Nonpharmaceutical Interventions (NPIs) are actions, apart from getting vaccinated and taking medicine, that people and communities can take to help slow the spread of illnesses like influenza and COVID-19. NPIs are also known as community mitigation strategies. NPIs are among the best ways of controlling pandemic flu and COVID-19 when vaccines are not yet available.  

The potential impacts of NPIs on influenza and COVID-19 are:

  • to delay the introduction of the pandemic virus into a population
  • delay the height and peak of the epidemic if the epidemic has started
  • reduce transmission by personal protective or environmental measures
  • reduce the total number of infections and hence the total number of severe cases and deaths.

NPIs include both actions that individuals and households can take (e.g. frequent hand washing, mask wearing, covering coughs and sneezes, keeping a distance from sick people, and not going to work sick) and social distancing policies that communities can enact (e.g. closing schools, working from home, restricting public gatherings).


General information
CDC. Nonpharmaceutical interventions (NPIs).
WHO. Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza. October 2019

Recent articles
Cowling BJ, Ali ST, Ng TWY, et al. Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health. 2020;5(5):e279-e288. doi:10.1016/S2468-2667(20)30090-6
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Fong MW, Gao H, Wong JY, et al. Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings—Social Distancing Measures. Emerging Infectious Diseases. 2020;26(5):976-984. doi:10.3201/eid2605.190995.
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Ryu S, Gao H, Wong JY, et al. Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings-International Travel-Related Measures. Emerg Infect Dis. 2020;26(5):961-966. doi:10.3201/eid2605.190993
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Tso RV, Cowling BJ. Importance of face masks for COVID-19 - a call for effective public education [published online ahead of print, 2020 Jul 2]. Clin Infect Dis. 2020;ciaa593. doi:10.1093/cid/ciaa593
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Xiao J, Shiu EYC, Gao H, et al. Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings-Personal Protective and Environmental Measures. Emerg Infect Dis. 2020;26(5):967-975. doi:10.3201/eid2605.190994
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(Updated 2 September 2020)