社交疏離幹預措施可顯著降低全球covid-19的發病率

社交疏離幹預措施可顯著降低全球covid-19的發病率

作者：

小柯機器人

發布時間：2020/7/20 15:51:30

英國牛津大學Nazrul Islam團隊分析了社交疏離幹預措施與covid-19發病率的關係。2020年7月15日，該成果發表在《英國醫學雜誌》上。

為了評估全球社交疏離幹預措施與冠狀病毒病2019（covid-19）發病率之間的關聯，研究組根據歐洲疾控中心等的數據，對149個國家和地區的covid-19病例進行了一項間斷時間序列分析的自然實驗。

這些國家和地區在2020年1月1日至5月30日實施了五項社交疏離幹預措施之一，包括關閉學校、工作場所和公共運輸，限制集體聚會和公共活動以及限制行動（封城）等。對實施社交疏離幹預措施前後covid-19的發病率比率（IRR）進行隨機效應分析，使用數據截至2020年5月30日，或幹預後30天。

平均而言，任何社交疏離幹預措施的實施都會使covid-19發病率總體下降13％，IRR為0.87。當其他四項社交疏離幹預措施到位時，關閉公共運輸並不能進一步降低covid-19發病率。來自11個國家/地區的數據還表明，關閉學校、關閉工作場所以及限制群眾聚會對疫情控制的總體有效性相差不大，IRR為0.85。在幹預順序方面，與其他社交疏離幹預措施實施後延遲封城相比，更早封城使得covid-19發生率下降幅度更大。

總之，社交疏離幹預措施可顯著降低全球covid-19的發病率。當採取其他四項社交疏離措施時，關閉公共運輸不會造成其他影響。較早實施封城可大大降低covid-19的發病率。

附：英文原文

Title: Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries

Author: Nazrul Islam, Stephen J Sharp, Gerardo Chowell, Sharmin Shabnam, Ichiro Kawachi, Ben Lacey, Joseph M Massaro, Ralph B D』Agostino, Martin White

Issue&Volume: 2020/07/15

Abstract: Objective To evaluate the association between physical distancing interventions and incidence of coronavirus disease 2019 (covid-19) globally.

Design Natural experiment using interrupted time series analysis, with results synthesised using meta-analysis.

Setting 149 countries or regions, with data on daily reported cases of covid-19 from the European Centre for Disease Prevention and Control and data on the physical distancing policies from the Oxford covid-19 Government Response Tracker.

Participants Individual countries or regions that implemented one of the five physical distancing interventions (closures of schools, workplaces, and public transport, restrictions on mass gatherings and public events, and restrictions on movement (lockdowns)) between 1 January and 30 May 2020.

Main outcome measure Incidence rate ratios (IRRs) of covid-19 before and after implementation of physical distancing interventions, estimated using data to 30 May 2020 or 30 days post-intervention, whichever occurred first. IRRs were synthesised across countries using random effects meta-analysis.

Results On average, implementation of any physical distancing intervention was associated with an overall reduction in covid-19 incidence of 13% (IRR 0.87, 95% confidence interval 0.85 to 0.89; n=149 countries). Closure of public transport was not associated with any additional reduction in covid-19 incidence when the other four physical distancing interventions were in place (pooled IRR with and without public transport closure was 0.85, 0.82 to 0.88; n=72, and 0.87, 0.84 to 0.91; n=32, respectively). Data from 11 countries also suggested similar overall effectiveness (pooled IRR 0.85, 0.81 to 0.89) when school closures, workplace closures, and restrictions on mass gatherings were in place. In terms of sequence of interventions, earlier implementation of lockdown was associated with a larger reduction in covid-19 incidence (pooled IRR 0.86, 0.84 to 0.89; n=105) compared with a delayed implementation of lockdown after other physical distancing interventions were in place (pooled IRR 0.90, 0.87 to 0.94; n=41).

Conclusions Physical distancing interventions were associated with reductions in the incidence of covid-19 globally. No evidence was found of an additional effect of public transport closure when the other four physical distancing measures were in place. Earlier implementation of lockdown was associated with a larger reduction in the incidence of covid-19. These findings might support policy decisions as countries prepare to impose or lift physical distancing measures in current or future epidemic waves.

DOI: 10.1136/bmj.m2743

Source: https://www.bmj.com/content/370/bmj.m2743