Effectiveness of non-pharmaceutical interventions as implemented in the UK during the COVID-19 pandemic: a rapid review

Thulani Ashcroft; Emilie Mcswiggan; Eldad Agyei-Manu; M. Nundy; N. Atkins; Jazz Kirkwood; M. Ben Salem Machiri; V. Vardhan; Bohee Lee; E. Kubat; S Ravishankar; P. Krishan; U. De Silva; E. O.  Lyahen; J. Rostron; A. Zawiejska; K. Ogarrio; M. Harikar; S. Chishty; D. Murreyi; B. Evans; D. Duval; S. Carville; S Brini; J Hill; M. Qureshi; Z. Simmons; I. Lyell; T. Kavoi; Marshall Dozier; Gwenetta Curry; Jose Ordonez-Mena; Simon  de Lusignan; Aziz Sheikh; Evropi Theodoratou; Ruth McQuillan

doi:10.1093/pubmed/fdaf017

Effectiveness of non-pharmaceutical interventions as implemented in the UK during the COVID-19 pandemic: a rapid review

Thulani Ashcroft
, Emilie Mcswiggan
, Eldad Agyei-Manu
, M. Nundy
, N. Atkins
, Jazz Kirkwood
, M. Ben Salem Machiri
, V. Vardhan
, Bohee Lee
, E. Kubat
, S Ravishankar
, P. Krishan
, U. De Silva
, E. O. Lyahen
, J. Rostron
, A. Zawiejska
, K. Ogarrio
, M. Harikar
, S. Chishty
, D. Murreyi

B. Evans, D. Duval, S. Carville, S Brini, J Hill, M. Qureshi, Z. Simmons, I. Lyell, T. Kavoi, Marshall Dozier, Gwenetta Curry, Jose Ordonez-Mena, Simon de Lusignan, Aziz Sheikh, Evropi Theodoratou, Ruth McQuillan^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Although non-pharmaceutical inventions (NPIs) were used globally to control the spread of COVID-19, their effectiveness remains uncertain. We aimed to assess the evidence on NPIs as implemented in the UK, to allow public health bodies to prepare for future pandemics.

METHODS: We used rapid systematic methods (search date: January 2024) to identify, critically appraise and synthesize interventional, observational and modelling studies reporting on NPI effectiveness in the UK.

RESULTS: Eighty-five modelling, nine observational and three interventional studies were included. Modelling studies had multiple quality issues; six of the 12 non-modelling studies were high quality. The best available evidence was for test and release strategies for case contacts (moderate certainty), which was suggestive of a protective effect. Although evidence for school-related NPIs and universal lockdown was also suggestive of a protective effect, this evidence was considered low certainty. Evidence certainty for the remaining NPIs was very low or inconclusive.

CONCLUSION: The validity and reliability of evidence on the effectiveness of NPIs as implemented in the UK during the COVID-19 pandemic is weak. To improve evidence generation and support decision-making during future pandemics or other public health emergencies, it is essential to build evaluation into the design of public health interventions.

Original language	English
Article number	fdaf017
Pages (from-to)	268-302
Number of pages	35
Journal	Journal of Public Health
Volume	47
Issue number	2
Early online date	4 Mar 2025
DOIs	https://doi.org/10.1093/pubmed/fdaf017
Publication status	Published - 1 Jun 2025

Keywords / Materials (for Non-textual outputs)

COVID-19
non-pharmaceutical interventions

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Ashcroft, T., Mcswiggan, E., Agyei-Manu, E., Nundy, M., Atkins, N., Kirkwood, J., Ben Salem Machiri, M., Vardhan, V., Lee, B., Kubat, E., Ravishankar, S., Krishan, P., De Silva, U., Lyahen, E. O., Rostron, J., Zawiejska, A., Ogarrio, K., Harikar, M., Chishty, S., ... McQuillan, R. (2025). Effectiveness of non-pharmaceutical interventions as implemented in the UK during the COVID-19 pandemic: a rapid review. Journal of Public Health, 47(2), 268-302. Article fdaf017. https://doi.org/10.1093/pubmed/fdaf017

