{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:20:44Z","timestamp":1790025644860,"version":"4.0.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017017","name":"Swedish Agency for Health Technology Assessment and Assessment of Social Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017017","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2022-06358"],"award-info":[{"award-number":["2022-06358"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>During the COVID-19 pandemic, most countries implemented non-pharmaceutical interventions (NPIs) to mitigate virus transmission and decrease morbidity and mortality. The aim of this umbrella review was to identify and map systematic reviews on the effectiveness of NPIs to reduce widespread community transmission of infectious diseases with pandemic potential. We searched electronic databases (Medline, Embase, Scopus, INAHTA [International Network of Agencies for Health Technology Asseesment], and World Health Organization COVID-19) and websites (January 2024). Systematic reviews on NPIs during outbreaks, epidemics, or pandemics of COVID-19, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, or Ebola were included and organized in an interactive evidence map grouped by type of intervention (individual\/population\/environmental), disease, risk of bias, and search date. Five of the 132 included reviews were assessed as having low, 43 moderate, and 84 high risk of bias. COVID-19 was targeted in 100 reviews, influenza 66, SARS 39, MERS 34, and Ebola in five reviews. The most frequently investigated NPIs were use of face masks, hand washing, physical distancing, travel restrictions, restrictions on public gatherings, and school closures. The five reviews at low risk of bias concluded at low level of evidence about the effectiveness of most NPIs, with exceptions of hand hygiene and some measures in school settings where low- to moderate-certainty evidence was found. There is substantial lack of evidence regarding the effectiveness of several commonly used NPIs, including restrictions on public gatherings, travel restrictions, and visiting restrictions in long-term care facilities. There is a paucity not only of systematic reviews but also of primary studies at low risk of bias.<\/jats:p>","DOI":"10.1093\/eurpub\/ckaf170","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T11:51:50Z","timestamp":1756986710000},"page":"200-207","source":"Crossref","is-referenced-by-count":2,"title":["Non-pharmaceutical interventions to prevent community transmission of infectious diseases with pandemic potential\u2014an umbrella review and evidence map"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1883-2000","authenticated-orcid":false,"given":"Jonas","family":"Bj\u00f6rk","sequence":"first","affiliation":[{"name":"Epidemiology, Population Studies and Infrastructures (EPI@LUND), Division of Occupational and Environmental Medicine, Lund University , Lund,","place":["Sweden"]},{"name":"Clinical Studies Sweden, Forum South, Sk\u00e5ne University Hospital , Lund,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunl\u00f6g","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, School of Medical Sciences, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro,","place":["Sweden"]},{"name":"Department of Communicable Disease Prevention and Control, Region \u00d6rebro , \u00d6rebro,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Johansson","sequence":"additional","affiliation":[{"name":"Swedish Agency for Health Technology Assessment and Assessment of Social Services , Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Dagerhamn","sequence":"additional","affiliation":[{"name":"Swedish Agency for Health Technology Assessment and Assessment of Social Services , Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Olofsson","sequence":"additional","affiliation":[{"name":"Swedish Agency for Health Technology Assessment and Assessment of Social Services , Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Wilbe Ramsay","sequence":"additional","affiliation":[{"name":"Swedish Agency for Health Technology Assessment and Assessment of Social Services , Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"2026021717520182700_ckaf170-B1","author":"Folkh\u00e4lsomyndigheten","year":"2023"},{"key":"2026021717520182700_ckaf170-B2","author":"European Centre for Disease Prevention and Control (ECDC)","year":"2020"},{"key":"2026021717520182700_ckaf170-B3","doi-asserted-by":"publisher","first-page":"e000071","DOI":"10.1136\/bmjmed-2021-000071","article-title":"Conducting umbrella reviews","volume":"1","author":"Belbasis","year":"2022","journal-title":"BMJ Med"},{"key":"2026021717520182700_ckaf170-B4","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1136\/bmjebm-2018-111137","article-title":"Evidence maps: a tool to guide research agenda setting","volume":"24","author":"Alahdab","year":"2019","journal-title":"BMJ Evid Based