varna Varna Bulgaria

3rd Department of Surgery 1st Medical Faculty of Charles University Motol University Hospital Prague Czech Republic

Academy of Medical Science of Bosnia and Herzegovina Sarajevo Bosnia and Herzegovina

Afghanistan National Public Health Institute Kabul Afghanistan

American University of Beirut Beirut Lebanon

Asfendiyarov Kazakh National Medical University Almaty Kazakhstan

Burjeel Cancer Institute Burjeel Medical City Abu Dhabi United Arab Emirates

Cardiology Division Clínica Olivos Buenos Aires Argentina

Center for Digital Health Medical Science Research Institute Kyung Hee University Medical Center Kyung Hee University College of Medicine Seoul Republic of Korea

Centre for Health Performance and Wellbeing Anglia Ruskin University Cambridge United Kingdom

Chair of Propedeutics of Surgical Diseases

Clinical Centre of Montenegro Podgorica Montenegro

Clinical Hospital Centre Split University Department of Health Studies University of Split Croatia

Clinical Trials New Zealand Waikato Hospital Campus Hamilton New Zealand

College of Medicine and Allied Health Sciences University of Sierra Leone Freetown Sierra Leone

Department of Anesthesia and Intensive Care Zealand University Hospital Roskilde Roskilde Denmark

Department of Anesthesiology Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam Netherlands

Department of Anesthesiology Intensive Therapy and Acute Intoxications Pomeranian Medical University in Szczecin Szczecin Poland

Department of Basic Sciences University of Kinshasa Faculty of Medicine Laboratory of Physiology Kinshasa Democratic Republic of the Congo

Department of Cancer Epidemiology and Prevention Research Cancer Care Alberta Alberta Health Services School of Medicine University of Calgary Calgary Canada

Department of Child and Adolescent Psychiatry Charité Universitätsmedizin Berlin Germany

Department of Clinical Medicine Centre for Tropical Medicine and Global Health Nuffield University of Oxford Oxford United Kingdom

Department of Community Health Faculty of Medicine Al Quds University East Jerusalem Palestine

Department of Community Medicine University College Hospital Ibadan Nigeria

Department of Dermatology and Allergology Städtisches Klinikum Dresden Academic Teaching Hospital Dresden Germany

Department of Emergency Medicine Hippokration Hospital Athens Greece

Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland United States of America

Department of Family Medicine and Public Health University of Botswana Faculty of Medicine Gaborone Botswana

Department of Gynecologic Surgery and Oncology Carmel Medical Center Haifa Israel

Department of Head and Neck and Thoracic Cancers Division of Radiation Oncology National Cancer Centre Singapore Singapore Singapore

Department of Health Behavior and Society Jimma University Jimma Ethiopia

Department of Health Medicine and Caring Sciences Pain and Rehabilitation Centre Linköping University Linköping Sweden

Department of Infectious Diseases Mongolian National University of Medical Sciences Ulaanbaatar Mongolia

Department of Medicine University of Cyprus Medical School Nicosia Cyprus

Department of Mental Health Ontario Canada

Department of Microbiology Universitas Syiah Kuala Banda Aceh Indonesia

Department of Nephrology Yonsei University Wonju College of Medicine Wonju si Gangwon do Republic of Korea

Department of Nutrition Exercise and Sports University of Copenhagen Copenhagen Denmark

Department of Pathology University of Lomé Lome Togo

Department of Pediatrics Immunology Infectious and Rare Diseases International European University Kyiv Ukraine

Department of Pediatrics Jessenius Faculty of Medicine in Martin University Teaching Hospital in Martin Comenius University in Bratislava Bratislava Slovakia

Department of Pediatrics Yonsei University College of Medicine Seoul Republic of Korea

Department of Precision Medicine Sungkyunkwan University School of Medicine Suwon Republic of Korea

Department of Preventive Medicine and Public Health Tokyo Medical University Tokyo Japan

Department of Preventive Medicine Yonsei University College of Medicine Seoul Republic of Korea

Department of Psychiatry University of Ottawa Ontario Canada

Department of Psychiatry Yonsei University Wonju College of Medicine Wonju si Gangwon do Republic of Korea

Department of Public Health Faculty of Medicine University of Medicine of Tirana Albania

Department of Public Health Jordan University of Science and Technology Irbid Jordan

Department of Public Health Yonsei University Seoul Republic of Korea

Departments of Laboratory Medicine and Internal Medicine China Medical University Hospital China Medical University Taichung Taiwan

Director Research and Innovation Center King Saud Medical City Ministry of Health and College of Medicine Alfaisal University Riyadh Saudi Arabia

Division of Medical Sciences National Cancer Centre Singapore Singapore Singapore

