First published on 4 March 2020 and updated on an ongoing basis; last updated on 14 October 2024 (changes detailed below); all the reviews in this Special Collection are free to access.
This Special Collection is one of a series of collections on COVID-19. It was originally published in English and is also available in Simplified Chinese, Traditional Chinese, Croatian, Czech, German, Farsi, French, Japanese, Bahasa Malaysia, Polish, Portuguese, Russian, and Spanish.
This Special Collection has been created in response to the COVID-19 pandemic and is regularly updated. It aims to ensure immediate access to systematic reviews most directly relevant to the prevention of infection. It includes reviews that are relevant to the WHO interim guidance, as well as other potentially relevant reviews from three Cochrane Networks: Cochrane Public Health and Health Systems; Cochrane Musculoskeletal, Oral, Skin and Sensory; and Cochrane Acute and Emergency Care, and also draws on the knowledge of Cochrane groups in affected regions. Many reviews in this collection have associated Cochrane Clinical Answers (CCAs), with links provided.
The different natures of pathogens and their modes of transmission compared with what is currently known about COVID-19 may limit the applicability of the evidence summarized in these reviews. Please note that the reviews included in this Special Collection summarize evidence, and their inclusion does not mean that the interventions reviewed have been shown to be an effective prevention measure.
Updated 14 October 2024 with a new Cochrane review, 'Laboratory-based molecular test alternatives to RT-PCR for the diagnosis of SARS-CoV-2 infection'.
Identification and diagnosis
Laboratory‐based molecular test alternatives to RT‐PCR for the diagnosis of SARS‐CoV‐2 infection
Diagnosing people with a SARS‐CoV‐2 infection played a critical role in managing the COVID‐19 pandemic and remains a priority for the transition to long‐term management of COVID‐19. Failure to detect SARS‐CoV‐2 when it is present risks spreading infection and results in missed opportunities for prevention. Currently, testing to confirm SARS‐CoV‐2 infection relies primarily on real‐time reverse transcription‐polymerase chain reaction (RT‐PCR). This requires specialist equipment and can take 24 hours to produce a result. Alternatives to RT‐PCR could, if sufficiently accurate, have a positive impact by expanding the range of diagnostic tools available for the timely identification of people infected by SARS‐CoV‐2, access to testing and the use of resources.
Obesity as an independent risk factor for COVID‐19 severity and mortality
People with a very high BMI (> 40 kg/m2) may be at higher risk of adverse outcomes from COVID-19 than those with a low BMI. This review aimed to evaluate obesity as an independent prognostic factor, and assess the effect of very high BMI on mortality, need for mechanical ventilation, hospitalisation, admission to intensive care, and severe disease or pneumonia in adults with confirmed COVID-19 disease. Associated Cochrane Clinical Answer: For adults with COVID-19, does obesity affect outcomes?
COVID‐19 illness is highly variable, ranging from infection with no symptoms through to pneumonia and life‐threatening consequences. Symptoms such as fever, cough, or loss of sense of smell (anosmia) or taste (ageusia), can help flag early on if the disease is present. Such information could be used either to rule out COVID‐19 disease, or to identify people who need to go for COVID‐19 diagnostic tests. This review, updated twice since its first publication in 2020, assesses the diagnostic accuracy of signs and symptoms to determine if a person presenting in primary care or to hospital outpatient settings, such as the emergency department or dedicated COVID‐19 clinics, has COVID‐19. Associated Cochrane Clinical Answer: What is the accuracy of World Health Organization (WHO)‐specified and related COVID‐19 symptoms for the diagnosis of COVID‐19?