@article{9fabead479d343e3953df813c06e519f,

title = "Effectiveness of non-pharmaceutical interventions as implemented in the UK during the COVID-19 pandemic: a rapid review",

abstract = "BACKGROUND: Although non-pharmaceutical inventions (NPIs) were used globally to control the spread of COVID-19, their effectiveness remains uncertain. We aimed to assess the evidence on NPIs as implemented in the UK, to allow public health bodies to prepare for future pandemics.METHODS: We used rapid systematic methods (search date: January 2024) to identify, critically appraise and synthesize interventional, observational and modelling studies reporting on NPI effectiveness in the UK.RESULTS: Eighty-five modelling, nine observational and three interventional studies were included. Modelling studies had multiple quality issues; six of the 12 non-modelling studies were high quality. The best available evidence was for test and release strategies for case contacts (moderate certainty), which was suggestive of a protective effect. Although evidence for school-related NPIs and universal lockdown was also suggestive of a protective effect, this evidence was considered low certainty. Evidence certainty for the remaining NPIs was very low or inconclusive.CONCLUSION: The validity and reliability of evidence on the effectiveness of NPIs as implemented in the UK during the COVID-19 pandemic is weak. To improve evidence generation and support decision-making during future pandemics or other public health emergencies, it is essential to build evaluation into the design of public health interventions.",

keywords = "COVID-19, non-pharmaceutical interventions",

author = "Thulani Ashcroft and Emilie Mcswiggan and Eldad Agyei-Manu and M. Nundy and N. Atkins and Jazz Kirkwood and \{Ben Salem Machiri\}, M. and V. Vardhan and Bohee Lee and E. Kubat and S Ravishankar and P. Krishan and \{De Silva\}, U. and Lyahen, \{E. O.\} and J. Rostron and A. Zawiejska and K. Ogarrio and M. Harikar and S. Chishty and D. Murreyi and B. Evans and D. Duval and S. Carville and S Brini and J Hill and M. Qureshi and Z. Simmons and I. Lyell and T. Kavoi and Marshall Dozier and Gwenetta Curry and Jose Ordonez-Mena and \{de Lusignan\}, Simon and Aziz Sheikh and Evropi Theodoratou and Ruth McQuillan",

note = "Data availability: Data extraction and quality appraisal for all included studies can be obtained by contacting the corresponding author.",

year = "2025",

month = jun,

day = "1",

doi = "10.1093/pubmed/fdaf017",

language = "English",

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Ashcroft, T, Mcswiggan, E, Agyei-Manu, E, Nundy, M, Atkins, N, Kirkwood, J, Ben Salem Machiri, M, Vardhan, V, Lee, B, Kubat, E, Ravishankar, S, Krishan, P, De Silva, U, Lyahen, EO, Rostron, J, Zawiejska, A, Ogarrio, K, Harikar, M, Chishty, S, Murreyi, D, Evans, B, Duval, D, Carville, S, Brini, S, Hill, J, Qureshi, M, Simmons, Z, Lyell, I, Kavoi, T, Dozier, M , Curry, G, Ordonez-Mena, J, de Lusignan, S, Sheikh, A , Theodoratou, E & McQuillan, R 2025, 'Effectiveness of non-pharmaceutical interventions as implemented in the UK during the COVID-19 pandemic: a rapid review', Journal of Public Health, vol. 47, no. 2, fdaf017, pp. 268-302. https://doi.org/10.1093/pubmed/fdaf017

TY - JOUR

T1 - Effectiveness of non-pharmaceutical interventions as implemented in the UK during the COVID-19 pandemic: a rapid review

AU - Ashcroft, Thulani

AU - Mcswiggan, Emilie

AU - Agyei-Manu, Eldad

AU - Nundy, M.

AU - Atkins, N.

