Effectiveness of Non-pharmaceutical Interventions in Nine Fields of Activity to Decrease SARS-CoV-2 Transmission

Background: We estimated the association between the level of restriction in nine different fields of activity and SARS-CoV-2 transmissibility in Spain, from 15 September 2020 to 9 May 2021. Methods: A stringency index (0-1) was created for each Spanish province (n = 50) daily. A hierarchical multip...

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Detalles Bibliográficos
Autores: Gómez-Ullate, David, Barbeito, Inés, Precioso, Daniel, Sierra, María José, Vegas Azcárate, Susana, Fernández Balbuena, Sonia, Vitoriano, Begoña, Cao, Ricardo, Monge, Susana
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:IE
Repositorio:Repositorio IE
OAI Identifier:oai:repositorio.ie.edu:20.500.14417/3564
Acceso en línea:https://doi.org/10.3389/fpubh.2023.1061331
https://hdl.handle.net/20.500.14417/3564
Access Level:acceso abierto
Palabra clave:COVID-19
SARS-CoV-2
Effectiveness
Hierarchical models
Logarithmic return
Non-pharmaceutical interventions (NPI)
Pandemic
Stringency index
Descripción
Sumario:Background: We estimated the association between the level of restriction in nine different fields of activity and SARS-CoV-2 transmissibility in Spain, from 15 September 2020 to 9 May 2021. Methods: A stringency index (0-1) was created for each Spanish province (n = 50) daily. A hierarchical multiplicative model was fitted. The median of coefficients across provinces (95% bootstrap confidence intervals) quantified the effect of increasing one standard deviation in the stringency index over the logarithmic return of the weekly percentage variation of the 7-days SARS-CoV-2 cumulative incidence, lagged 12 days. Results: Overall, increasing restrictions reduced SARS-CoV-2 transmission by 22% (RR = 0.78; one-sided 95%CI: 0, 0.82) in 1 week, with highest effects for culture and leisure 14% (0.86; 0, 0.98), social distancing 13% (0.87; 0, 0.95), indoor restaurants 10% (0.90; 0, 0.95) and indoor sports 6% (0.94; 0, 0.98). In a reduced model with seven fields, culture and leisure no longer had a significant effect while ceremonies decreased transmission by 5% (0.95; 0, 0.96). Models R 2 was around 70%. Conclusion: Increased restrictions decreased COVID-19 transmission. Limitations include remaining collinearity between fields, and somewhat artificial quantification of qualitative restrictions, so the exact attribution of the effect to specific areas must be done with caution.