Antibody tests for identification of current and past infection with SARS‐CoV‐2
This updated review summarises evidence of the accuracy of COVID‐19 antibody tests; both laboratory‐based tests and rapid tests using a lateral flow format. The diagnostic challenges associated with the COVID‐19 pandemic resulted in rapid development of diagnostic test methods for detecting SARS‐CoV‐2 infection. Serology tests to detect the presence of antibodies to SARS‐CoV‐2 enable detection of past infection and may detect cases of SARS‐CoV‐2 infection that were missed by earlier diagnostic tests. Understanding the diagnostic accuracy of serology tests for SARS‐CoV‐2 infection may enable development of effective diagnostic and management pathways, inform public health management decisions and understanding of SARS‐CoV‐2 epidemiology. Associated Cochrane Clinical Answers: What is the accuracy of immunoglobulin G (IgG) and IgM antibody tests for the detection of current SARS‐CoV‐2 infection? and What is the accuracy of immunoglobulin G (IgG) and IgM antibody tests for the detection of past SARS‐CoV‐2 infection?
Rapid, point‐of‐care antigen tests for diagnosis of SARS‐CoV‐2 infection
Accurate rapid diagnostic tests for SARS‐CoV‐2 infection would be a useful tool to help manage the COVID‐19 pandemic. Testing strategies that use rapid antigen tests to detect current infection have the potential to increase access to testing, speed detection of infection, and inform clinical and public health management decisions to reduce transmission. This is the second update of his review, which was first published in 2020. This review focuses solely on rapid antigen tests. Associated Cochrane Clinical Answer: What is the accuracy of rapid, point‐of‐care antigen tests for the diagnosis of SARS‐CoV‐2 infection?
It is important to identify people with COVID-19 disease whose condition may deteriorate, to assess whether they should receive intensive care or whether they can be treated in a less intensive way or through outpatient care. This review assesses the effectiveness of routine, blood-based laboratory tests in someone with diagnosed SARS-CoV-2 infection and with moderate or mild COVID-19 to predict their likelihood of death or deterioraton to severe or critical COVID-19.
Vaccination
Efficacy and safety of COVID‐19 vaccines
Different forms of vaccines have been developed to prevent SARS‐CoV‐2 virus infection and subsequent COVID‐19 disease. Several vaccines are in widespread use globally. This new review aims to assess the efficacy and safety of COVID‐19 vaccines against SARS‐CoV‐2, as a full primary vaccination series or a booster dose. Associated Cochrane Clinical Answers: What are the benefits and risks of RNA‐based vaccines for preventing COVID‐19?, What are the benefits and risks of inactivated virus vaccines for preventing COVID‐19?, What are the benefits and risks of non‐replicant viral vector vaccines for preventing COVID‐19?, and What are the benefits and risks of protein subunit vaccines for preventing COVID‐19?.
This scoping review provides an overview of the existing literature on immune response and long-term clinical outcomes after COVID-19 vaccination. Several vaccines have proved to be highly effective in terms of protection from severe COVID-19, however patients with compromised immune status develop a weaker and less stable immune response to vaccination. Strong immune response may not always translate into clinical benefit, therefore it is important to synthesise evidence on modified schemes and types of vaccination in these population subgroups for guiding health decisions. Associated Cochrane Clinical Answer: What evidence is available on vaccines against SARS-CoV-2 in people at higher risk of lower immune response?
Interventions to increase COVID‐19 vaccine uptake: a scoping review
This scoping review maps interventions aimed at increasing COVID‐19 vaccine uptake and decreasing COVID‐19 vaccine hesitancy. Vaccine hesitancy is a serious threat to the goal of nationwide vaccination in many countries and poses a substantial threat to population health. Vaccines are effective in preventing severe COVID‐19, a disease for which few treatments are available and which can lead to disability or death. Widespread vaccination against COVID‐19 may help protect those not yet able to get vaccinated. In addition, new and vaccine‐resistant mutations of SARS‐CoV‐2 may be less likely to develop if the spread of COVID‐19 is limited. Different vaccines are now widely available in many settings. Associated Cochrane Clinical Answer: What evidence is available on interventions to increase COVID‐19 vaccine uptake or decrease COVID‐19 vaccine hesitancy?
Infectious diseases are a major cause of illness and death among older adults. Vaccines can prevent infectious diseases, including against seasonal influenza, pneumococcal diseases, herpes zoster and COVID‐19. However, the uptake of vaccination among older adults varies across settings and groups. Communication with healthcare workers can play an important role in older people's decisions to vaccinate. This review explores healthcare workers' perceptions and experiences of communicating with older adults about vaccination. Associated Cochrane Clinical Answer: What are healthcare workers' (HCWs') perceptions and experiences in communicating with older adults (> 50 years) about vaccination?
