Current public health guidance for community settings and infection prevention and control measures in healthcare settings for COVID-19: a rapid review [v1.0]

 On 14 December 2020, a SARS-CoV-2 variant of concern was reported in the UK and on 18 December, another new variant of concern was reported by national authorities in South Africa.
\n As a result of these new, highly transmittable variants, the World Health Organization (WHO) advised that prevention advice for the public should be further strengthened and infection prevention and control guidance measures reinforced.
\n Guidance from 20 countries and three agencies was reviewed and compared with current Irish guidance for community settings and infection prevention and control measures in healthcare settings, relevant to COVID-19.
\n In general, the current Irish guidance is at least as stringent, if not more stringent that that specified by the countries and agencies reviewed. However, a small number of measures were identified that were considered to be more stringent than the current Irish guidance.
\n In general, in community settings:
\no Masks should be worn in indoor work communities in Finland if more than one person is residing in that space, while Irish guidance recommends face coverings are used in crowded workplaces.
\no Masks are required when anyone aged two years of age or older leaves their home, that is, indoor and outdoor settings regardless of crowding in Singapore. Whereas, in Ireland, masks are required for anyone aged 13 years or older in crowded outdoor spaces or where social distancing cannot be maintained indoors.
\no Face masks are compulsory for children aged six years and older in France.
\no There are minor differences in the recommended humidity level indoors (between 30-50% [Canada] versus 20-60% in Ireland) and the frequency and or duration of intermittent ventilation of indoor settings (rooms should be ventilated for 10 minutes three times daily [France]), intermittent ventilation should be between 10 to 30 minutes depending on the season (Germany).
\n In general, in healthcare settings:
\no N95 and or FFP2 or FFP3 respirators are recommended as standard PPE to be used by healthcare workers when caring for suspected or confirmed cases of COVID-19 in guidance from Canada, Finland, Germany, the ECDC and CDC, compared to surgical masks in Ireland.
\n With respect to transport:
\no In New Zealand, all international arrivals must wear medical grade face masks (as opposed to fabric face coverings in Ireland), and depart to a managed isolation or quarantine facility
\no In Spain, facemasks must be worn by those aged six years and older on school transport.
\no In Germany, FFP2 masks are to be worn on all public transport.
\n In educational settings:
\no A lower minimum age at which face coverings are required in school, that is, six years (France, Spain) and 10 years (Canada, Austria) as opposed to 13 years in Ireland.
\no Use of twice daily temperature checks and symptoms screening for staff and students in Singapore.
\n With respect to vulnerable groups:
\no FFP2 masks are provided to adults aged 65 years and older in Austria and to those aged 60 years and older with certain medical conditions in Germany.
\n Some recent guidance updates may have been prompted by concerns in relation to the new variants. For example, guidance from Australia in relation to a minimum 14-day hotel-quarantine, including a negative SARS-COV-2 test to exit quarantine, specifically reference the UK variant of COVID-19 (SARS-CoV-2 VOC B.1.1.7). While the new variants are noted to be highly transmissible, it is unclear if their mode of transmission differs from other strains of the virus in circulation.
\n Previous evidence summaries conducted by HIQA examined the relative importance of droplet versus contact transmission to the spread of SARS-CoV-2, as well as the potential for airborne transmission of SARS-CoV-2 via aerosols. These evidence summaries concluded that there was insufficient evidence to determine the relative importance of droplet versus contact transmission to the spread of SARS-CoV-2, and that there was low certainty evidence that SARS-CoV-2 may transmit via aerosols.
\n Evidence identified from scoping work does not appear to have any significant impact on the overall conclusions in the original evidence summaries, though there is some evidence to suggest that contact transmission may not be as important as droplet transmission for the spread of SARS-CoV-2. Scoping did not identify any relevant scientific literature referring to differences in the mode of transmission of the new variants of concern.

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