Despite their widespread use, relative ease of implementation, broad choice of available tools and their importance in developing countries where other measures (for example, increases in healthcare capacity, social distancing or enhanced testing) are difficult to implement 22, little is currently known about the effectiveness of different risk-communication strategies. Some studies focused on a single country or even a town 14, 15, 16, 17, 18 while other research combined data from multiple countries but pooled NPIs into rather broad categories 15, 19, 20, 21, which eventually limits the assessment of specific, potentially critical, NPIs that may be less costly and more effective than others. Additionally, modelling studies typically focus on NPIs that directly influence contact probabilities (for example, social distancing measures 18, social distancing behaviours 12, self-isolation, school closures, bans on public events 20 and so on). These categories include travel restrictions 2, 8, social distancing 9, 10, 11, 12 and personal protective measures 13.
To date, studies of the country-specific progression of the COVID-19 pandemic 7 have mostly explored the independent effects of a single category of interventions. Because many countries rolled out several NPIs simultaneously, the challenge arises of disentangling the impact of each individual intervention. Therefore, knowledge of the most effective NPIs would allow stakeholders to judiciously and timely implement a specific sequence of key interventions to combat a resurgence of COVID-19 or any other future respiratory outbreak. Government interventions may cause substantial economic and social costs 5 while affecting individuals’ behaviour, mental health and social security 6. Decisions had to be taken under rapidly changing epidemiological situations, despite (at least at the very beginning of the epidemic) a lack of scientific evidence on the individual and combined effectiveness of these measures 2, 3, 4, degree of compliance of the population and societal impact. In the absence of vaccines and antiviral medication, non-pharmaceutical interventions (NPIs) implemented in response to (emerging) epidemic respiratory viruses are the only option available to delay and moderate the spread of the virus in a population 1.Ĭonfronted with the worldwide COVID-19 epidemic, most governments have implemented bundles of highly restrictive, sometimes intrusive, NPIs. Using country-specific ‘what-if’ scenarios, we assess how the effectiveness of NPIs depends on the local context such as timing of their adoption, opening the way for forecasting the effectiveness of future interventions. Less disruptive and costly NPIs can be as effective as more intrusive, drastic, ones (for example, a national lockdown). Our results indicate that a suitable combination of NPIs is necessary to curb the spread of the virus. We validate our findings with two external datasets recording 42,151 additional NPIs from 226 countries. We propose a modelling approach that combines four computational techniques merging statistical, inference and artificial intelligence tools. Here we quantify the impact of 6,068 hierarchically coded NPIs implemented in 79 territories on the effective reproduction number, R t, of COVID-19.
Assessing the effectiveness of non-pharmaceutical interventions (NPIs) to mitigate the spread of SARS-CoV-2 is critical to inform future preparedness response plans.
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