European Centre for Disaster Medicine Council of Europe Strasbourg France

Faculty of Health Sciences University of Macau Macau China

Faculty of Medical Sciences University of Kragujevac Kragujevac Serbia

Faculty of Medicine Kuwait University Jabriya Kuwait

Faculty of Medicine University of Versailles Saint Quentin en Yvelines Montigny le Bretonneux France

Faculty of Social Sciences Tampere University Tampere Finland

Family Medicine Global and Public Health Unit University of Zimbabwe Faculty of Medicine and Health Sciences Harare Zimbabwe

General Directorate of Public Health Ministry of Health of Turkey Adnan Saygun St Çankaya Ankara Turkey

Geriatrics and Long Term Care Department Rumailah Hospital Doha Qatar

Gilbert and Rose Marie Chagoury School of Medicine Lebanese American University Beirut Lebanon

Grupo de Investigación Biomedicina Faculty of Medicine Fundación Universitaria Autónoma de las Americas Institución Universitaria Visión de las Américas Pereira Colombia

IFORD University of Yaoundé 2 Yaoundé Cameroon

Instituto Nacional da Propriedade Industrial Rio de Janeiro Rio de Janeiro Brazil

Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran Instituto Nacional de Cancerologia Mexico City Mexico

John F Kennedy Medical Center Edison New Jersey United States of America

Kokilaben Dhirubhai Ambani Hospital and Research Institute Mumbai India

Laboratory of Microorganisms and Actives Biomolecules Faculty of Sciences of Tunis University Tunis El Manar Tunis Tunisia

Master of Clinical Epidemiology and Biostatistics Universidad Cientifica del Sur Lima Peru

Medical Research Foundation of Trinidad and Tobago Port of Spain Trinidad and Tobago

Molecular Biology Laboratory Research Institute for Tropical Medicine Muntinlupa City Philippines

Mongolian National University of Medical Sciences Ulaanbaatar Mongolia

MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine Fajara Gambia

National Institute of Health Islamabad Pakistan

National Institute of Neurology

National Institute of Public Health Maribor Slovenia

National Public Health Institute of Cape Verde Praia Santiago Island Cape Verde

National University of Asunción School of Medical Sciences San Lorenzo Paraguay

National University of Ireland Galway Republic of Ireland

Oncology Academic Programme Duke NUS Medical School Singapore Singapore

Ottawa Hospital Research Institute Clinical Epidemiology Program University of Ottawa Ottawa Ontario Canada

Parc Sanitari Sant Joan de Deu ICREA CIBERSAM ISCIII Barcelona Spain

Pediatrics and Pediatric Nephrology Department Faculty of Medicine Ain Shams University Cairo Egypt

Postgraduate Institute of Medicine University of Colombo Colombo Sri Lanka

Public Health Unit School of Medicine and Health Sciences Central University Accra Ghana

Research and Development Unit Parc Sanitari Sant Joan de Déu CIBERSAM ISCIII Dr Antoni Pujadas Barcelona Spain

Respiratory and Critical Care Unit IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy

RIMU Research Institute of Medical University Plovdiv Bulgaria

Royal College of Surgeons in Ireland Bahrain Al Sayh Bahrain

Saw Swee Hock School of Public Health National University of Singapore Singapore Singapore

School of Global Health and Department of Preventive and Social Medicine Faculty of Medicine Chulalongkorn University Bangkok Thailand

School of Health and Wellbeing University of Glasgow Glasgow United Kingdom

School of Health Sciences The University of Georgia Georgia

School of Medicine The Maldives National University Male Maldives

School of Medicine University of Juba Juba South Sudan

Sechenov 1st Moscow State Medical University Moscow Russia

St Parascheva Infectious Disease Hospital Iasi Romania

The Chinese University of Hong Kong Hong Kong SAR China

Tribhuvan University Teaching Hospital Institute of Medicine Kathmandu Nepal

Tropical Cardiology Central University of Venezuela Caracas Venezuela

Tuberculosis Research and Prevention Center Yerevan Armenia

Universidad Cientifica del Sur Lima Peru

University Hospital St George Plovdiv Bulgaria

University of Coimbra Coimbra Portugal

University of Nouakchott Al Aasriya and The Mauritanian Association for Scientific Research Development Nouakchott Mauritania

University of Southern California Los Angeles California United States of America

University of Sulaimani College of Medicine Sulaymaniyah Iraq

Urology Institute University Hospitals Case Western Reserve University Cleveland Ohio United States of America

Yemen Field Epidemiology Training Program Yemen

Yonsei University College of Medicine Seoul Republic of Korea

Zambia National Public Health Institute Lusaka Zambia

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