AU - Kirkwood, Jazz

AU - Ben Salem Machiri, M.

AU - Vardhan, V.

AU - Lee, Bohee

AU - Kubat, E.

AU - Ravishankar, S

AU - Krishan, P.

AU - De Silva, U.

AU - Lyahen, E. O.

AU - Rostron, J.

AU - Zawiejska, A.

AU - Ogarrio, K.

AU - Harikar, M.

AU - Chishty, S.

AU - Murreyi, D.

AU - Evans, B.

AU - Duval, D.

AU - Carville, S.

AU - Brini, S

AU - Hill, J

AU - Qureshi, M.

AU - Simmons, Z.

AU - Lyell, I.

AU - Kavoi, T.

AU - Dozier, Marshall

AU - Curry, Gwenetta

AU - Ordonez-Mena, Jose

AU - de Lusignan, Simon

AU - Sheikh, Aziz

AU - Theodoratou, Evropi

AU - McQuillan, Ruth

N1 - Data availability: Data extraction and quality appraisal for all included studies can be obtained by contacting the corresponding author.

PY - 2025/6/1

Y1 - 2025/6/1

N2 - BACKGROUND: Although non-pharmaceutical inventions (NPIs) were used globally to control the spread of COVID-19, their effectiveness remains uncertain. We aimed to assess the evidence on NPIs as implemented in the UK, to allow public health bodies to prepare for future pandemics.METHODS: We used rapid systematic methods (search date: January 2024) to identify, critically appraise and synthesize interventional, observational and modelling studies reporting on NPI effectiveness in the UK.RESULTS: Eighty-five modelling, nine observational and three interventional studies were included. Modelling studies had multiple quality issues; six of the 12 non-modelling studies were high quality. The best available evidence was for test and release strategies for case contacts (moderate certainty), which was suggestive of a protective effect. Although evidence for school-related NPIs and universal lockdown was also suggestive of a protective effect, this evidence was considered low certainty. Evidence certainty for the remaining NPIs was very low or inconclusive.CONCLUSION: The validity and reliability of evidence on the effectiveness of NPIs as implemented in the UK during the COVID-19 pandemic is weak. To improve evidence generation and support decision-making during future pandemics or other public health emergencies, it is essential to build evaluation into the design of public health interventions.

AB - BACKGROUND: Although non-pharmaceutical inventions (NPIs) were used globally to control the spread of COVID-19, their effectiveness remains uncertain. We aimed to assess the evidence on NPIs as implemented in the UK, to allow public health bodies to prepare for future pandemics.METHODS: We used rapid systematic methods (search date: January 2024) to identify, critically appraise and synthesize interventional, observational and modelling studies reporting on NPI effectiveness in the UK.RESULTS: Eighty-five modelling, nine observational and three interventional studies were included. Modelling studies had multiple quality issues; six of the 12 non-modelling studies were high quality. The best available evidence was for test and release strategies for case contacts (moderate certainty), which was suggestive of a protective effect. Although evidence for school-related NPIs and universal lockdown was also suggestive of a protective effect, this evidence was considered low certainty. Evidence certainty for the remaining NPIs was very low or inconclusive.CONCLUSION: The validity and reliability of evidence on the effectiveness of NPIs as implemented in the UK during the COVID-19 pandemic is weak. To improve evidence generation and support decision-making during future pandemics or other public health emergencies, it is essential to build evaluation into the design of public health interventions.

KW - COVID-19

KW - non-pharmaceutical interventions

U2 - 10.1093/pubmed/fdaf017

DO - 10.1093/pubmed/fdaf017

M3 - Article

C2 - 40037637

SN - 1741-3842

VL - 47

SP - 268

EP - 302

JO - Journal of Public Health

JF - Journal of Public Health

IS - 2

M1 - fdaf017

ER -

Effectiveness of non-pharmaceutical interventions as implemented in the UK during the COVID-19 pandemic: a rapid review

Abstract

Keywords / Materials (for Non-textual outputs)

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