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Assessing their effectiveness is essential in policy support but often challenging, due to interactions between measures, the increase of immunity, variant emergence and seasonal effects. These factors make results difficult to interpret over a long period of time. Using a mechanistic approach, we estimate the overall effectiveness of sets of NPIs in reducing transmission over time. Our approach quantifies the effectiveness by comparing the observed effective reproduction number, which is the number of secondary infections caused by a typical infected person, to a counterfactual reproduction number if no NPIs were taken. The counterfactual reproduction number accounts for seasonal variations in transmissibility, for emergence of more transmissible variants, and for changes in immunity in the population. The immune fraction is reconstructed from age-specific data of longitudinal serological surveys and vaccination coverage, taking immunity loss due to waning into account. We estimate the effectiveness of NPIs in the Netherlands from the start of the pandemic in March 2020 until the emergence of the Omicron variant in November 2021. We find that the effectiveness of NPIs was high in March and April 2020 during the first pandemic wave and in January and February 2021, coinciding with the two periods with the most stringent measures. For both periods the effectiveness was estimated at approximately 50%, i.e., without any measures the reproduction number would have been twice as high as observed. The proposed approach synthesises available epidemiological data from different sources to reconstruct the population-level immunity. With sufficient data, it can be applied not only to COVID-19 but also to other directly transmitted diseases, such as influenza. This method provides a near real-time assessment of the effectiveness of control measures when the required data are available.<\/jats:p>","DOI":"10.1371\/journal.pcbi.1013502","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T17:42:01Z","timestamp":1758130921000},"page":"e1013502","update-policy":"https:\/\/doi.org\/10.1371\/journal.pcbi.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Estimating the effectiveness of non-pharmaceutical interventions against COVID-19 transmission in the Netherlands"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4169-5665","authenticated-orcid":true,"given":"Jantien A.","family":"Backer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Don","family":"Klinkenberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8235-757X","authenticated-orcid":true,"given":"Fuminari","family":"Miura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacco","family":"Wallinga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"issue":"10242","key":"pcbi.1013502.ref001","doi-asserted-by":"crossref","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":"DK Chu","year":"2020","journal-title":"Lancet"},{"key":"pcbi.1013502.ref002","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":"S Talic","year":"2021","journal-title":"BMJ"},{"issue":"4","key":"pcbi.1013502.ref003","doi-asserted-by":"crossref","DOI":"10.1016\/S2468-2667(23)00046-4","article-title":"Effectiveness assessment of non-pharmaceutical interventions: lessons learned from the COVID-19 pandemic","volume":"8","author":"A Lison","year":"2023","journal-title":"The Lancet Public Health"},{"issue":"7820","key":"pcbi.1013502.ref004","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1038\/s41586-020-2405-7","article-title":"Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe","volume":"584","author":"S Flaxman","year":"2020","journal-title":"Nature"},{"key":"pcbi.1013502.ref005","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.ijid.2020.10.066","article-title":"Effectiveness of non-pharmaceutical interventions on COVID-19 transmission in 190 countries from 23 January to 13 April 2020","volume":"102","author":"Y Bo","year":"2021","journal-title":"Int J Infect Dis"},{"issue":"1","key":"pcbi.1013502.ref006","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s12916-020-01872-8","article-title":"The impact of non-pharmaceutical interventions on SARS-CoV-2 transmission across 130 countries and territories","volume":"19","author":"Y Liu","year":"2021","journal-title":"BMC Med"},{"issue":"6531","key":"pcbi.1013502.ref007","doi-asserted-by":"crossref","DOI":"10.1126\/science.abd9338","article-title":"Inferring the effectiveness of government interventions against COVID-19","volume":"371","author":"JM Brauner","year":"2021","journal-title":"Science"},{"issue":"1","key":"pcbi.1013502.ref008","doi-asserted-by":"crossref","first-page":"5820","DOI":"10.1038\/s41467-021-26013-4","article-title":"Understanding the effectiveness of government interventions against the resurgence of COVID-19 in Europe","volume":"12","author":"M Sharma","year":"2021","journal-title":"Nat Commun"},{"issue":"1","key":"pcbi.1013502.ref009","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1186\/s12879-023-08106-1","article-title":"Impact of non-pharmaceutical interventions, weather, vaccination, and variants on COVID-19 transmission across departments in France","volume":"23","author":"J Paireau","year":"2023","journal-title":"BMC Infect Dis"},{"issue":"2257","key":"pcbi.1013502.ref010","first-page":"20230132","article-title":"Effectiveness of social distancing measures and lockdowns for reducing transmission of COVID-19 in non-healthcare, community-based settings","volume":"381","author":"C Murphy","year":"2023","journal-title":"Philos Trans A Math Phys Eng Sci"},{"key":"pcbi.1013502.ref011","volume-title":"Covid-19 reproductiegetal (Covid-19 reproduction number","author":"National Institute for Public Health and the Environment (RIVM)","year":"2023"},{"key":"pcbi.1013502.ref012","unstructured":"Backer JA. 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