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Royal Society report: what would a comprehensive evaluation suggest about non-pharmaceutical interventions during COVID-19?

par Paul, Elisabeth ;Brown, Garrett Wallace;Bell, David;von Agris, Jean Merlin;Ridde, Valéry
Référence Critical public health, 34, 1, page (1-10)
Publication Publié, 2024-05-23

Article révisé par les pairs

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Résumé :

A recent report by the Royal Society examined the literature on the effectiveness of non-pharmaceutical interventions (NPIs) aimed at reducing the transmission of SARS-CoV-2 during the COVID-19 pandemic. It emphatically concluded that they were ‘effective’, which we argue may be misleading to policymakers. This paper performs a critical analysis of the Royal Society report and explains what a proper evaluation of NPIs would mean, arguing that theory-based evaluations are required to approach complex issues and nurture democratic debates on societal choices. We argue that, first, testing the relationship between NPI interventions and their effectiveness in reducing SARS-CoV-2 transmission over a bounded period (a single outcome) is irrelevant for policymaking, because several criteria must be balanced to evaluate any intervention, including efficiency, equity, acceptability, long-term impacts, and sustainability. Second, ignoring the disruptive and unintended effects of NPIs leads to wrong conclusions regarding their overall value. Third, we question the mere objective of NPIs, that is, reducing viral transmission. Finally, we question the methodology used by the Royal Society Report regarding the literature selection and quality. To conclude, we argue that the Royal Society report is not only irrelevant and weak from a methodological point of view but also dangerously misleading in terms of policymaking. Four years after the start of the COVID-19 pandemic, it is high time for researchers, journals, and policymakers to stop debating over NPIs’ mere effectiveness against a parameter that requires a PCR test to determine, but engage in public health-based evaluations that weigh all criteria of interest.