Setting up and relaxation of public health social and physical distancing measures for COVID-19: a rapid review

INTRODUCTION: Physical and social distancing refer to purposeful reduction of close contact between people, such as school closures and workplace closures. These measures are useful in containing coronavirus disease 2019 (COVID-19) but have negative effects on social structures and the economy. There is thus a need for optimal timing on when to setup and relax them. We examined the evidence regarding the initiation and lifting of these public health measures. METHODS: We searched for eligible studies in PubMed, Scopus, and Google Scholar in April 2020, and conducted a qualitative synthesis of the study findings. RESULTS: We searched for eligible studies in PubMed, Scopus, and Google Scholar in April 2020, and conducted a qualitative synthesis of the study findings. The electronic searches yielded 2503 records, from which we included 10 observational and mathematical modeling studies. These studies used data from one or multiple countries on COVID-19 (nine studies) or another viral epidemic such as Zika (one study). Most of the studies show the importance of using physical and social distancing at the start of the epidemic and utilising a staggered approach when easing the restrictions, while scaling up testing. The lifting of lockdown measures should be accompanied by continued use of personal protective equipment, the limiting of workdays, and wide-scale testing. CONCLUSION: This review highlights the importance of timeous action when faced with an epidemic, let alone a pandemic. The setting up and relaxation of public measures are time sensitive and data-driven actions. In the absence of a safe and effective vaccine, these findings are relevant for the sustainable containment of COVID-19 in African countries.