Rapid review of public health guidance on physical distancing in the context of COVID-19

 Guidance documents relating to physical distancing measures during the COVID-19 pandemic from ten countries and two international public health bodies were considered in this review. \n There was some variation in the guidance issued (across different settings) in relation to the recommended safe physical distance required to reduce the risk of SARS-CoV-2 transmission: \no Public health agencies in Scotland, England, Northern Ireland, the United States and Canada currently recommend maintaining a physical distance of 2 metres (or 6 feet) for the general public, where possible. \no A physical distance of 1.5 metres is recommended in Switzerland and Australia. \no Public health agencies in Norway and Singapore, and the WHO, recommend maintaining a physical distance of at least 1 metre in non-healthcare settings. In some higher risk settings or activities, physical distancing of more than 1 metre is advised. The ECDC advises a physical distancing of at least 1 metre when using public transport. \no Public Health England has advised that 1 metre, in addition to risk mitigation measures, is sufficient in selected settings such as bars, restaurants, and close contact services. \no There is currently no requirement for physical distancing in New Zealand as the disease is contained. \n Physical distancing recommendations in education and childcare settings acknowledge that adhering to physical distancing measures with young children may be more challenging, but advise that physical contact should be minimised, where possible. \n In general, the guidance on physical distancing recommends that appropriate risk mitigation strategies should be implemented when physical distancing measures cannot be consistently applied. \n A limited number of frameworks have been developed to facilitate an assessment of the risk of transmission of SARS-CoV-2 in different settings. All frameworks recommend the use of additional risk mitigation strategies when safe physical distancing guidance cannot be consistently applied. \n A physical distance of within 1 to 2 metres of a confirmed case of COVID-19 was outlined in most definitions of ‘close contact’. Other considerations included the duration of exposure, the setting, the nature of the contact (that is, direct or indirect) and the timing of the contact during the clinical course of infection of the confirmed case.

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