. 2021 Dec 2;11(12):e055781.

doi: 10.1136/bmjopen-2021-055781.

Public health implications of SARS-CoV-2 variants of concern: a rapid scoping review

Mari Somerville^{1

2}, Janet A Curran^{3

2}, Justine Dol¹, Leah Boulos⁴, Lynora Saxinger⁵, Alexander Doroshenko⁶, Stephanie Hastings⁷, Bearach Reynolds^{8

9}, Allyson J Gallant¹, Hwayeon Danielle Shin¹, Helen Wong¹, Daniel Crowther¹, Marilyn Macdonald¹, Ruth Martin-Misener¹, Jeannette Comeau^{10

11}, Holly McCulloch², Andrea C Tricco^{12

13

14}

Affiliations

¹ Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada.
² Department of Pediatrics, IWK Health, Halifax, Nova Scotia, Canada.
³ Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada jacurran@dal.ca.
⁴ Maritime SPOR SUPPORT Unit, Nova Scotia Health, Halifax, Nova Scotia, Canada.
⁵ Division of Infectious Diseases, Department of Medicine, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada.
⁶ Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
⁷ Health Systems Evaluation and Evidence, Alberta Health Services, Calgary, Alberta, Canada.
⁸ Department of Infectious Diseases, St Vincents Hospital, Dublin, Leinster, UK.
⁹ Evidence Synthesis Ireland, National University of Ireland, Galway, UK.
¹⁰ Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
¹¹ Division of Infectious Diseases, IWK Health, Halifax, Nova Scotia, Canada.
¹² Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
¹³ Epidemiology Division and Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
¹⁴ Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, School of Nursing, Queen's University, Kingston, Ontario, Canada.

PMID: 34857582
PMCID: PMC8640198
DOI: 10.1136/bmjopen-2021-055781

Public health implications of SARS-CoV-2 variants of concern: a rapid scoping review

Mari Somerville et al. BMJ Open. 2021.

. 2021 Dec 2;11(12):e055781.

doi: 10.1136/bmjopen-2021-055781.

Authors

Affiliations

¹ Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada.
² Department of Pediatrics, IWK Health, Halifax, Nova Scotia, Canada.
³ Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada jacurran@dal.ca.
⁴ Maritime SPOR SUPPORT Unit, Nova Scotia Health, Halifax, Nova Scotia, Canada.
⁵ Division of Infectious Diseases, Department of Medicine, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada.
⁶ Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
⁷ Health Systems Evaluation and Evidence, Alberta Health Services, Calgary, Alberta, Canada.
⁸ Department of Infectious Diseases, St Vincents Hospital, Dublin, Leinster, UK.
⁹ Evidence Synthesis Ireland, National University of Ireland, Galway, UK.
¹⁰ Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
¹¹ Division of Infectious Diseases, IWK Health, Halifax, Nova Scotia, Canada.
¹² Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
¹³ Epidemiology Division and Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
¹⁴ Queen's Collaboration for Health Care Quality Joanna Briggs Institute Centre of Excellence, School of Nursing, Queen's University, Kingston, Ontario, Canada.

PMID: 34857582
PMCID: PMC8640198
DOI: 10.1136/bmjopen-2021-055781

Abstract

Objectives: The four SARS-CoV-2 variants of concern (VOC; Alpha, Beta, Gamma and Delta) identified by May 2021 are highly transmissible, yet little is known about their impact on public health measures. We aimed to synthesise evidence related to public health measures and VOC.

Design: A rapid scoping review.

Data sources: On 11 May 2021, seven databases (MEDLINE, Embase, the Cochrane Database of Systematic Reviews, Central Register of Controlled Trials, Epistemonikos' L-OVE on COVID-19, medRxiv, bioRxiv) were searched for terms related to VOC, public health measures, transmission and health systems. No limit was placed on date of publication.

Eligibility criteria: Studies were included if they reported on any of the four VOCs and public health measures, and were available in English. Only studies reporting on data collected after October 2020, when the first VOC was reported, were included.

Data extraction and synthesis: Titles, abstracts and full-text articles were screened by two independent reviewers. Data extraction was completed by two independent reviewers using a standardised form. Data synthesis and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.

Results: Of the 37 included studies, the majority assessed the impact of Alpha (n=32) and were conducted in Europe (n=12) or the UK (n=9). Most were modelling studies (n=28) and preprints (n=28). The majority of studies reported on infection control measures (n=17), followed by modifying approaches to vaccines (n=13), physical distancing (n=6) and either mask wearing, testing or hand washing (n=2). Findings suggest an accelerated vaccine rollout is needed to mitigate the spread of VOC.

Conclusions: The increased severity of VOC requires proactive public health measures to control their spread. Further research is needed to strengthen the evidence for continued implementation of public health measures in conjunction with vaccine rollout. With no studies reporting on Delta, there is a need for further research on this and other emerging VOC on public health measures.

Keywords: COVID-19; health policy; public health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

**Figure 1**
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 flow diagram for new systematic reviews which included searches of databases, registers and other sources. VOC, variant of concern. From: Page MJ *et al*

**Figure 2**
Overview of country or region of data collection and variant of concern up until 11 May 2021.

**Figure 3**
Overview of country or region of data collection and public health subtopic up until 11 May 2021. VOC, variant of concern.

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Public health implications of SARS-CoV-2 variants of concern: a rapid scoping review

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Public health implications of SARS-CoV-2 variants of concern: a rapid scoping review

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