We need better evidence on non-drug interventions for COVID-19
Almost 1300 controlled trials have been registered for drug interventions for COVID-19. Among them have been large, well powered, international trials that have assessed the effectiveness of treatments such as dexamethasone and hydroxychloroquine. But why have non-drug interventions not been subject to the same interrogation? The BESSI Collaboration (Behavioural, Environmental, Social, and Systems Interventions (for pandemic preparedness)) is currently being developed. But so far only 10 controlled trials of non-drug interventions have been registered, with three reported. This makes no sense. Drug interventions are generally aimed at a relatively small group of people who have been infected and are ill. Non-drug interventions, such as physical distancing, face coverings, or school patterns of re-opening, are aimed at whole population groups, and yet these are hardly being tested.