Narrative review of non-pharmaceutical behavioural measures for the prevention of COVID-19 (SARS-CoV-2) based on the Health-EDRM framework

  1. Emily Ying Yang Chan
  2. Tayyab Salim Shahzada
  3. Tiffany Sze Tung Sham
  4. Caroline Dubois
  5. Zhe Huang
  6. Sida Liu
  7. Janice Ying-en Ho
  8. Kevin K C Hung
  9. Kin On Kwok
  10. Rajib Shaw

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Abstract

Introduction

Non-pharmaceutical measures to facilitate a response to the COVID-19 pandemic, a disease caused by novel coronavirus SARS-CoV-2, are urgently needed. Using the World Health Organization (WHO) health emergency and disaster risk management (health-EDRM) framework, behavioural measures for droplet-borne communicable diseases and their enabling and limiting factors at various implementation levels were evaluated.

Sources of data

Keyword search was conducted in PubMed, Google Scholar, Embase, Medline, Science Direct, WHO and CDC online publication databases. Using the Oxford Centre for Evidence-Based Medicine review criteria, 10 bottom-up, non-pharmaceutical prevention measures from 104 English-language articles, which published between January 2000 and May 2020, were identified and examined.

Areas of agreement

Evidence-guided behavioural measures against transmission of COVID-19 in global at-risk communities were identified, including regular handwashing, wearing face masks and avoiding crowds and gatherings.

Areas of concern

Strong evidence-based systematic behavioural studies for COVID-19 prevention are lacking.

Growing points

Very limited research publications are available for non-pharmaceutical measures to facilitate pandemic response.

Areas timely for research

Research with strong implementation feasibility that targets resource-poor settings with low baseline health-EDRM capacity is urgently needed.

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  1. ScreenIT

    SciScore for 10.1101/2020.05.29.20116475: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Research databases examined in this study included PubMed, Google Scholar, Embase, Medline and Science Direct.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Google Scholar
    suggested: (Google Scholar, RRID:SCR_008878)
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    Medline
    suggested: (MEDLINE, RRID:SCR_002185)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Meanwhile, for measures that have no direct alternatives available, it is important for authorities and policymakers to understand the capacity limitations of certain target groups, and provide additional support or put in place other preventive measures. In cases where material resources are scarce, the measures of awareness on sneezing and coughing etiquette as well as avoiding hand-to-face contact are the most convenient to adopt as they require little to no commodities. However, it should be well-noted that these measures are likely the most challenging in compliance and enforceability, as they rely on the modification of frequent and natural human behaviours whose modifications would require awareness and practice45,46. Furthermore, these can be challenging to implement in target groups with less capacity for health literacy and translation of education into practice, such as infants and elderly suffering from dementia. Cultural patterns can be associated with behavioural intentions, in the case of avoiding utensil-sharing during meals, enforcing change may be conflicted with cultural and traditional norms in Asia and certain European communities124. Of the enabling factors documented for each proposed measure, shared enablers can be identified: accessibility and affordability of resources; related knowledge, awareness and understanding of risk; and associated top-down policy facilitation. Majority of personal and household practices heavily rely on access to resources, ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1093/bmb/ldaa030
  3. Version published to 10.1101/2020.05.29.20116475v1 on medRxiv