PT - JOURNAL ARTICLE AU - Zhao, Hedi AU - Jatana, Sukhdeep AU - Bartoszko, Jessica AU - Loeb, Mark TI - Nonpharmaceutical interventions to prevent viral respiratory infection in community settings: an umbrella review AID - 10.1183/23120541.00650-2021 DP - 2022 Apr 01 TA - ERJ Open Research PG - 00650-2021 VI - 8 IP - 2 4099 - http://openres.ersjournals.com/content/8/2/00650-2021.short 4100 - http://openres.ersjournals.com/content/8/2/00650-2021.full SO - erjor2022 Apr 01; 8 AB - Background Respiratory viruses pose an important public health threat to most communities. Nonpharmaceutical interventions (NPIs) such as masks, hand hygiene or physical distancing, among others, are believed to play an important role in reducing transmission of respiratory viruses. In this umbrella review, we summarise the evidence of the effectiveness of NPIs for the prevention of respiratory virus transmission in the community setting.Observations A systematic search of PubMed, Embase, Medline and Cochrane reviews resulted in a total of 24 studies consisting of 11 systematic reviews and meta-analyses, 12 systematic reviews without meta-analyses and one standalone meta-analysis. The current evidence from these data suggests that hand hygiene is protective against respiratory viral infection. The use of hand hygiene and facemasks, facemasks alone and physical distancing were interventions with inconsistent evidence. Interventions such as school closures, oral hygiene or nasal saline rinses were shown to be effective in reducing the risk of influenza; however, the evidence is sparse and mostly of low and critically low quality.Conclusions Studies on the effectiveness of NPIs for the prevention of respiratory viral transmission in the community vary in study design, quality and reported effectiveness. Evidence for the use of hand hygiene or facemasks is the strongest; therefore, the most reasonable suggestion is to use hand hygiene and facemasks in the community setting.Evidence from this umbrella review point to hand hygiene and facemasks as effective nonpharmaceutical methods to prevent respiratory viral transmission in the community setting https://bit.ly/3x6rGu8