Childhood vaccination is one of the most effective ways to prevent serious illnesses and deaths in children. However, worldwide, many children do not receive all recommended vaccinations, for several potential reasons. Vaccines might be unavailable, or parents may experience difficulties in accessing vaccination services; for instance, because of poor quality health services, distance from a health facility, or lack of money. Some parents may not accept available vaccines and vaccination services. Our understanding of what influences parents’ views and practices around childhood vaccination, and why some parents may not accept vaccines for their children, is still limited. This qualitative evidence synthesis aims to (1) explore parents’ and informal caregivers’ views and practices regarding routine childhood vaccination, and the factors influencing acceptance, hesitancy, or nonacceptance of routine childhood vaccination; (2) develop a conceptual understanding of what and how different factors reduce parental acceptance of routine childhood vaccination; and (3) explore how the findings of this review can enhance our understanding of the related Cochrane Reviews of intervention effectiveness. Associated Cochrane Clinical Answer: What factors influence parents' and informal caregivers' views and practices regarding routine childhood vaccination?
Infection control in healthcare settings
In epidemics of highly infectious diseases, such as Ebola, severe acute respiratory syndrome (SARS), or coronavirus (COVID-19), healthcare workers are at much greater risk of infection than the general population, due to their contact with patients' contaminated body fluids. Personal protective equipment (PPE) can reduce the risk by covering exposed body parts. This review evaluates which type of full-body PPE and which method of donning or doffing PPE have the least risk of contamination or infection for healthcare workers, and which training methods increase compliance with PPE protocols. Associated Cochrane Clinical Answer: Which type of personal protective equipment (PPE), and which interventions to increase PPE use by healthcare workers, help reduce the spread of highly infectious diseases?
Many dental procedures produce aerosols (droplets, droplet nuclei and splatter) that harbour various pathogenic micro‐organisms and may pose a risk for the spread of infections between dentist and patient. The COVID‐19 pandemic has led to greater concern about this risk. This review assesses the effectiveness of methods used during dental treatment procedures to minimize aerosol production and reduce or neutralize contamination in aerosols. Associated Cochrane Clinical Answers: How does high‐volume evacuation (HVE) compare with no HVE or alternative dental suction for reducing contaminated aerosols during dental procedures? and How do antimicrobial coolants compare with one another or with placebo for reducing contaminated aerosols during dental procedures?
When new respiratory infectious diseases become widespread, such as during the COVID‐19 pandemic, healthcare workers’ adherence to infection prevention and control (IPC) guidelines becomes even more important. Strategies in these guidelines include the use of personal protective equipment such as masks, face shields, gloves and gowns; the separation of patients with respiratory infections from others; and stricter cleaning routines. These strategies can be difficult and time‐consuming to adhere to in practice. This rapid qualitative review identifies barriers and facilitators to healthcare workers’ adherence to IPC guidelines for respiratory infectious diseases. Associated Cochrane Clinical Answer: What are the organizational, environmental, and individual barriers and facilitators affecting healthcare workers' adherence to infection prevention and control (IPC) guidelines for respiratory infectious diseases?
Interventions to improve hand hygiene compliance in patient care
Healthcare‐associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. This review assesses the short‐ and long‐term success of strategies to improve compliance to recommendations for hand hygiene, and to determine whether an increase in hand hygiene compliance can reduce rates of healthcare‐associated infection. Associated Cochrane Clinical Answers: What are the effects of multimodal campaigns to improve hand hygiene of healthcare workers?and What are the effects of performance feedback, education, and olfactory/visual cues on hand hygiene of healthcare workers?
'Standard Precautions' refers to a system of actions, such as using personal protective equipment or adhering to safe handling of needles, that healthcare workers take to reduce the spread of germs in healthcare settings such as hospitals and nursing homes. This review assesses the effectiveness of interventions that target healthcare workers to improve adherence to Standard Precautions in patient care. Associated Cochrane Clinical Answer: Does healthcare worker education improve adherence to standard precautions for controlling health care‐associated infections?
