Isolation and quarantine to prevent transmission of infectious diseases (multiple reviews)

Added November 23, 2020

What is this? Isolation and quarantine are among the non-pharmaceutical interventions being used to minimise transmission of COVID-19. Several reviews are summarised here, with more details, including citations and links to the full reviews, available further down this page.

What was found: The Jefferson review (search done in October 2010) found that isolation of patients in hospital wards or at home can be effective in reducing the spread of respiratory viruses and the Baharoon review (search done before October 2019) found that early identification and isolation of MERS patients may have prevented transmission in healthcare facilities and in the community. However, the Teasdale review (search done in February 2013) found that people were ambivalent about adopting isolation in some contexts, because of its perceived adverse impact and potential social stigma.

At the time of their rapid review, the modelling studies included by Nussbaumer-Streit et al. (search done on 23 June 2020) consistently reported a benefit of simulated quarantine measures for reducing transmission of coronaviruses. They concluded that early implementation of quarantine and combining it with other public health measures is important for its effectiveness.

At the time of their rapid review, the studies included by Webster et al. (search done on 30 January 2020) showed that the main influencers of adherence to quarantine were a person’s knowledge about the disease and quarantine procedure, social norms, perceived benefits of quarantine and perceived risk of the disease, and practical issues (such as running out of supplies or the financial consequences of being out of work).

The Fong review (search done in November 2018) found limited evidence that measures such as isolating ill individuals and quarantining of exposed individuals were effective interventions to reduce transmission in influenza pandemics.

What are the reviews:

Citation: Baharoon S, Memish ZA. MERS-CoV as an emerging respiratory illness: a review of prevention methods. Travel Medicine and Infectious Disease. 2019;32:101520.

In this narrative review, the authors searched for studies of prevention or infection control measures for MERS-CoV. The review was submitted for publication in October 2019 but it is unclear when the authors did their search, whether they restricted it in any way or how many studies they included.

Citation: Fong MW, Gao H, Wong JY, et al. Nonpharmaceutical measures for pandemic influenza in non-healthcare settings: social distancing measures. Emerging Infectious Diseases. 2020 May;26(5):976.

In this series of systematic reviews, the authors searched for studies of the effects of social distancing measures for pandemic influenza, and covered six measures: isolating ill individuals, contact tracing, quarantining exposed individuals, school measures or closures, workplace measures or closures, and crowd avoidance, with multiple search periods documented up to November 2018. They included 107 epidemiological studies, 37 simulation studies, 12 observational studies, and one interventional study; and also analyzed archival data from the 1918 influenza pandemic.

Citation: Jefferson T, Del Mar CB, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database of Systematic Reviews. 2011;(7):CD006207.

In this Cochrane review, the authors searched for randomized trials and observational studies of physical interventions that might prevent respiratory virus transmission. They did not restrict by language of publication and did their searches in October 2010. They identified 67 eligible studies, spread across many different interventions.

Citation: Nussbaumer-Streit B, Mayr V, Dobrescu AI, et al. Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review. Cochrane Database of Systematic Reviews. 2020;(4):CD013574.

In this Cochrane Rapid Review, the authors searched for research into the effects of quarantine (alone or in combination with other measures) of individuals who had contact with confirmed cases of COVID‐19, who had travelled from countries with a declared outbreak, or who lived in regions with high transmission of the disease. They also looked for studies of SARS and MERS. They did their most recent search on 23 June 2020. They included 4 observational studies and 28 modelling studies on COVID‐19, and 4 observational studies and 15 modelling studies on SARS and MERS. A podcast is available here.

Citation: Teasdale E, Santer M, Geraghty AWA, et al. Public perceptions of non-pharmaceutical interventions for reducing transmission of respiratory infection: systematic review and synthesis of qualitative studies. BMC Public Health. 2014;14:589.

In this systematic review, the authors searched for qualitative research on public perceptions of physical interventions for reducing transmission of respiratory infection. They did not restrict their searches by date or language of publication and did the search in February 2013. They included 16 studies (total: 1022 participants).

Citation: Webster RK, Brooks SK, Smith LE, et al. How to improve adherence with quarantine: Rapid review of the evidence. Public Health. 2020;182:163-9.

In this rapid review, the authors searched for research assessing factors that influence people’s adherence to quarantine. They restricted their searches to articles published in English, Italian and French, and did the search on 30 January 2020. They included 14 studies and identified 9 factors associated with adherence to quarantine.

Other reviews of this topic:

Citation: Saunders-Hastings P, Reisman J, Krewski D. Assessing the state of knowledge regarding the effectiveness of interventions to contain pandemic influenza transmission: a systematic review and narrative synthesis. PLOS ONE. 2016;11(12):e0168262

 

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