Evaluating COVID-19 Public Health Measures: A Comprehensive Overview

The coronavirus disease 2019, known as COVID-19, spread around the world and was declared a public health emergency by the World Health Organization on January 30, 2020. Since then, millions of confirmed cases and deaths have occurred, leading to significant economic challenges and increased healthcare costs.

#Public Health Measures

In response to the COVID-19 pandemic, many public health measures were put in place. These measures are actions taken by individuals, communities, and governments to limit the spread of the disease. They can include simple personal actions like hand washing and wearing masks, as well as broader social steps like physical distancing, changes to schools, and business operations.

To better understand these measures and their effects, the World Health Organization started a multi-year project in 2021 to gather information and support the implementation of these measures in different contexts.

#Need for Review

With so much research being published about COVID-19, there is a need to bring together this information to help inform the public, healthcare workers, and decision-makers. Many Systematic Reviews have been conducted on this topic, but an overview of these reviews is important due to the sheer volume of studies available.

#Limitations of Current Reviews

Current overviews of systematic reviews related to public health measures for COVID-19 tend to have limitations. Some focus too narrowly on specific outcomes, such as symptoms in children, while others cast too wide a net, analyzing reviews from before the pandemic began. Additionally, none of these reviews have examined the unintended health, social, and economic consequences of these public health measures.

#Review Question

The upcoming overview aims to summarize research on two main areas:

1. The effectiveness of single and combined public health measures in reducing the spread of COVID-19.
2. The unintended positive and negative impacts of these measures on health and other areas such as social, education, and economic outcomes.

#Eligibility Criteria

#Study Designs

We will include systematic reviews that analyze primary studies of any type, including experimental, observational, and modeling studies that provide information on the effectiveness or Unintended Consequences of public health measures related to COVID-19. We will not consider abstracts, meeting papers, editorials, primary studies, or reviews without risk of bias assessments.

#Duplicate Publications

If there are duplicate publications, we will take the most recent or complete version. We will define a systematic review as one that includes an explicit search in at least two databases, a detailed description of the methods used, and a summary of the studies included.

#Population

There will be no restrictions on the population being studied, as long as the research is connected to COVID-19. Studies that do not isolate data relevant to COVID-19 will be excluded.

#Interventions

The review will focus on public health measures set in place due to COVID-19. Based on guidelines from the World Health Organization, these measures aim to reduce transmission. We will categorize the measures into seven groups:

• Surveillance: Screening, testing, contact tracing
• Response: Quarantine and isolation
• Services: School closures, business operations
• Social interactions: Physical distancing, stay-at-home orders
• Physical environment: Ventilation and cleaning
• Individual protection: Hand washing, mask use
• Movement: Travel restrictions, quarantine

We will include both single and multiple interventions in our review.

#Outcomes of Interest

We will look for systematic reviews that report on various outcomes, including:

• Transmission-related outcomes: Number of COVID-19 cases, rates of positivity, and changes in outbreak patterns.
• Health systems outcomes: Hospitalization rates, need for intensive care, and healthcare availability.
• Non-COVID-19 health outcomes: Mental health, substance use, and sleeping patterns.
• Unintended social and economic consequences: Housing issues, educational outcomes, unemployment rates, and economic growth.

Reviews that do not report clear data or examine the overall impact of COVID-19 without focusing on specific interventions will be excluded.

#Setting

We will accept studies conducted in any country or setting, such as schools, businesses, and healthcare facilities. The research must involve people, not laboratory settings.

#Publication Venue

We will not include studies published as preprints since we want to focus on higher quality reviews.

#Search Method

The main source for our search will be a living evidence repository specifically for COVID-19. The search will include keywords related to public health measures, and the strategy will be reviewed by experts in the field.

We will utilize a validated automatic classifier to identify relevant systematic reviews, and we will also check reference lists from included reviews.

#Quality Assessment

We will have two researchers independently assess the quality of the reviews using a tool designed for systematic reviews. They will evaluate how well the reviews followed proper guidelines and rate their overall confidence in the findings.

If we find reviews that have major limitations, we will consider this while determining which reviews to include.

#Data Extraction

Two researchers will extract data from included reviews using a standardized form. They will resolve any disagreements through discussion or with a third reviewer if needed. The data will include:

• Basic details about the systematic reviews, such as titles and publication dates.
• Information on the primary studies included in the reviews.
• Context details, including countries and settings.
• Information on the interventions studied.
• Reported outcomes and key findings.
• Any risk of bias assessments and certainty of evidence ratings.

We will pilot-test the data extraction form before applying it to the included reviews.

#Data Synthesis

Results will be presented in tables and summarized narratively. We will categorize outcome data based on the findings of systematic reviews and present the effects of interventions in an outcomes matrix.

We will assess whether each intervention had a positive effect, little to no effect, an uncertain effect, or a negative effect on various outcomes.

#Overlapping Reviews

We will include overlapping systematic reviews, as it is important to show the current body of evidence on this topic.

#Conclusion

The upcoming overview of systematic reviews will provide valuable insights into the effectiveness and impacts of public health measures related to COVID-19. By synthesizing the existing literature, our review aims to inform public health policies and practices, ultimately contributing to better outcomes in health and beyond in the face of the pandemic.