Meticillin‐resistant Staphylococcus aureus (MRSA) is a common hospital‐acquired pathogen that increases morbidity, mortality, and healthcare costs. Its control continues to be an unresolved issue in many hospitals worldwide. This review assesses the effectiveness of wearing gloves, a gown or a mask when contact is anticipated with a hospitalized patient colonized or infected with MRSA, or with the patient's immediate environment. Associated Cochrane Clinical Answer: Do gloves, gowns, and masks reduce transmission of MRSA in the hospital setting?
Overgowns are widely used in newborn nurseries and neonatal intensive care units. It is thought that gowns may help to prevent the spread of nosocomial infection and serve as a reminder to staff and visitors to wash their hands before contact with the infant. This review assesses the effects of the wearing of an overgown by attendants and visitors on the incidence of infection and death in infants in newborn nurseries. Associated Cochrane Clinical Answer: Does gowning by attendants and visitors in newborn nurseries help prevent neonatal morbidity and mortality?
Cuffed versus uncuffed endotracheal tubes for neonates
Endotracheal intubation is a commonly performed procedure in neonates. Some endotracheal tubes (ETT) are equipped with a cuff that can be inflated after insertion of the ETT in the airway to limit leak or aspiration. A potential benefit of using an inflated cuffed ETT may be less exposure of healthcare workers to aerosolized particles that could cause horizontal transmission of infections such as COVID-19. With improved understanding of neonatal airway anatomy and the widespread use of cuffed ETTs by anesthesiologists, the use of cuffed tubes is increasing in neonates; however, there exists variability and ambiguity in many aspects of care surrounding the use of cuffed ETTs within the neonatal population. This review assesses the evidence for or against using a cuffed tube in newborn babies. Associated Cochrane Clinical Answer: How do cuffed endotracheal tubes compare with uncuffed endotracheal tubes for neonates and young infants requiring mechanical ventilation?
Behavioural interventions to promote workers' use of respiratory protective equipment
Respiratory hazards are common in the workplace. Depending on the hazard and exposure, the health consequences may include mild to life‐threatening illnesses from infectious agents, acute effects ranging from respiratory irritation to chronic lung conditions, or even cancer from exposure to chemicals or toxins. Use of respiratory protective equipment (RPE) is an important preventive measure in many occupational settings. RPE only offers protection when worn properly, when removed safely and when it is either replaced or maintained regularly. The effectiveness of behavioural interventions either directed at employers or organizations or directed at individual workers to promote RPE use in workers remains an important unanswered question. This review assesses the effects of any behavioural intervention either directed at organizations or at individual workers on observed or self‐reported RPE use in workers when compared to no intervention or an alternative intervention. Associated Cochrane Clinical Answer: Do educational interventions improve respiratory protective equipment (RPE) use in the workplace?
Chlorhexidine bathing of the critically ill for the prevention of hospital‐acquired infection
Hospital‐acquired infection is a frequent adverse event in patient care; it can lead to longer stays in the intensive care unit, additional medical complications, permanent disability or death. Prevalence of infection is particularly high in the intensive care unit, where people who are critically ill have suppressed immunity and are subject to increased invasive monitoring. Chlorhexidine is a low‐cost product, widely used as a disinfectant and antiseptic, which may be used to bathe people who are critically ill with the aim of killing bacteria and reducing the spread of hospital‐acquired infections. This review assesses the effects of chlorhexidine bathing on the number of hospital‐acquired infections in people who are critically ill. Associated Cochrane Clinical Answer: What are the effects of chlorhexidine bathing for preventing hospital‐acquired infection in people admitted to intensive care units (ICUs)?
COVID‐19 infection poses a serious risk to patients and – due to its contagious nature – to those healthcare workers (HCWs) treating them. If the mouth and nose of HCWs are irrigated with antimicrobial solutions, this may help reduce the risk of active infection being passed from infected patients to HCWs through droplet transmission or direct contact. However, the use of such antimicrobial solutions may be associated with harms related to the toxicity of the solutions themselves, or alterations in the natural microbial flora of the mouth or nose. Understanding these possible side effects is particularly important when the HCWs are otherwise fit and well. This review assesses the benefits and harms of antimicrobial mouthwashes and nasal sprays used by healthcare workers (HCWs) to protect themselves when treating patients with suspected or confirmed COVID‐19 infection.
