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This article is the authors’ final published version in Population Health Management, Volume 24, Issue 3, June 2021, Pages 299-303.

The published version is available at Copyright © Savage et al.


Coronavirus disease 2019 (COVID-19) has rapidly become a worldwide pandemic ushering in a global health and economic crisis. In the absence of vaccines or definitive drug therapies, current strategies against COVID-19 rely on preventing the transmission of disease through nonpharmaceutical interventions such as social distancing and proper hand hygiene. For practical and perhaps ethical reasons, the clinical efficacy of these public health measures for managing pandemics has not been demonstrated in randomized controlled clinical trials. Accordingly, guideline recommendations for using nonpharmaceutical interventions are based primarily on observational and modeling studies and on expert opinion. A recent position paper from the World Health Organization (WHO) graded the quality of evidence to be low for the efficacy of social distancing interventions for mitigating pandemic influenza.1 Nonetheless, observational studies have credited nonpharmaceutical interventions with slowing the spread of COVID-19 in China and on the west coast of the United States.2–4 These apparent salutary effects in the COVID-19 pandemic mirror the benefits of similar interventions observed in prior influenza pandemics.5 Further confirmation of the importance of these measures has come with the loosening of social distancing practices and subsequent rapid surge of cases in the Sunbelt region of the United States as the country attempted to reopen.

In addition to general measures such as closure of schools and nonessential businesses, public health guidelines for managing COVID-19 include a series of specific, quantitative recommendations that are the focus of this analysis (Table 1).6–8 Among these are explicit rules regarding interpersonal distancing (6 feet), limitation of group gatherings (10 people), duration of quarantine for exposed individuals (14 days), and duration of handwashing (20 seconds). These recommendations have received wide interest from the international medical community and general public. The goal of this analysis is to critically evaluate the evidence basis behind these specific, quantitative nonpharmaceutical interventions that have a prominent role in mitigating the current COVID-19 pandemic.

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Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

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