Melbourne: COVID-19 protocols such as handwashing, mask-wearing, and physical distancing are associated with reductions in the incidence of the viral disease, and should be continued alongside vaccination, according to a review of the latest evidence published in The BMJ on Thursday.

The review indicated a statistically significant 53 per cent reduction in the incidence of COVID-19 with mask-wearing and a 25 per cent reduction with physical distancing.

However, the experts said more stringent measures, such as lockdowns and closures of borders, schools, and workplaces need further assessment to weigh their potential negative effects on general populations.

The team, including researchers from Monash University in Australia, analysed databases for studies that assessed the effectiveness of public health measures in reducing the incidence of COVID-19, SARS-CoV-2 transmission, and mortality.

As many as 72 studies met their inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures.

Of the 35 studies of individual measures, 34 were observational and one was a randomised controlled trial.

They were carried out in Asia (11), the US (9), Europe (7), the Middle East (3), Africa (3), South America (1), and Australia (1).

Results from 8 of these 35 studies were analysed in detail, which indicated a statistically significant 53 per cent reduction in the incidence of COVID-19 with mask wearing and a 25 per cent reduction with physical distancing, the researchers said.

Handwashing also indicated a substantial 53 per cent reduction in COVID-19 incidence, although this was not statistically significant after adjusting for the small number of studies included, they said.

Detailed analysis was not possible for other measures, including quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces, due to differences in study design, outcome measures and quality.

The researchers conclude that personal and social measures, including handwashing, mask wearing, and physical distancing are effective at reducing the incidence of COVID-19.

They noted that more stringent measures, such as lockdowns and closures of borders, schools, and workplaces “need to be carefully assessed by weighing the potential negative effects of these measures on general populations.”

Further research is also needed to assess the effectiveness of public health measures after adequate vaccination coverage, said study lead author Stella Talic from Monash University.

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