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Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities

ÓhAiseadha et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph20075223
Mar 2023  
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Exercise for COVID-19
9th treatment shown to reduce risk in October 2020
 
*, now with p < 0.00000000001 from 67 studies.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,800+ studies for 98 treatments. c19early.org
Review of studies on non-pharmaceutical interventions for COVID-19 showing negative impacts on mental health, physical activity, and obesity.
Reviews covering exercise for COVID-19 include1-3.
ÓhAiseadha et al., 23 Mar 2023, peer-reviewed, 7 authors. Contact: coilin.ohaiseadha@hse.ie (corresponding author).
This PaperExerciseAll
Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population Health and Health Inequalities
Coilín Óhaiseadha, Gerry A Quinn, Ronan Connolly, Awwad Wilson, Michael Connolly, Willie Soon, Paul Hynds
International Journal of Environmental Research and Public Health, doi:10.3390/ijerph20075223
Since the start of the COVID-19 pandemic in early 2020, governments around the world have adopted an array of measures intended to control the transmission of the SARS-CoV-2 virus, using both pharmaceutical and non-pharmaceutical interventions (NPIs). NPIs are public health interventions that do not rely on vaccines or medicines and include policies such as lockdowns, stay-at-home orders, school closures, and travel restrictions. Although the intention was to slow viral transmission, emerging research indicates that these NPIs have also had unintended consequences for other aspects of public health. Hence, we conducted a narrative review of studies investigating these unintended consequences of NPIs, with a particular emphasis on mental health and on lifestyle risk factors for non-communicable diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and tobacco smoking. We reviewed the scientific literature using combinations of search terms such as 'COVID-19 , 'pandemic', 'lockdowns', 'mental health', 'physical activity', and 'obesity'. NPIs were found to have considerable adverse consequences for mental health, physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption varied greatly within and between studies. The variability in consequences for different groups implies increased health inequalities by age, sex/gender, socioeconomic status, pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use of NPIs in attempts to control the spread of the pandemic should be weighed against the potential adverse impacts on other aspects of public health. Our findings should also be of relevance for future pandemic preparedness and pandemic response teams.
Conflicts of Interest: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of the data; in the writing of the manuscript; or in the decision to publish the results.
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Although the ' 'intention was to slow viral transmission, emerging research indicates that these NPIs have ' 'also had unintended consequences for other aspects of public health. Hence, we conducted a ' 'narrative review of studies investigating these unintended consequences of NPIs, with a ' 'particular emphasis on mental health and on lifestyle risk factors for non-communicable ' 'diseases (NCD): physical activity (PA), overweight and obesity, alcohol consumption, and ' 'tobacco smoking. We reviewed the scientific literature using combinations of search terms ' 'such as ‘COVID-19′, ‘pandemic’, ‘lockdowns’, ‘mental health’, ‘physical activity’, and ' '‘obesity’. NPIs were found to have considerable adverse consequences for mental health, ' 'physical activity, and overweight and obesity. The impacts on alcohol and tobacco consumption ' 'varied greatly within and between studies. The variability in consequences for different ' 'groups implies increased health inequalities by age, sex/gender, socioeconomic status, ' 'pre-existing lifestyle, and place of residence. In conclusion, a proper assessment of the use ' 'of NPIs in attempts to control the spread of the pandemic should be weighed against the ' 'potential adverse impacts on other aspects of public health. Our findings should also be of ' 'relevance for future pandemic preparedness and pandemic response teams.</jats:p>', 'DOI': '10.3390/ijerph20075223', 'type': 'journal-article', 'created': {'date-parts': [[2023, 3, 23]], 'date-time': '2023-03-23T07:07:57Z', 'timestamp': 1679555277000}, 'page': '5223', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Unintended Consequences of COVID-19 Non-Pharmaceutical Interventions (NPIs) for Population ' 'Health and Health Inequalities', 'prefix': '10.3390', 'volume': '20', 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-4243-1493', 'authenticated-orcid': False, 'given': 'Coilín', 'family': 'ÓhAiseadha', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Public Health, Health Service Executive, D08 W2A8 ' 'Dublin, Ireland'}]}, { 'ORCID': 'http://orcid.org/0000-0003-0023-2621', 'authenticated-orcid': False, 'given': 'Gerry A.', 'family': 'Quinn', 'sequence': 'additional', 'affiliation': [ { 'name': 'Centre for Molecular Biosciences, Ulster University, Coleraine ' 'BT52 1SA, UK'}]}, { 'ORCID': 'http://orcid.org/0000-0001-5843-3544', 'authenticated-orcid': False, 'given': 'Ronan', 'family': 'Connolly', 'sequence': 'additional', 'affiliation': [ {'name': 'Independent Scientist, D08 Dublin, Ireland'}, { 'name': 'Center for Environmental Research and Earth Sciences (CERES), ' 'Salem, MA 01970, USA'}]}, { 'given': 'Awwad', 'family': 'Wilson', 'sequence': 'additional', 'affiliation': [ { 'name': 'National Drug Treatment Centre, Health Service Executive, D02 ' 'NY26 Dublin, Ireland'}]}, { 'given': 'Michael', 'family': 'Connolly', 'sequence': 'additional', 'affiliation': [ {'name': 'Independent Scientist, D08 Dublin, Ireland'}, { 'name': 'Center for Environmental Research and Earth Sciences (CERES), ' 'Salem, MA 01970, USA'}]}, { 'given': 'Willie', 'family': 'Soon', 'sequence': 'additional', 'affiliation': [ { 'name': 'Center for Environmental Research and Earth Sciences (CERES), ' 'Salem, MA 01970, USA'}, { 'name': 'Institute of Earth Physics and Space Science (ELKH EPSS), H-9400 ' 'Sopron, Hungary'}]}, { 'ORCID': 'http://orcid.org/0000-0002-1260-2688', 'authenticated-orcid': False, 'given': 'Paul', 'family': 'Hynds', 'sequence': 'additional', 'affiliation': [ { 'name': 'SpatioTemporal Environmental Epidemiology Research (STEER) ' 'Group, Environmental Sustainability & Health Institute, ' 'Technological University, D07 H6K8 Dublin, Ireland'}, { 'name': 'Irish Centre for Research in Applied Geoscience, University ' 'College Dublin, D02 FX65 Dublin, Ireland'}]}], 'member': '1968', 'published-online': {'date-parts': [[2023, 3, 23]]}, 'reference': [ { 'key': 'ref_1', 'doi-asserted-by': 'crossref', 'first-page': '1015', 'DOI': '10.1016/S0140-6736(20)30673-5', 'article-title': 'COVID-19: Towards controlling of a pandemic', 'volume': '395', 'author': 'Bedford', 'year': '2020', 'journal-title': 'Lancet'}, { 'key': 'ref_2', 'doi-asserted-by': 'crossref', 'first-page': '1314', 'DOI': '10.1016/S0140-6736(20)32117-6', 'article-title': 'Living with the COVID-19 pandemic: Act now with the tools we have', 'volume': '396', 'author': 'Bedford', 'year': '2020', 'journal-title': 'Lancet'}, { 'key': 'ref_3', 'doi-asserted-by': 'crossref', 'first-page': '121560', 'DOI': '10.1016/j.techfore.2022.121560', 'article-title': 'Developing a mental health index using a machine learning approach: ' 'Assessing the impact of mobility and lockdown during the COVID-19 ' 'pandemic', 'volume': '178', 'author': 'Nanath', 'year': '2022', 'journal-title': 'Technol. 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