透過物理干預以中斷或減少呼吸道病毒的傳播的效果（Cochrane Review）

【30秒重點】

• 呼吸道病毒流行時，戴口罩是研究中最一致有效的防護。
• Cochrane 2011年的系統性回顧：N95不比一般外科口罩好，卻更貴、更不舒服、更刺激皮膚。
• 洗手時再加殺病毒劑或消毒劑，能不能減少傳播仍不確定。
• 入境篩檢只能讓疫情擴散延遲一點點，社交距離的證據也有限。

2020/04/01

2011年系統性評估的研究發現（以下Google 翻譯，我稍改了一點）：

• 口罩或N95呼吸器是最一致、最全面的支持措施。
• N95呼吸器不亞於簡單的手術口罩，但價格昂貴，不舒適且對皮膚有刺激性。
• 在正常的洗手過程中添加殺病毒劑或防腐劑以減少呼吸道疾病的傳播其效果仍然不確定。
• 在入境口岸進行篩查之類的全球性措施導致擴散的邊際延遲並不顯著。
• 僅有有限的證據顯示社交疏遠（彼此身體保持距離）是有效的，特別是與暴露風險有關的。

Surgical masks or N95 respirators were the most consistent and comprehensive supportive measures. N95 respirators were non-inferior to simple surgical masks but more expensive, uncomfortable and irritating to skin. Adding virucidals or antiseptics to normal handwashing to decrease respiratory disease transmission remains uncertain. Global measures, such as screening at entry ports, led to a non-significant marginal delay in spread. There was limited evidence that social distancing was effective, especially if related to the risk of exposure.


Physical interventions to interrupt or reduce the spread of respiratory viruses. - PubMed - NCBI

Cochrane Database Syst Rev. 2011 Jul 6;(7):CD006207. doi: 10.1002/14651858.CD006207.pub4.

Physical interventions to interrupt or reduce the spread of respiratory viruses.

Jefferson T1, Del Mar CB, Dooley L, Ferroni E, Al-Ansary LA, Bawazeer GA, van Driel ML, Nair S, Jones MA, Thorning S, Conly JM.

Author information

1

The Cochrane Collaboration, Via Puglie 23, Roma, Italy, 00187.

Abstract

BACKGROUND:

Viral epidemics or pandemics of acute respiratory infections like influenza or severe acute respiratory syndrome pose a global threat. Antiviral drugs and vaccinations may be insufficient to prevent their spread.

OBJECTIVES:

To review the effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses.

SEARCH STRATEGY:

We searched The Cochrane Library, the Cochrane Central Register of Controlled Trials (CENTRAL 2010, Issue 3), which includes the Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to October 2010), OLDMEDLINE (1950 to 1965), EMBASE (1990 to October 2010), CINAHL (1982 to October 2010), LILACS (2008 to October 2010), Indian MEDLARS (2008 to October 2010) and IMSEAR (2008 to October 2010).

SELECTION CRITERIA:

In this update, two review authors independently applied the inclusion criteria to all identified and retrieved articles and extracted data. We scanned 3775 titles, excluded 3560 and retrieved full papers of 215 studies, to include 66 papers of 67 studies. We included physical interventions (screening at entry ports, isolation, quarantine, social distancing, barriers, personal protection, hand hygiene) to prevent respiratory virus transmission. We included randomised controlled trials (RCTs), cohorts, case-controls, before-after and time series studies.

DATA COLLECTION AND ANALYSIS:

We used a standardised form to assess trial eligibility. We assessed RCTs by randomisation method, allocation generation, concealment, blinding and follow up. We assessed non-RCTs for potential confounders and classified them as low, medium and high risk of bias.

MAIN RESULTS:

We included 67 studies including randomised controlled trials and observational studies with a mixed risk of bias. A total number of participants is not included as the total would be made up of a heterogenous set of observations (participant people, observations on participants and countries (object of some studies)). The risk of bias for five RCTs and most cluster-RCTs was high. Observational studies were of mixed quality. Only case-control data were sufficiently homogeneous to allow meta-analysis. The highest quality cluster-RCTs suggest respiratory virus spread can be prevented by hygienic measures, such as handwashing, especially around younger children. Benefit from reduced transmission from children to household members is broadly supported also in other study designs where the potential for confounding is greater. Nine case-control studies suggested implementing transmission barriers, isolation and hygienic measures are effective at containing respiratory virus epidemics. Surgical masks or N95 respirators were the most consistent and comprehensive supportive measures. N95 respirators were non-inferior to simple surgical masks but more expensive, uncomfortable and irritating to skin. Adding virucidals or antiseptics to normal handwashing to decrease respiratory disease transmission remains uncertain. Global measures, such as screening at entry ports, led to a non-significant marginal delay in spread. There was limited evidence that social distancing was effective, especially if related to the risk of exposure.

AUTHORS' CONCLUSIONS:

Simple and low-cost interventions would be useful for reducing transmission of epidemic respiratory viruses. Routine long-term implementation of some measures assessed might be difficult without the threat of an epidemic.

Update of

• Physical interventions to interrupt or reduce the spread of respiratory viruses. [Cochrane Database Syst Rev. 2010]

PMID:

 

21735402

 

PMCID:

 

PMC6993921

 

DOI:

 

10.1002/14651858.CD006207.pub4