COVID‐19 infection poses a serious risk to patients and – due to its contagious nature – to those healthcare workers (HCWs) treating them. If the mouth and nose of patients with infection are irrigated with antimicrobial solutions, this may help the patients by killing any coronavirus present at those sites. It may also reduce the risk of the active infection being passed to HCWs through droplet transmission or direct contact. However, the use of such antimicrobial solutions may be associated with harms related to the toxicity of the solutions themselves or alterations in the natural microbial flora of the mouth or nose. This review assesses the benefits and harms of antimicrobial mouthwashes and nasal sprays administered to patients with suspected or confirmed COVID‐19 infection to both the patients and the HCWs caring for them.
COVID‐19 infection poses a serious risk to patients and – due to its contagious nature – to those healthcare workers (HCWs) treating them. The risks of transmission of infection are greater when a patient is undergoing an aerosol‐generating procedure (AGP). Not all those with COVID‐19 infection are symptomatic or suspected of harbouring the infection. If a patient who is not known to have or suspected of having COVID‐19 infection is to undergo an AGP, it would nonetheless be sensible to minimise the risk to those HCWs treating them. This review assesses the benefits and harms of antimicrobial mouthwashes and nasal sprays administered to HCWs and/or patients when undertaking AGPs on patients without suspected or confirmed COVID‐19 infection.
Infection control in the community
Communication to promote and support physical distancing for COVID‐19 prevention and control
This review is an update of a rapid review undertaken in 2020 to identify relevant, feasible and effective communication approaches to promote acceptance, uptake and adherence to physical distancing measures for COVID‐19 prevention and control. The rapid review was published when little was known about transmission, treatment or future vaccination, and when physical distancing measures (isolation, quarantine, contact tracing, crowd avoidance, work and school measures) were the cornerstone of public health responses globally.
This updated review includes more recent evidence to extend what we know about effective pandemic public health communication. This includes considerations of changes needed over time to maintain responsiveness to pandemic transmission waves, the (in)equities and variable needs of groups within communities due to the pandemic, and highlights again the critical role of effective communication as integral to the public health response.
SARS‐CoV‐2‐neutralising monoclonal antibodies to prevent COVID‐19
Monoclonal antibodies (mAbs) are laboratory‐produced molecules derived from the B cells of an infected host, designed to target one specific protein. They are being investigated as potential prophylaxis to prevent coronavirus disease 2019 (COVID‐19); they are relevant for people who do not respond or respond poorly to vaccinations. This review assesses the effects of SARS‐CoV‐2‐neutralising mAbs, including mAb fragments, to prevent infection with SARS‐CoV‐2 causing COVID‐19, and uses a living systematic review approach to maintain the currency of the evidence. Associated Cochrane Clinical Answers: Can postexposure SARS-CoV-2-neutralising monoclonal antibodies help prevent COVID-19? and Can pre-exposure SARS-CoV-2-neutralising monoclonal antibodies help prevent COVID-19?
Long‐term care facilities are at particularly high risk of outbreaks of COVID-19, caused by the novel coronavirus SARS‐CoV‐2, and the burden of morbidity and mortality is very high among residents living in these facilities. This review assesses the effects of non‐pharmacological measures implemented in long‐term care facilities to prevent or reduce the transmission of SARS‐CoV‐2 infection among residents, staff, and visitors. Associated Cochrane Clinical Answers: What are the effects of COVID-19 entry regulation measures in long-term care facilities (LCTFs)?; What are the effects of contact regulation and transmission-reducing measures on COVID-19 in long-term care facilities (LCTFs)?; What are the effects of COVID-19 outbreak control measures in long-term care facilities (LCTFs)?; and What are the effects of COVID-19 surveillance measures in long-term care facilities (LCTFs)?
