Behavioural Measures Controlling Covid

--- title: Behavioural Measures Controlling Covid tags: live-v0.1, behaviour, policy, social norms permalink: https://c19vax.scibeh.org/pages/c19behaviour ---  {%hackmd GHtBRFZdTV-X1g8ex-NMQg %} # The success of behavioural measures in controlling COVID-19 :::success Would you like to find out more about the success of behavioral measures in controlling COVID-19? We created a search query specifically for this page, which links you to other interesting resources like Twitter threads, blogposts, websites, videos and more. Check out the search query that we generated specifically for this page [here](https://hypothes.is/groups/Jk8bYJdN/behsci?q=contact+tracing+spread). Would you like to know more about how we generated the search queries and how our underlying knowledge base works? Click [here](https://hackmd.io/B3R70tuNTiGy6wi9HObuSQ) to learn more. ::: ## The scientific consensus and behavioral measures In the face of a lack of effective treatments for COVID-19, until vaccination has achieved herd immunity, the only effective measures to control the pandemic are mainly behavioral: mask-wearing, physical distancing, hand hygiene, accompanied by testing and tracing. These behavioral measures have controlled the spread of the virus and in some cases even eliminated the virus from a country. For example, in New Zealand the government decided early on to eliminate the virus and implemented a strict nationwide lockdown on 26 March 2020. In early May, the last known case was identified, which marked the end of known community spread. On 8 June 2020, the New Zealand government effectively declared the pandemic over, 103 days after the first identified case ([Baker et al., 2020](https://dx.doi.org/10.1056/nejmc2025203)). Although there was a subsequent outbreak in August 2020, that too was [brought under control](https://www.nytimes.com/2020/10/07/world/australia/new-zealand-coronavirus.html) by October 2020. There is a [scientific consensus](https://www.johnsnowmemo.com/) that behavioral measures are a necessary component of any strategy to control the pandemic until the vaccine has become widely administered ([Alwan et al., 2020](https://dx.doi.org/10.1016/S0140-6736(20)32153-X)). Because a large proportion of people who catch COVID-19 would need intensive hospital care, [a natural, extreme herd immunity approach would be overwhelming for hospitals](https://www.theguardian.com/world/2021/may/28/a-look-at-prof-gowers-herd-immunity-document-sent-to-dominic-cummings). It is thus most reasonable to apply social distancing measures to control the spread and help healthcare systems cope.  ---- ## Vaccines and other health protective measures Despite vaccines being rolled out now, health-protective behaviors remain critical for the foreseeable future. Even though the available COVID-19 vaccines are highly effective, the intensity of the pandemic and development of new viral strains means that it will take months before the impact of the vaccine fully kicks in [(Paltiel et al., 2020](https://dx.doi.org/10.1377/hlthaff.2020.02054)). Promisingly, a [recent pre-print](https://www.medrxiv.org/content/10.1101/2021.03.19.21253963v1) (not yet peer-reviewed) found that people's intentions to engage in protective behavioral measures does not decrease post-vaccination. Another [recent preprint](https://www.medrxiv.org/content/10.1101/2021.01.09.21249480v1.article-info) suggests very strongly that a fast re-opening from lock-down, acompanied by a slow vaccination rate, can nullify the effects of vaccination on deaths. In other words, to make sure that we reduce the number of deaths, vaccinations must be accompanied by continued social distancing and only a slow relaxation of restrictions. [Rader et al (2021)](https://www.thelancet.com/journals/landig/article/PIIS2589-7500(20)30293-4/fulltext) found that self-reported mask wearing---over and above government mandates---was significantly associated with better transmission control. It is important to remember we can all continue to keep each other safe by wearing a mask as the government begins to cease mandates for their use. **So keep your mask on, practice hand hygiene, and maintain physical distance to stay safe.** ## Details of effectiveness of behavioral measures The effectiveness of behavioral measures to control the pandemic was examined in a large study by [Haug et al. (2020)](https://dx.doi.org/10.1038/s41562-020-01009-0). The researchers considered more than 30,000 interventions (e.g., laws to enforce social distancing or other policy measures) in nearly 250 countries and jurisdictions. Their main results are shown in the figure below. ![](https://i.imgur.com/jToLDLh.png) In the figure, the effects of various interventions on the change in "reproductive number" (_R_) are rank-ordered from most effective to least effective (top to bottom). The reproductive number is a crucial indicator of the spread of a pandemic: a value >1 implies that the virus is increasing its spread whereas a value <1 implies that the pandemic has been brought under control and the spread is decelerating. Thus, the more successful a measure is in the figure above, the more it will be to the left of 0, implying that it successfully reduced the value of _R_. The largest impacts on _R_ resulting from strictly behavioral measures were found to be: * small gathering cancellations (reduction in _R_ between −0.22 and –0.35) * closure of educational institutions (reduction in _R_ between −0.15 to −0.21) * border restrictions (−0.057 to –0.23). * individual movement restrictions (−0.08 to −0.13) * national lockdowns (−0.008 to −0.14) * wearing masks (−0.018 to –0.12; not shown in the figure) ---- Page contributors: Stephan Lewandowsky {%hackmd GHtBRFZdTV-X1g8ex-NMQg %} {%hackmd TLvrFXK3QuCTATgnMJ2rng %} {%hackmd oTcI4lFnS12N2biKAaBP6w %}