Review Article - Special Collection: Infection Prevention and Control Physical distancing for reducing and mitigating COVID-19 transmission: A rapid review

Ekpereonne B. Esu, Ehimario U. Igumbor, Anthony T. Okoro, Patience O. Idiege, Kelechi Meremikwu, Angela E. Oyo-Ita, Kathleen A. Dunn, Hannah H. Hurwitz, Martin M. Meremikwu

Journal of Public Health in Africa | Vol 16, No 2 | a611 | DOI: https://doi.org/10.4102/jphia.v16i2.611 | © 2025 Ekpereonne B. Esu, Ehimario U. Igumbor, Anthony T. Okoro, Patience O. Idiege, Kelechi Meremikwu, Angela E. Oyo-Ita, Kathleen A. Dunn, Hannah Hamilton-Hurwitz, Martin M. Meremikwu | This work is licensed under CC Attribution 4.0
Submitted: 10 May 2024 | Published: 06 March 2025

About the author(s) Ekpereonne B. Esu, Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar Department of Public Health, Faculty of Allied Medical Sciences, College of Medical Sciences, University of Calabar, Calabar, Nigeria
Ehimario U. Igumbor, Centre for Infectious Disease Research, Nigerian Institute of Medical Research, Lagos, Nigeria
Anthony T. Okoro, Department of Computer Science, University of Calabar, Calabar Cross River Health and Demographic Surveillance System, University of Calabar, Calabar, Nigeria
Patience O. Idiege, University of Calabar Teaching Hospital, Calabar, Nigeria
Kelechi Meremikwu, Keck Medical Center, University of Southern California, Los Angeles, United States
Angela E. Oyo-Ita, Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar Department of Community Medicine, Faculty of Medicine, College of Medical Sciences, University of Calabar, Calabar, Nigeria
Kathleen A. Dunn, World Health Organization, Geneva, Switzerland Public Health Agency of Canada, Ottawa, Switzerland
Hannah H. Hurwitz, World Health Organization, Geneva, Switzerland
Martin M. Meremikwu, Department of Paediatrics, College of Medical Sciences, University of Calabar, Calabar, Nigeria

Abstract

Background: Physical distancing is an infection prevention and control (IPC) intervention and public health and social measure (PHSM) aimed at reducing respiratory infections. However, the optimal distance for preventing severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) transmission remains uncertain.

Aim: This study aimed to determine whether a distance of 1 m is optimal for reducing SARS-CoV-2 transmission.

Setting: Community and healthcare settings.

Methods: The Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PubMed and Embase were searched for studies conducted in community, healthcare and other defined settings between 01 January 2020 and 07 September 2022. The quality of the evidence was assessed with the ROBINS-I tool. This study is registered on PROSPERO (CRD42022355706).

Results: One retrospective cohort study enrolled 242 school districts in Massachusetts, United States, which included 537 336 students and 99 390 staff attending in-person instruction between September 2020 and January 2021. No significant differences in SARS-CoV-2 cases were observed among both groups for students (adjusted incidence rate ratio [aIRR]: 0.904; 95% confidence interval [CI]: 0.616–1.325) and staff (aIRR: 1.015; 95% CI: 0.754–1.366).

Conclusion: In this sole study, SARS-CoV-2 cases were similar regardless of physical distance (1 metre vs 2 metres), although they studied a limited number of events. Physical distancing was part of a broader set of mitigation measures employed in the study setting; including consistent mask use.

Contribution: The effectiveness of physical distancing against SARS-CoV-2 infection is significantly influenced by mask use, thus its impact on physical distancing effectiveness cannot be separated. Further studies are needed to increase the certainty of the evidence.

Keywords

physical distancing; SARS-CoV-2; COVID-19; systematic review; rapid review

Sustainable Development Goal

Goal 3: Good health and well-being

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