{"id":2298,"date":"2022-03-25T11:47:38","date_gmt":"2022-03-25T11:47:38","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/?p=2298"},"modified":"2023-06-08T14:35:23","modified_gmt":"2023-06-08T14:35:23","slug":"why-we-urgently-need-a-long-term-research-agenda-on-non-pharmaceutical-interventions-to-guide-policies-and-practices-in-the-current-and-future-public-health-emergencies","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2022\/03\/25\/why-we-urgently-need-a-long-term-research-agenda-on-non-pharmaceutical-interventions-to-guide-policies-and-practices-in-the-current-and-future-public-health-emergencies\/","title":{"rendered":"Why we urgently need a long-term research agenda on non-pharmaceutical interventions to guide policies and practices in the current and future public health emergencies"},"content":{"rendered":"<p><span style=\"font-weight: 400\">Blog entry written on:<\/span> <a href=\"https:\/\/ebm.bmj.com\/content\/early\/2022\/01\/31\/bmjebm-2021-111825\"><em>Randomized trials on non-pharmaceutical interventions for COVID-19: a scoping review<\/em><\/a><span style=\"font-weight: 400\">, <\/span><span style=\"font-weight: 400\">(bmjebm-2021-111825)<\/span><\/p>\n<p><em>Authors: Julian Hirt, Perrine Janiaud, Lars G. Hemkens<\/em><\/p>\n<hr \/>\n<p><span style=\"font-weight: 400\">Drastic measures such as quarantine, school and workplace closures, curfews, travel restrictions, and mandatory diagnostic testing interventions have been taken worldwide to prevent the spread of COVID-19. Some of these measures, so-called non-pharmaceutical interventions (NPI) are still ongoing and impacting millions of people around the globe. A review conducted by our team of the <\/span><a href=\"https:\/\/f1000research.com\/articles\/9-1193\/v2\"><span style=\"font-weight: 400\">first 100-days COVID-19 clinical research agenda<\/span><\/a><span style=\"font-weight: 400\"> highlighted the lack of assessments of NPI in trials. Since then, there have been multiple calls for more research on their comparative effectiveness.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Arguing that mapping the trial landscape helps to identify what evaluations on which NPIs are (not) being conducted and helps to guide policy strategies, we aimed at providing a systematic overview of the major characteristics and results of randomized assessments of NPIs to prevent COVID-19. <\/span><span style=\"font-weight: 400\">As of August 2021, we identified 41 randomized trials assessing NPIs. As of November 2021, only 12 of them were completed including 9 with published results. The trials assessed very diverse NPIs, mostly protective equipment, COVID-19-related information and education programs, access to mass events under specific safety measures, testing and screening strategies, and hygiene management.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">So far, the worldwide clinical research agenda failed to provide urgently needed evidence determining best strategies to prevent COVID-19 in schools, workplaces, nursing homes and other settings substantially affected. Many argue that such randomized trials are difficult to conduct. It is certainly a challenge; one being the need for large sample sizes to detect an effect of public health measures in populations with low event rates. <\/span><a href=\"https:\/\/trialsjournal.biomedcentral.com\/articles\/10.1186\/s13063-021-05209-5\"><span style=\"font-weight: 400\">For example<\/span><\/a><span style=\"font-weight: 400\">,<\/span><span style=\"font-weight: 400\"> it was shown that about 1,000 schools in Norway \u2013 nearly all \u2013 would have been needed to participate in a trial assessing school closures to demonstrate a meaningful risk reduction in a situation with low incidences. However, this number is put into perspective when considering that single countries in Europe count more than 80,000 primary schools and that more than 1.5\u2009billion students were deprived of schooling worldwide in the early days of the pandemic.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">We shed light on efforts to streamline the randomized assessment of interventions which often use innovative designs such as the recently initiated, fully remote and <\/span><a href=\"https:\/\/www.fhi.no\/studier\/koronabrille-studien\/\"><span style=\"font-weight: 400\">virtual GLASSY trial<\/span><\/a> <span style=\"font-weight: 400\">(<\/span><a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2022.02.04.22270120v1\"><span style=\"font-weight: 400\">protocol<\/span><\/a><span style=\"font-weight: 400\">)<\/span><span style=\"font-weight: 400\">. This highly pragmatic web-based trial is assessing the effectiveness of wearing glasses in public spaces without any personal interaction between investigators and participants. This trial, which has been setup in very short time and randomized in few days more than 2,000 persons, is clearly demonstrating the feasibility and potential of such approaches.<\/span><\/p>\n<p><span style=\"font-weight: 400\">We decided to continue our tracking of randomized assessments of NPIs and provide all information on their key design characteristics and their status, freely accessible via <\/span><a href=\"https:\/\/covid-evidence.org\/database?page=npi\"><span style=\"font-weight: 400\">covid-evidence.org<\/span><\/a><span style=\"font-weight: 400\">. Methods are published on the <\/span><a href=\"https:\/\/osf.io\/fq9jh\/\"><span style=\"font-weight: 400\">Open Science Framework<\/span><\/a><span style=\"font-weight: 400\">.<\/span><span style=\"font-weight: 400\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">As of February 22, 2022, there are 57 trials with 11 of them published. Only 11 published trials for interventions impacting millions of people. We hope that massive efforts are being made to establish an urgently needed long-term research agenda globally and specifically focusing on behavioral, environmental, social and systems level interventions (<\/span><a href=\"https:\/\/www.bessi-collab.net\/\"><span style=\"font-weight: 400\">BESSI<\/span><\/a><span style=\"font-weight: 400\">) to guide policies and practices in the current and inevitable future public health emergencies.<\/span><\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/unnamed-11.