Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Title: Prevention of COVID-19. Part 1: Non-pharmacological Strategies and Interventions for Effective Disease Control

Version 1 : Received: 3 August 2023 / Approved: 4 August 2023 / Online: 4 August 2023 (12:08:52 CEST)

A peer-reviewed article of this Preprint also exists.

Aho Glele, L.S.; de Rougemont, A. Non-Pharmacological Strategies and Interventions for Effective COVID-19 Control: A Narrative Review. J. Clin. Med. 2023, 12, 6465. Aho Glele, L.S.; de Rougemont, A. Non-Pharmacological Strategies and Interventions for Effective COVID-19 Control: A Narrative Review. J. Clin. Med. 2023, 12, 6465.

Abstract

(1) Background: The COVID-19 pandemic had a devastating impact on the world, causing widespread illness and death. It is essential to focus on prevention strategies to limit the spread of the disease. Despite the advent of vaccines, maintaining a vigilant approach to prevention remains paramount. While vaccines are essential, they do not guarantee absolute immunity, and their protective effect may diminish over time; (2) Methods: We reviewed effective strategies to prevent COVID-19 transmission. We focused on me-ta-analyses (MA), literature reviews (LR) and the health care context. Various prevention measures and interventions were reviewed. Both es-tablished practices and unresolved issues were considered; (3) Results: Standard precautions (SP) as the cornerstone of infection control, with hand hygiene and mask use as key components. Debate about the relative importance of droplet versus aerosol transmission led to differences in recommendations between agencies at the onset of the pandemic. We have clarified the role of personal protective equipment (PPE), including eye protection. The effectiveness of masks in pre-venting transmission is reviewed. The use of surgical masks is recommended to prevent droplet transmission, while eye protection is recommended in combination with masks. Although data show some risk reduction, the clear superiority of N95/FFP2 over surgical masks remains unproven. In terms of room occupancy, ventilation is critical in reducing the risk of transmission in poorly ventilated environments. The use of negative pressure isolation rooms (NPIRs) is being investigated. The presence of viral RNA on surfaces does not necessarily indicate infectivity, and the risk of transmission by surface contact is low if surfaces are properly maintained and hand hygiene is practised regularly. Testing for SARS-CoV-2 in asymptomatic persons in healthcare settings may help prevent transmission; (4) Conclusions: Prevention of SARS-CoV-2 transmission requires a multifaceted approach, including reducing particle emissions from infected persons by wearing masks, eliminating aerosols by ventilation, ensuring physical separation, and protecting exposed persons with masks and eye protection.

Keywords

Covid-19; SARS-CoV-2; prevention; non-pharmacological interventions; standard precautions; airborne and droplet transmission; personal protective equipment; mask; ventilation; room occupancy; testing for SARS-CoV-2

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

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