Revisiting COVID-19 policies: 10 evidence-based recommendations for where to go from here.

COVID-19 Evidence-based recommendations Harm reduction Outdoor transmission Pandemic Pandemic preparedness Policy Public health SARS-CoV-2 School closure Vaccines

Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
13 11 2021
Historique:
received: 28 06 2021
accepted: 22 10 2021
entrez: 14 11 2021
pubmed: 15 11 2021
medline: 18 11 2021
Statut: epublish

Résumé

Strategies to control coronavirus 2019 disease (COVID-19) have often been based on preliminary and limited data and have tended to be slow to evolve as new evidence emerges. Yet knowledge about COVID-19 has grown exponentially, and the expanding rollout of vaccines presents further opportunity to reassess the response to the pandemic more broadly. We review the latest evidence concerning 10 key COVID-19 policy and strategic areas, specifically addressing: 1) the expansion of equitable vaccine distribution, 2) the need to ease restrictions as hospitalization and mortality rates eventually fall, 3) the advantages of emphasizing educational and harm reduction approaches over coercive and punitive measures, 4) the need to encourage outdoor activities, 5) the imperative to reopen schools, 6) the far-reaching and long-term economic and psychosocial consequences of sustained lockdowns, 7) the excessive focus on surface disinfection and other ineffective measures, 8) the importance of reassessing testing policies and practices, 9) the need for increasing access to outpatient therapies and prophylactics, and 10) the necessity to better prepare for future pandemics. While remarkably effective vaccines have engendered great hope, some widely held assumptions underlying current policy approaches call for an evidence-based reassessment. COVID-19 will require ongoing mitigation for the foreseeable future as it transforms from a pandemic into an endemic infection, but maintaining a constant state of emergency is not viable. A more realistic public health approach is to adjust current mitigation goals to be more data-driven and to minimize unintended harms associated with unfocused or ineffective control efforts. Based on the latest evidence, we therefore present recommendations for refining 10 key policy areas, and for applying lessons learned from COVID-19 to prevent and prepare for future pandemics.

Sections du résumé

BACKGROUND
Strategies to control coronavirus 2019 disease (COVID-19) have often been based on preliminary and limited data and have tended to be slow to evolve as new evidence emerges. Yet knowledge about COVID-19 has grown exponentially, and the expanding rollout of vaccines presents further opportunity to reassess the response to the pandemic more broadly.
MAIN TEXT
We review the latest evidence concerning 10 key COVID-19 policy and strategic areas, specifically addressing: 1) the expansion of equitable vaccine distribution, 2) the need to ease restrictions as hospitalization and mortality rates eventually fall, 3) the advantages of emphasizing educational and harm reduction approaches over coercive and punitive measures, 4) the need to encourage outdoor activities, 5) the imperative to reopen schools, 6) the far-reaching and long-term economic and psychosocial consequences of sustained lockdowns, 7) the excessive focus on surface disinfection and other ineffective measures, 8) the importance of reassessing testing policies and practices, 9) the need for increasing access to outpatient therapies and prophylactics, and 10) the necessity to better prepare for future pandemics.
CONCLUSIONS
While remarkably effective vaccines have engendered great hope, some widely held assumptions underlying current policy approaches call for an evidence-based reassessment. COVID-19 will require ongoing mitigation for the foreseeable future as it transforms from a pandemic into an endemic infection, but maintaining a constant state of emergency is not viable. A more realistic public health approach is to adjust current mitigation goals to be more data-driven and to minimize unintended harms associated with unfocused or ineffective control efforts. Based on the latest evidence, we therefore present recommendations for refining 10 key policy areas, and for applying lessons learned from COVID-19 to prevent and prepare for future pandemics.

Identifiants

pubmed: 34774012
doi: 10.1186/s12889-021-12082-z
pii: 10.1186/s12889-021-12082-z
pmc: PMC8590121
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

2084

Informations de copyright

© 2021. The Author(s).

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Auteurs

Daniel T Halperin (DT)

Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.

Norman Hearst (N)

Department of Family and Community Medicine, School of Medicine, University of California, San Francisco, CA, USA.

Stephen Hodgins (S)

School of Public Health, University of Alberta, Edmonton, AB, Canada.

Robert C Bailey (RC)

School of Public Health, University of Illinois, Chicago, IL, USA.

Jeffrey D Klausner (JD)

Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

Helen Jackson (H)

Independent Consultant, Harare, Zimbabwe.

Richard G Wamai (RG)

Integrated Initiative for Global Health, Northeastern University, Boston, MA, USA.
School of Public Health, University of Nairobi, Nairobi, Kenya.

Joseph A Ladapo (JA)

Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Mead Over (M)

Center for Global Development, Washington, D.C, USA.

Stefan Baral (S)

Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA.

Kevin Escandón (K)

School of Medicine, Universidad del Valle, Cali, Colombia. kevin.escandonvargas@gmail.com.
Department of Microbiology, Universidad del Valle, Grupo de Investigación en Virus Emergentes VIREM, Cali, Colombia. kevin.escandonvargas@gmail.com.

Monica Gandhi (M)

Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA.

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