International travel‐related control measures to contain the COVID‐19 pandemic: a rapid review
In late 2019, the first cases of coronavirus disease 2019 (COVID‐19) were reported in Wuhan, China, followed by a worldwide spread. Numerous countries have implemented control measures related to international travel, including border closures, travel restrictions, screening at borders, and quarantine of travellers. This rapid review assesses the effectiveness of international travel‐related control measures during the COVID‐19 pandemic on infectious disease transmission and screening‐related outcomes. Associated Cochrane Clinical Answers: What are the effects of international travel restrictions on the spread of COVID‐19?; What are the effects of quarantining travelers crossing international borders (with or without screening) on the spread of COVID‐19? and What are the effects of entry and/or exit screening at international borders on the spread of COVID‐19?
Universal screening for SARS‐CoV‐2 infection: a rapid review
Most people infected with SARS‐CoV‐2 have mild disease with unspecific symptoms, but about 5% become critically ill with respiratory failure, septic shock and multiple organ failure. An unknown proportion of infected individuals never experience COVID‐19 symptoms although they are infectious, that is, they remain asymptomatic. Those who develop the disease, go through a presymptomatic period during which they are infectious. Universal screening to detect individuals who are infected with SARS‐CoV‐2 before presenting clinically, could be an important measure to contain the spread of the disease. This rapid review aims to assess the effectiveness of universal screening for SARS‐CoV‐2 infection compared with no screening, and the accuracy of universal screening in people who have not presented to clinical care for symptoms of COVID‐19. Associated Cochrane Clinical Answer: What is the accuracy of symptom screening and elicitation of information about travel history and exposure to a known infected person for diagnosing severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection?
Coronavirus (COVID‐19) is a new virus that has spread quickly throughout the world. COVID‐19 spreads easily between people who are in close contact, or through coughs and sneezes. Most infected people suffer mild flu‐like symptoms, but some become seriously ill and even die. This rapid review assesses quarantine (alone or in combination with other measures) of individuals who had contact with confirmed cases of COVID‐19, who travelled from countries with a declared outbreak, or who live in regions with high transmission of the disease. Associated Cochrane Clinical Answers: What are the effects of quarantine for close contacts of people with confirmed COVID‐19?; What are the effects of quarantine for individuals traveling from a country with a declared COVID‐19 outbreak?; and What are the effects of quarantine plus other measures for controlling the spread of COVID‐19?
Digital contact tracing technologies in epidemics: a rapid review
Reducing transmission of SARS‐CoV‐2 is a global priority. Contact tracing identifies people who were recently in contact with an infected individual, in order to isolate them and reduce further transmission. Digital technology could be implemented to boost manual contact tracing, with digital tools being grouped into three areas: 1) outbreak response; 2) proximity tracing; and 3) symptom tracking. This rapid review assesses the benefits, harms, and acceptability of personal digital contact tracing solutions for identifying contacts of an identified positive case of an infectious disease. Associated Cochrane Clinical Answer: During epidemics, how effective are digital contact tracing technologies for identifying secondary cases and close contacts?
Physical interventions to interrupt or reduce the spread of respiratory viruses
Viral epidemics or pandemics of acute respiratory infections like influenza or severe acute respiratory syndrome pose a global threat. Antiviral drugs and vaccinations may be insufficient to prevent their spread. This review assesses the effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. Associated Cochrane Clinical Answer: Can physical interventions help reduce the spread of respiratory viruses?
Hand cleaning with ash for reducing the spread of viral and bacterial infections: a rapid review
Handwashing is important to reduce the spread and transmission of infectious disease. Ash, the residue from stoves and fires, is a material used for cleaning hands in settings where soap is not widely available. This review assesses the benefits and harms of hand cleaning with ash compared with hand cleaning using soap or other materials for reducing the spread of viral and bacterial infections. Associated Cochrane Clinical Answer: Does hand cleaning with ash reduce the spread of viral and bacterial infections?
