Experimental studies needed to inform policies to reduce the spread of COVID-19



Attempts to reduce the spread of SARS-CoV-2 are factored into the ideas, plans and action plans (policies) that governments propose to reduce the risk of individuals becoming infected with the virus and developing the virus. COVID-19. These policies are supposed to be guided by scientific knowledge. There are plenty – 45,565 COVID-19-focused research articles, commentaries and reviews have appeared in biomedical and health journals since the start of the pandemic.

Although academic scientists have produced research on COVID-19, there are few, if any, well-designed studies directly relevant to government policies and decisions. Think about reopening schools – the debate over what needs to be done to reduce the risk of infection is heated – smaller classrooms, masking, screening, regular disinfection of all surfaces. What we know about safe schools reopening comes from the recent experience of seven or eight countries. The unique pandemic circumstances of these countries and the different ways in which they have handled the reopening make this research difficult to interpret.

Experimental studies are needed to inform government policies on ways to reduce the spread of SARS-CoV-2. In these studies, researchers choose an intervention or course of action (for example, exposure to substances or guidelines believed to influence health outcomes), identify eligible people, randomly group them together to receive or not. intervention and study what is happening in each group. These studies are “controlled” because they remove the differences between the groups allowing to establish the “cause” and the “effect”.

Without experimental studies relevant to school openings, policymakers are looking at what is available. If it was April, conventional wisdom would be – no masks and disinfection of all surfaces. Now in August – masking is a priority, with sanitizing further down the list. While physical distancing remains a priority, the value of screening is questionable, assuming parents have the common sense to keep children at home if they have a fever, cold, or exposure to a virus.

Government policies in this pandemic have been driven by good intentions, expert consultation, WHO recommendations and examples given by other countries.

There are many opportunities for experimental studies directly related to government policy to reduce the spread of the virus. For example, the authors of a study published in August in Transboundary and Emerging Diseases argue that humidity is a key factor in the spread of the virus. Overall, they estimated that a decrease in relative humidity of one percent was associated with an increase in cases of seven to eight percent – a large effect. The authors cite other studies with similar results and suggest that there is a biological mechanism involved. As the virus is transmitted by respiratory aerosols (very small droplets that can remain suspended in the air), they will stay airborne longer in dry, less humid air and for shorter periods in humid air.

Studies on humidity are far from definitive. At the same time, the potential impact of their results on reducing the spread of the virus is substantial. In Canada, intensive use of air conditioning (summer) and central heating (winter) dries up the air, potentially increasing transmission of the virus.

Ontario should undertake experiments to examine the relationship between humidity and the transmission of SARS-CoV-2. The intervention is safe and the results would be relevant to almost everyone, as many of us are together indoors for long periods of time (e.g. homes, classrooms, retirement homes, institutions corrections, etc.). There are many other variables that could be studied in schools, including class size, use of screening and disinfection surfaces.

Experiments are needed to assess ways to reduce the spread of SARS-CoV-2. This would force government policy makers to consult academic scientists on how best to design and implement experimental studies, and then facilitate those studies with large populations such as students. The first steps are for policy makers to admit the obvious – the way forward is not clear – something they are loath to admit. And for the rest of us to take on a role we don’t like to take on: being guinea pigs.

While billions of dollars are invested in testing and developing drug treatments and vaccines, we lack experimental studies directly related to government policies. The impact of approved vaccines on herd immunity will be modest – you can bet on that. As a result, reducing the spread of the virus will continue to play an important role in the years to come. Producing evidence of their effectiveness could save lives today and make better and more transparent decisions in the future.

Michael H. Boyle is Professor Emeritus and Laura Duncan is Assistant Professor (part-time) at McMaster University. They are both researchers at the Offord Center for Child Studies.



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