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-2299 size-full\" src=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/unnamed-11.jpg\" alt=\"8 masks hung up against a wall. The masks are different colours and patterns. The wall is grey.\" width=\"512\" height=\"342\" srcset=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/unnamed-11.jpg 512w, https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/unnamed-11-300x200.jpg 300w\" sizes=\"auto, (max-width: 512px) 100vw, 512px\" \/><\/a><\/p>\n<p><strong>Funding<\/strong><\/p>\n<p>This study was part of the COVID-evidence project which is supported by the Swiss National Science Foundation. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.<\/p>\n<hr \/>\n<p><strong>Authors<\/strong><\/p>\n<p><strong>Julian Hirt<\/strong><\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Julian.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-2300 \" src=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Julian.jpg\" alt=\"Image of blog author, Julian Hirt. The image is in colour and Julian is smiling with his teeth. He has short brown hair and a dark shirt on.\" width=\"309\" height=\"293\" srcset=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Julian.jpg 394w, https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Julian-300x284.jpg 300w\" sizes=\"auto, (max-width: 309px) 100vw, 309px\" \/><\/a><\/p>\n<p>Department of Clinical Research, University Hospital Basel, University of Basel, Basel,<br \/>\nSwitzerland<\/p>\n<p>International Graduate Academy, Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany<\/p>\n<p><strong>Orcid:<\/strong> 0000-0001-6589-3936<\/p>\n<p><strong>Conflicts of interest:<\/strong> Nothing to declare.<\/p>\n<p><strong>Perrine Janiaud<\/strong><\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Perrine.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2301 \" src=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Perrine.jpg\" alt=\"Image of blog author Perrine Janiaud. The image is in colour and Perrine is smiling with her teeth. She is wearing a cream blazer and dark top.\" width=\"301\" height=\"311\" srcset=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Perrine.jpg 405w, https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Perrine-290x300.jpg 290w\" sizes=\"auto, (max-width: 301px) 100vw, 301px\" \/><\/a><\/p>\n<p>Department of Clinical Research, University Hospital Basel, University of Basel, Basel,<br \/>\nSwitzerland<\/p>\n<p><strong>Orcid:<\/strong> 0000-0001-7684-8014<\/p>\n<p><strong>Conflicts of interest:<\/strong> Nothing to declare.<\/p>\n<p><strong>Lars G. Hemkens<\/strong><\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Lars.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-2302 \" src=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Lars.jpg\" alt=\"Image of blog author Lars G. Hemkens. The image is in colour. Lars is smiling with his mouth shut and has blue eyes. He is wearing a blue shirt and a dark blue blazer.\" width=\"206\" height=\"269\" srcset=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Lars.jpg 392w, https:\/\/blogs.bmj.com\/bmjebmspotlight\/files\/2022\/03\/Lars-230x300.jpg 230w\" sizes=\"auto, (max-width: 206px) 100vw, 206px\" \/><\/a><\/p>\n<p>Department of Clinical Research, University Hospital Basel, University of Basel, Basel,<br \/>\nSwitzerland<\/p>\n<p>Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA,<\/p>\n<p>Meta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany<\/p>\n<p><strong>Orcid:<\/strong> 0000-0002-3444-1432<\/p>\n<p><strong>Conflicts of interest:<\/strong> Nothing to declare.<\/p>\n<hr \/>\n<p><strong>DISCLAIMER<\/strong><\/p>\n<p>The views and opinions expressed on this site are solely those of the original authors. They do not necessarily represent the views of the BMJ and should not be used to replace medical advice. All information on this blog is for general information, is not peer-reviewed, requires checking with original sources and should not be used to make any decisions about healthcare. No responsibility for its accuracy and correctness is assumed by us, and we disclaim all liability and responsibility arising from any reliance placed on such commentary or content by any user or visitor to the Website, or by anyone who may be informed of any of its content. Any reliance you place on the material posted on this site is therefore strictly at your own risk.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Blog entry written on: Randomized trials on non-pharmaceutical interventions for COVID-19: a scoping review, (bmjebm-2021-111825) Authors: Julian Hirt, Perrine Janiaud, Lars G. Hemkens Drastic measures such as quarantine, school and workplace closures, curfews, travel restrictions, and mandatory diagnostic testing interventions have been taken worldwide to prevent the spread of COVID-19. Some of these measures, so-called [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2022\/03\/25\/why-we-urgently-need-a-long-term-research-agenda-on-non-pharmaceutical-interventions-to-guide-policies-and-practices-in-the-current-and-future-public-health-emergencies\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":405,"featured_media":2290,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14439,14351,14438],"tags":[],"class_list":["post-2298","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-covid-19-2","category-ebm","category-ebm-spotlight"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Why we urgently need a long-term research agenda on non-pharmaceutical interventions to guide policies and practices in the current and future public health emergencies - BMJ EBM Spotlight<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2022\/03\/25\/why-we-urgently-need-a-long-term-research-agenda-on-non-pharmaceutical-interventions-to-guide-policies-and-practices-in-the-current-and-future-public-health-emergencies\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Why we urgently need a long-term research agenda on non-pharmaceutical interventions to guide policies and practices in the current and future public health emergencies - BMJ EBM Spotlight\" \/>\n<meta property=\"og:description\" content=\"Blog entry written on: Randomized trials on non-pharmaceutical interventions for COVID-19: a scoping review, (bmjebm-2021-111825) Authors: Julian Hirt, Perrine Janiaud, Lars G. 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