Med"},{"key":"2026021717520182700_ckaf170-B5","author":"Bj\u00f6rk","year":"2024"},{"key":"2026021717520182700_ckaf170-B6","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/m18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann Intern Med"},{"key":"2026021717520182700_ckaf170-B7","doi-asserted-by":"publisher","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"Shea","year":"2017","journal-title":"Bmj"},{"key":"2026021717520182700_ckaf170-B8","author":"Swedish Agency for Health Technology Assessment and Assessment of Social Services","year":"2024"},{"key":"2026021717520182700_ckaf170-B9","doi-asserted-by":"publisher","first-page":"2000725","DOI":"10.2807\/1560-7917.ES.2020.25.49.2000725","article-title":"Community use of face masks and similar barriers to prevent respiratory illness such as COVID-19: a rapid scoping review","volume":"25","author":"Brainard","year":"2020","journal-title":"Euro Surveill"},{"key":"2026021717520182700_ckaf170-B10","doi-asserted-by":"publisher","first-page":"CD006207","DOI":"10.1002\/14651858.CD006207.pub6","article-title":"Physical interventions to interrupt or reduce the spread of respiratory viruses","volume":"1","author":"Jefferson","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"2026021717520182700_ckaf170-B11","doi-asserted-by":"publisher","DOI":"10.1088\/1752-7163\/ac1ea5","article-title":"Efficacy of face masks against respiratory infectious diseases: a systematic review and network analysis of randomized-controlled trials","volume":"15","author":"Tran","year":"2021","journal-title":"J Breath Res"},{"key":"2026021717520182700_ckaf170-B12","doi-asserted-by":"publisher","first-page":"542","DOI":"10.7326\/M20-3213","article-title":"Masks for prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings: a living rapid review","volume":"173","author":"Chou","year":"2020","journal-title":"Ann Intern Med"},{"key":"2026021717520182700_ckaf170-B13","doi-asserted-by":"publisher","first-page":"e2336","DOI":"10.1002\/rmv.2336","article-title":"Comparative effectiveness of N95, surgical or medical, and non-medical facemasks in protection against respiratory virus infection: a systematic review and network meta-analysis","volume":"32","author":"Kim","year":"2022","journal-title":"Rev Med Virol"},{"key":"2026021717520182700_ckaf170-B14","doi-asserted-by":"publisher","first-page":"CD015029","DOI":"10.1002\/14651858.CD015029.pub2","article-title":"Measures implemented in the school setting to contain the COVID-19 pandemic","volume":"5","author":"Littlecott","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"2026021717520182700_ckaf170-B15","doi-asserted-by":"publisher","first-page":"1973","DOI":"10.1016\/S0140-6736(20)31142-9","article-title":"Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis","volume":"395","author":"Chu","year":"2020","journal-title":"Lancet"},{"key":"2026021717520182700_ckaf170-B16","doi-asserted-by":"publisher","first-page":"210","DOI":"10.3201\/eid1002.030730","article-title":"Risk factors for SARS among persons without known contact with SARS patients, beijing, China","volume":"10","author":"Wu","year":"2004","journal-title":"Emerg Infect Dis"},{"key":"2026021717520182700_ckaf170-B17","doi-asserted-by":"publisher","first-page":"235","DOI":"10.3201\/eid1002.030626","article-title":"Probable secondary infections in households of SARS patients in Hong Kong","volume":"10","author":"Lau","year":"2004","journal-title":"Emerg Infect Dis"},{"key":"2026021717520182700_ckaf170-B18","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1017\/s0950268806006996","article-title":"SARS transmission in Vietnam outside of the health-care setting","volume":"135","author":"Tuan","year":"2007","journal-title":"Epidemiol Infect"},{"key":"2026021717520182700_ckaf170-B19","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1186\/s12889-022-13667-y","article-title":"The effectiveness of hand hygiene interventions for preventing community transmission or acquisition of novel coronavirus or influenza infections: a systematic review","volume":"22","author":"Gozdzielewska","year":"2022","journal-title":"BMC Public Health"},{"key":"2026021717520182700_ckaf170-B20","doi-asserted-by":"publisher","first-page":"e068302","DOI":"10.1136\/bmj-2021-068302","article-title":"Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis","volume":"375","author":"Talic","year":"2021","journal-title":"BMJ"},{"key":"2026021717520182700_ckaf170-B21","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1539\/joh.10-0024-fs","article-title":"An effective quarantine measure reduced the total incidence of influenza A H1N1 in the workplace: another way to control the H1N1 flu pandemic","volume":"53","author":"Miyaki","year":"2011","journal-title":"J Occup Health"},{"key":"2026021717520182700_ckaf170-B22","doi-asserted-by":"publisher","first-page":"e053371","DOI":"10.1136\/bmjopen-2021-053371","article-title":"Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies","volume":"11","author":"Walsh","year":"2021","journal-title":"BMJ Open"},{"key":"2026021717520182700_ckaf170-B23","doi-asserted-by":"publisher","first-page":"CD015085","DOI":"10.1002\/14651858.CD015085.pub2","article-title":"Non-pharmacological measures implemented in the setting of long-term care facilities to prevent SARS-CoV-2 infections and their consequences: a rapid review","volume":"9","author":"Stratil","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"2026021717520182700_ckaf170-B24","doi-asserted-by":"publisher","first-page":"e129","DOI":"10.1016\/s2666-7568(20)30065-9","article-title":"Factors associated with SARS-CoV-2 infection and outbreaks in long-term care facilities in England: a national cross-sectional survey","volume":"2","author":"Shallcross","year":"2021","journal-title":"Lancet Healthy Longev"},{"key":"2026021717520182700_ckaf170-B25","doi-asserted-by":"publisher","author":"Oster","year":"2021","DOI":"10.1101\/2021.05.19.21257467"},{"key":"2026021717520182700_ckaf170-B26","doi-asserted-by":"publisher","first-page":"e12055","DOI":"10.1002\/cesm.12055","article-title":"The effects of public health and social measures (PHSM) implemented during the COVID-19 pandemic: an overview of systematic reviews","volume":"2","author":"Fadlallah","year":"2024","journal-title":"Cochrane Evid Synth Methods"},{"key":"2026021717520182700_ckaf170-B27","doi-asserted-by":"publisher","first-page":"00650","DOI":"10.1183\/23120541.00650-2021","article-title":"Nonpharmaceutical interventions to prevent viral respiratory infection in community settings: an umbrella review","volume":"8","author":"Zhao","year":"2022","journal-title":"ERJ Open Res"},{"key":"2026021717520182700_ckaf170-B28","doi-asserted-by":"publisher","first-page":"e462","DOI":"10.1093\/pubmed\/fdab102","article-title":"COVID-19 pandemic: health impact of staying at home, social distancing and \u2018lockdown\u2019 measures-a systematic review of systematic reviews","volume":"43","author":"Chiesa","year":"2021","journal-title":"J Public Health (Oxf)"},{"key":"2026021717520182700_ckaf170-B29","first-page":"19","article-title":"The effectiveness of face masks in preventing COVID-19 transmission: a systematic review","volume":"23","author":"SeyedAhmad","year":"2023","journal-title":"Infect Disord Drug Targets"},{"key":"2026021717520182700_ckaf170-B30","doi-asserted-by":"crossref","first-page":"811","DOI":"10.21037\/atm-20-6745","article-title":"Wearing masks to reduce the spread of respiratory viruses: a systematic evidence mapping","volume":"9","author":"Li","year":"2021","journal-title":"Ann Transl Med"},{"key":"2026021717520182700_ckaf170-B31","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1136\/bmjebm-2022-112085","article-title":"School closures during COVID-19: an overview of systematic reviews","volume":"28","author":"Hume","year":"2023","journal-title":"BMJ Evid Based Med"},{"key":"2026021717520182700_ckaf170-B32","doi-asserted-by":"publisher","first-page":"e279","DOI":"10.1093\/pubmed\/fdae025","article-title":"Non-pharmaceutical interventions to reduce COVID-19 transmission in the UK: a rapid mapping review and interactive evidence gap map","volume":"46","author":"Duval","year":"2024","journal-title":"J Public Health (Oxf)"},{"key":"2026021717520182700_ckaf170-B33","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1007\/s10654-022-00908-y","article-title":"The methodologies to assess the effectiveness of non-pharmaceutical interventions during COVID-19: a systematic review","volume":"37","author":"Banholzer","year":"2022","journal-title":"Eur J Epidemiol"},{"key":"2026021717520182700_ckaf170-B34","doi-asserted-by":"publisher","first-page":"e080528","DOI":"10.1136\/bmj-2024-080528","article-title":"Non-pharmaceutical interventions: evaluating challenges and priorities for future health shocks","volume":"387","author":"Majeed","year":"2024","journal-title":"BMJ"},{"key":"2026021717520182700_ckaf170-B35","doi-asserted-by":"publisher","first-page":"6202","DOI":"10.1038\/s41598-022-09942-y","article-title":"Evaluating efficacy of indoor non-pharmaceutical interventions against COVID-19 outbreaks with a coupled spatial-SIR agent-based simulation framework","volume":"12","author":"Gunaratne","year":"2022","journal-title":"Sci Rep"}],"container-title":["European Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/36\/1\/200\/64275978\/ckaf170.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/36\/1\/200\/64275978\/ckaf170.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T22:52:07Z","timestamp":1771368727000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurpub\/article\/36\/1\/200\/8254627"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,9,15]]},"published-print":{"date-parts":[[2026,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/eurpub\/ckaf170","relation":{},"ISSN":["1101-1262","1464-360X"],"issn-type":[{"value":"1101-1262","type":"print"},{"value":"1464-360X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2025,9,15]]}}}