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Place of distancing measures in containing epidemics: a scoping review
Dhekra Chebil1,2,3, Donia Ben Hassine2,4, Sarra Melki2,4
1Infection Prevention Control Department, Ibn Al Jazzar University Hospital, Kairouan, Tunisia.
The Libyan Journal of Medicine
|November 3, 2022
Summary
Implementing combined distancing measures early, like quarantine and school closures, effectively mitigates epidemics by reducing transmission rates. However, these public health interventions can cause adverse psychological and economic effects.
Area of Science:
- Public Health
- Epidemiology
- Health Policy
Background:
- Distancing measures are critical for mitigating epidemics.
- Understanding the typology, effectiveness, and side effects of these measures is essential for public health preparedness.
- Previous epidemics like the 2009 influenza A and the ongoing SARS-CoV-2 pandemic highlight the importance of distancing strategies.
Purpose of the Study:
- To investigate the typology, effectiveness, and side effects of distancing rules during epidemics.
- To provide evidence-based insights for developing future epidemic response plans.
Main Methods:
- A scoping review was conducted using electronic searches of MEDLINE and PubMed.
- Keywords included "social isolation," "social distancing," "quarantine," and "epidemics."
- The PRISMA-ScR statement guided the reporting of the review, including 93 studies from an initial 314 titles.
Main Results:
- Distancing measures were categorized into case-based and community-based interventions.
- Combined measures (school closure, home working, isolation, quarantine) effectively reduced the basic reproduction number (R 0 ) and flattened epidemic curves.
- Early and high-rate implementation of combined interventions, alongside other non-pharmaceutical measures, demonstrated greater effectiveness.
- Isolation and quarantine were effective in reducing the attack rate during the 2009 Influenza pandemic but posed a risk of household transmission.
- Lockdowns in the COVID-19 pandemic significantly reduced R 0 and increased doubling time.
- School closure and workplace distancing showed moderate effectiveness as single interventions.
- Adverse effects included psychological disorders, unhealthy behaviors, economic disruption, social discrimination, and stigmatization.
Conclusions:
- Combined distancing measures, when implemented early and comprehensively, are effective in controlling epidemic outbreaks.
- The judicious application of these measures is crucial to maximize benefits and minimize adverse community effects.
- Evidence-based strategies are vital for informing decision-makers and strengthening national capacities for future epidemic preparedness.
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