Nursing homes for older people provide an environment likely to promote the acquisition and spread of meticillin‐resistant Staphylococcus aureus (MRSA), putting residents at increased risk of colonization and infection. It is recognized that infection prevention and control strategies are important in preventing and controlling MRSA transmission. This review aims to determine the effects of infection prevention and control strategies for preventing the transmission of MRSA in nursing homes for older people. Associated Cochrane Clinical Answer: Does an education intervention in nursing homes help prevent the transmission of methicillin‐resistant Staphylococcus aureus (MRSA)?
Measures implemented in the school setting to contain the COVID‐19 pandemic: a scoping review
In response to the spread of SARS‐CoV‐2 and the impact of COVID‐19, national and subnational governments implemented a variety of measures in order to control the spread of the virus and the associated disease. One setting affected heavily by these measures is the school setting. By mid‐April 2020, 192 countries had closed schools, affecting more than 90% of the world’s student population. In consideration of the adverse consequences of school closures, many countries around the world reopened their schools in the months after the initial closures. This review identifies and comprehensively maps the evidence assessing the impacts of measures implemented in the school setting to reopen schools, or keep schools open, or both, during the SARS‐CoV‐2/COVID‐19 pandemic, with particular focus on the types of measures implemented in different school settings, the outcomes used to measure their impacts and the study types used to assess these. Associated Cochrane Clinical Answer: What evidence is available on measures implemented in school settings to reopen schools and/or keep schools open during the COVID‐19 pandemic?
Measures implemented in the school setting to contain the COVID‐19 pandemic
This review provides an updated assessment of the evidence on the effectiveness of measures implemented in primary and secondary school settings to keep schools open safely during the COVID‐19 pandemic. The review focuses on the different types of measures implemented to reduce contact and to make contact safer within schools and the wider community, and surveillance and response measures. It examines the impact of these measures on disease transmission, and looks at unintended consequences of the measures and how the measures were implemented.
Most countries have implemented measures within the school setting in order to reopen schools or keep them open whilst aiming to contain the spread of SARS‐CoV‐2. For informed decision‐making on implementation, adaptation, or suspension of such measures, it is not only crucial to evaluate their effectiveness with regard to SARS‐CoV‐2 transmission, but also to assess their unintended consequences. This review comprehensively identifies and maps the evidence on the unintended health and societal consequences of school‐based measures to prevent and control the spread of SARS‐CoV‐2, with the aim of generating a descriptive overview of the range of unintended (beneficial or harmful) consequences reported as well as the study designs that were employed to assess these outcomes. This review was designed to complement an existing Cochrane Review on the effectiveness of these measures by synthesising evidence on the implications of the broader system‐level implications of school measures beyond their effects on SARS‐CoV‐2 transmission. Associated Cochrane Clinical Answer: What evidence is available on unintended health and societal consequences of measures implemented in the school setting to contain the COVID‐19 pandemic?
Workplace interventions to reduce the risk of SARS‐CoV‐2 infection outside of healthcare settings
Different interventions that attempt to prevent or reduce workers' exposure to SARS‐CoV‐2 in the workplace have been implemented during the pandemic. This Cochrane Review evaluates the effects of these interventions on the COVID‐19 infection rate, absenteeism, COVID‐19‐related mortality, and adverse events. Associated Cochrane Clinical Answer: For adult workers outside healthcare settings after contact with an infected person, how does a test‐based attendance strategy compare with a standard 10‐day self‐isolation in terms of rates of SARS‐CoV‐2 infection?
Acknowledgements
This Special Collection was developed by Lisa Bero (Senior Editor, Public Health and Health Systems), working with Toby Lasserson (Deputy Editor in Chief), Newton Opiyo (Associate Editor), Robin Featherstone (Information Specialist), and Monaz Mehta (Editor) in the Cochrane Editorial & Methods Department. Colleagues from the Public Health and Health Systems Network, Cochrane China Network, Cochrane Wounds, and Cochrane Acute Respiratory Infections Groups also provided input on the selection of reviews for this Special Collection.
Translation
This Special Collection was translated into [language] by [name of Cochrane Group and optionally translators] on [date of the latest translation update].Image credit
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Contact
Cochrane Editorial and Methods Department (emd@cochrane.org)