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Review
. 2021 Nov 13;21(1):2084.
doi: 10.1186/s12889-021-12082-z.

Revisiting COVID-19 policies: 10 evidence-based recommendations for where to go from here

Daniel T Halperin  1 , Norman Hearst  2 , Stephen Hodgins  3 , Robert C Bailey  4 , Jeffrey D Klausner  5 , Helen Jackson  6 , Richard G Wamai  7   8 , Joseph A Ladapo  9 , Mead Over  10 , Stefan Baral  11 , Kevin Escandón #  12   13 , Monica Gandhi #  14
Affiliations
Review

Revisiting COVID-19 policies: 10 evidence-based recommendations for where to go from here

Daniel T Halperin et al. BMC Public Health. .

Abstract

Background: Strategies to control coronavirus 2019 disease (COVID-19) have often been based on preliminary and limited data and have tended to be slow to evolve as new evidence emerges. Yet knowledge about COVID-19 has grown exponentially, and the expanding rollout of vaccines presents further opportunity to reassess the response to the pandemic more broadly.

Main text: We review the latest evidence concerning 10 key COVID-19 policy and strategic areas, specifically addressing: 1) the expansion of equitable vaccine distribution, 2) the need to ease restrictions as hospitalization and mortality rates eventually fall, 3) the advantages of emphasizing educational and harm reduction approaches over coercive and punitive measures, 4) the need to encourage outdoor activities, 5) the imperative to reopen schools, 6) the far-reaching and long-term economic and psychosocial consequences of sustained lockdowns, 7) the excessive focus on surface disinfection and other ineffective measures, 8) the importance of reassessing testing policies and practices, 9) the need for increasing access to outpatient therapies and prophylactics, and 10) the necessity to better prepare for future pandemics.

Conclusions: While remarkably effective vaccines have engendered great hope, some widely held assumptions underlying current policy approaches call for an evidence-based reassessment. COVID-19 will require ongoing mitigation for the foreseeable future as it transforms from a pandemic into an endemic infection, but maintaining a constant state of emergency is not viable. A more realistic public health approach is to adjust current mitigation goals to be more data-driven and to minimize unintended harms associated with unfocused or ineffective control efforts. Based on the latest evidence, we therefore present recommendations for refining 10 key policy areas, and for applying lessons learned from COVID-19 to prevent and prepare for future pandemics.

Keywords: COVID-19; Evidence-based recommendations; Harm reduction; Outdoor transmission; Pandemic; Pandemic preparedness; Policy; Public health; SARS-CoV-2; School closure; Vaccines.

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Conflict of interest statement

Dr. Kevin Escandón and Dr. Stefan Baral are Senior Editorial Board Members for BMC Infectious Diseases. These authors were not involved in any of the decisions regarding review of the manuscript or its acceptance. Two in-house Editors for the BMC Series and two anonymous expert reviewers assessed this manuscript. Dr. Jeffrey D. Klausner serves as an independent medical director of Curative, Inc., a SARS-CoV-2 testing and vaccination company. The other authors declare no conflicts of interest. The authors confirm that they have read BMC’s guidance on competing interests. Views expressed here are solely those of the authors and do not represent the position or policy of any institution or organization.

Figures

Fig. 1
Fig. 1
Evidence-based recommendations for 10 key COVID-19 policy and strategic areas. Figure designed by Karina Escandón
See this image and copyright information in PMC

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