11/25—Indirect evidence for zinc and SARS-CoV-2 infections
Zinc for the prevention and treatment of SARS-CoV-2 and other acute viral respiratory infections: a rapid review
118 publications of 1,627 records met the inclusion criteria (35 Chinese and 83 English publications), 32 for prevention, 78 for treatment and 8 for both. Four RCTs specific to SARS-CoV-2 are ongoing; two are investigating zinc for prevention and two for treatment. Currently, indirect evidence suggests zinc may potentially reduce the risk, duration and severity of SARS-CoV-2 infections, particularly for populations at risk of zinc deficiency including people with chronic disease co-morbidities and older adults. Direct evidence to determine if zinc is effective for either prevention or treatment of SARS-CoV-2 is pending.
Physical interventions to interrupt or reduce the spread of respiratory viruses
We included 44 new RCTs and cluster‐RCTs in this update, bringing the total number of randomised trials to 67. There were no included studies conducted during the COVID‐19 pandemic. The risk of bias for the RCTs and cluster‐RCTs was mostly high or unclear. There is moderate certainty evidence that wearing a mask probably makes little or no difference to the outcome of laboratory‐confirmed influenza compared to not wearing a mask (RR 0.91, 95% CI 0.66 to 1.26; 6 trials; 3005 participants). The use of a N95/P2 respirator compared to a medical/surgical mask probably makes little or no difference for the objective and more precise outcome of laboratory‐confirmed influenza infection (RR 1.10, 95% CI 0.90 to 1.34; moderate‐certainty evidence; 5 trials; 8407 participants). Restricting the pooling to healthcare workers made no difference to the overall findings. n a comparison of hand hygiene interventions with control (no intervention), there was a 16% relative reduction in the number of people with acute respiratory infections in the hand hygiene group (RR 0.84, 95% CI 0.82 to 0.86; 7 trials; 44,129 participants; moderate‐certainty evidence), suggesting a probable benefit. There is uncertainty about the effects of face masks.
How to improve adherence with quarantine: rapid review of the evidence
We found 3163 articles and included 14 in the review. Adherence to quarantine ranged from as little as 0 up to 92.8%. The main factors which influenced or were associated with adherence decisions were the knowledge people had about the disease and quarantine procedure, social norms, perceived benefits of quarantine and perceived risk of the disease, as well as practical issues such as running out of supplies or the financial consequences of being out of work.
Effectiveness of containment measures against COVID-19 in Singapore: implications for other national containment efforts
As of 1 April 2020, 1000 COVID-19 cases were reported in Singapore. The posterior mean Rt was below 1 for most of the time, peaking at 1.1 (95% CI 1.0–1.3) on week 9 of 2020 due to a spreading event in one of the clusters. 827 (82.7%) of cases infected less than one person on average. We estimate that robust surveillance, active case detection, prompt contact tracing, and quarantine of close contacts kept Rt below 1.
Declines in SARS-CoV-2 Transmission, Hospitalizations, and Mortality After Implementation of Mitigation Measures
State-mandated stay-at-home orders and public mask mandates coupled with case investigations with contact tracing contributed to an 82% reduction in COVID-19 incidence, 88% reduction in hospitalizations, and 100% reduction in mortality in Delaware during late April–June.
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