Implementing public health control measures

ABSTRACT

Early in response to the COVID-19 pandemic, before vaccines and other therapeutics were available, individual- and community-level nonpharmaceutical interventions (NPI) were the only option available to public health officials to prevent or slow transmission. Because the use of these control measures was the only approach available at the time—and a clearer understanding of COVID-19 transmission was needed—a wide array of NPIs was implemented or recommended. These included social distancing, travel bans, stay-at-home orders, school, office, and nonessential business closures, and cancellation of events, as well as hand washing, frequent cleaning, and other enhanced hygiene practices. While these measures work best with a layered, additive approach, limited federal guidance and different jurisdictional approaches to the use of control measures led to vastly different implementation of NPIs across the USA. With the introduction of pharmaceutical interventions, including convalescent plasma, antivirals, and vaccines, confusion about the need for, and use of NPIs especially face coverings, grew. The COVID-19 pandemic has brought to light the importance of utilizing NPIs as part of the approach to reduce the risk of infection and control population-level spread of diseases like seasonal influenza and respiratory syncytial virus. However, it has also highlighted the importance of clear public messaging and authentic community engagement around NPI use.