Today Cochrane released the first Rapid Review related to COVID-19:
"Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review". (link to the review)
Below the press release.





How effective is quarantine alone or in combination with other public health measures to control Coronavirus (COVID-19)?
 
Today, Cochrane publishes a new Rapid Review assessing the effectiveness of quarantine during the COVID-19 pandemic.
 
The review summarizes evidence available from modelling studies that show how quarantining affects the spread of COVID-19. The studies included in the review consistently conclude that quarantine can play a role in controlling the spread of coronavirus. Whilst early implementation of quarantine and its combination with other public health measures helps to ensure effectiveness, key uncertainties remain as to how these measures can best be adopted and when they can be relaxed.
 
Currently, there are no effective medicines or vaccines available to treat or prevent COVID-19. For this reason, restrictive public health measures such as isolation, physical distancing, and quarantine have been used in a number of countries to reduce transmission of the virus. Isolation refers to the separation of people with symptoms from others, whereas quarantine is the restriction of people who have no symptoms, but who have had contact with people with confirmed or suspected infection. Quarantine can be implemented on a voluntary basis or can be legally enforced by authorities and may be applied at an individual, group, or community level.
 
This review was done in a short space of time as part of Cochrane’s organizational attempt to meet the need for up to date summaries of evidence to support decision-making in combating the effects and impact of COVID-19.
Cochrane researchers used abbreviated usual systematic review methods in order to address the following questions as quickly as possible in the review:
 

• Is quarantine of asymptomatic individuals who were in contact with a confirmed or suspected case of COVID-19, effective to control the COVID-19 outbreak?
• Are there differences in the effectiveness of quarantine in different settings?
• How effective is quarantine when combined with other interventions such as case isolation, school closures or antiviral drugs in reducing transmission, incidence of diseases, and death? 
• Is quarantine of individuals coming from a country with a declared COVID-19 outbreak, effective in controlling the COVID-19 outbreak?

 
The authors identified 29 relevant studies. Of these, ten focused on COVID-19, 15 focused on related evidence on SARS (Severe Acute Respiratory Syndrome), two focused on SARS and other viruses, and two focused on MERS (Middle East Respiratory Syndrome). The ten studies addressing COVID-19 were all modelling studies simulating outbreak scenarios in China, Great Britain, South Korea, and a cruise ship.
 
The COVID-19 modelling studies included in the review consistently report a benefit of quarantine measures, and show similar findings from studies on SARS and MERS.
 
The authors of this Cochrane Review concluded that;
 

• Quarantine of people exposed to confirmed cases may avert high proportions of infections and deaths compared to no measures (low certainty of evidence).
• The effect of quarantine of travelers from a country with a declared outbreak to avert transmission and deaths was small (very low certainty evidence).
• In general, the combination of quarantine with other prevention and control measures such as school closures, travel restrictions, physical distancing had a greater effect on the reduction of transmissions, cases which required critical care beds, and deaths than quarantine alone (low certainty of evidence.)
• More comprehensive and early implementation of prevention and control measures may be more effective in containing the COVID-19 outbreak.

 
The researchers rate their confidence in the results to be low or very low because of the way that models used in the studies were developed. They are based on assumptions about parameters like the true prevalence of infection which could be updated when we know more about this aspect of the COVID 19 pandemic.
 
However, the authors also stress the importance of using information about the local context in deciding on how measures such as quarantining should be adopted and when they can be lifted. Lead author Barbara Nußbaumer Streit said “This Cochrane Review shows that whilst quarantine may help in containing the COVID-19 outbreak, decision-makers will need to constantly monitor the outbreak situation locally in order to maintain the best possible balance of measures in place, and that there is an acceptable trade-off between benefits and harms.”
 
Cochrane Editor in Chief, Karla Soares-Weiser, added, “Cochrane is helping to construct the evidence base for policymakers working on the COVID-19 global response. We have a series of Rapid Reviews being produced and shared with global decision-makers, this is the first one in this series. This review is particularly helpful for decision makers looking for evidence to inform their decisions around the implementation of quarantine measures.”

Last month Läkartidningen publiced an article highlighting the collaboration between Cochrane Sweden and HTA Skåne (Health Technology Accessment) regarding gathering and accessing the increasing volume of evidence related to COVID-19. You can read the whole article here.

Keen to get experience with systematic reviews, but not sure where to start? Or perhaps you’re already experienced, and want to help out? Can you help with translations? 

TaskExchange is an online platform that connects people needing help with their systematic review with people who have the time and skills to help. A variety of tasks are posted on the platform, from literature searching, article screening and translation and data extraction, to statistical analysis, and consumer reviews. Whether you’re a complete beginner or very experienced, you’re bound to find a task that suits you! Any tasks completed count towards a Cochrane Membership.

Read more here.