COVID-19: Evidence on Physical Distancing / Remdesivir & Moderate Disease

NEJM Journal Watch

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Physical distancing of at least 1 meter (3.3 feet) is associated with lower risk for spread of coronaviruses, according to a meta-analysis in the Lancet.

Researchers examined 44 studies on the effects of nonpharmaceutical interventions on the risk for transmitting SARS-CoV, SARS-CoV-2, and MERS-CoV in healthcare and non-healthcare settings. Risk for transmitting the viruses was lower when exposure was at 1 meter or more, compared with less than 1 meter (adjusted odds ratio, 0.18). Risk was lower with increasing distance. N95 masks provided greater protection than surgical face masks, but both were protective. Specifically for SARS-CoV-2, mask use was associated with a 60% reduced risk for infection, compared with no mask use. Eye protection was also associated with lower infection risk.

The researchers say the analysis provides “the best available evidence that current policies of at least 1 m physical distancing are associated with a large reduction in infection, and distances of 2 m might be more effective.”

In other COVID-19 news, unpublished results of a phase 3, manufacturer-conducted trial suggest that remdesivir had an effect on patients with moderate COVID-19 who were hospitalized with pneumonia but didn’t have reduced oxygen levels. Patients who received 5 days of remdesivir had a higher rate of improving at least one point on a 7-point ordinal scale by day 11, compared with those who received standard care alone (76% vs. 66%). Findings for 10 days’ remdesivir were not statistically significant.