Physical interventions to prevent the spread of respiratory viruses

Added March 16, 2020

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.

What is this? The arrival of a new respiratory virus, such as COVID-19, is followed by a lead-time for the development of vaccines and treatments, and these may have a limited effect in containing or interrupting spread of the virus. Therefore, physical interventions that might interrupt or reduce its spread are particularly important.

In this Cochrane systematic review, the authors searched for research (randomized trials and observational studies) into 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.

What works: Frequent handwashing reduces the spread of respiratory viruses. Normal handwashing with soap appears to be as effective as virucidals or antiseptics. Containment of transmission by isolation in hospital wards or at home can be instituted rapidly and be effective in reducing the spread of respiratory virus epidemics. Containment of transmission by wearing masks, gloves and gowns can be instituted rapidly and be effective in reducing the spread of respiratory virus epidemics.

 What doesn’t work: Nothing noted.

What’s uncertain: There is little evidence to support the benefit of N95 respirators over simple surgical masks. There is insufficient evidence to support routine screening at entry ports or social distancing (spatial separation of at least one metre between those infected and those non-infected) as methods to reduce virus spread during epidemics.


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