What is the effectiveness of financial support schemes for individuals requested to self-isolate following a positive Covid test or positive contact: A rapid review

Testing for COVID-19 has been deployed globally as a tool to interrupt transmission through isolating positive contacts from the broader population. Financial support systems have been deployed to increase the isolation compliance, there is uncertainty as to the effectiveness of these measures. Three reviews were identified, as well as four primary studies that were published after the review search dates. Six studies showed that financial support for isolation was associated with a higher compliance to isolate. Two epidemiological modelling studies found that increased levels of social isolation were associated with a reduction in COVID-19 transmission. The findings from a DCE demonstrated a positive relationship with longer isolation duration and higher financial requirements. An economic model showed that support programmes have the potential to be a cost-effective intervention. A retrospective observational study offered evidence supporting the viability of delivering medically assisted isolation hotels for people unable to isolate at home. Further to the COVID-19 literature, two household surveys found that financial support and improved social restriction information was associated with compliance with H1N1 isolation Policy and practice implications: There is limited evidence to suggest that financial support for isolation can increase compliance, lower social engagement, and reduce infection levels. There is insufficient evidence to inform the optimal scale of financial support required. There was no evidence related to effectiveness of financial support for disadvantaged populations who are required to isolate or any insight to the impact of financial support on equality The overall certainty in the evidence is relatively low. Most studies relied on participant reported data on preference or behaviour, and where observational data were used there were issues with data quality and unobserved cofounders. #### Rapid Review Details ##### Review conducted by Review conducted by Health Technology Wales ##### Review Team Review Team Lauren Elston, Jenni Washington, Elise Hasler, Tom Winfield ##### Review submitted to the WCEC on Review submitted to the WCEC on 27th July 2022 ##### Stakeholder consultation meeting Stakeholder consultation meeting 13th June 2022 ##### Rapid Review report issued by the WCEC on Rapid Review report issued by the WCEC on August 2022 ##### WCEC Team WCEC Team ##### This review should be cited as This review should be cited as RR00020.Wales COVID-19 Evidence Centre. A rapid review of the effectiveness of financial support schemes for individuals requested to self-isolate following a positive Covid test or positive contact. August 2022 This report can be accessed from the WCEC library: ##### Disclaimer Disclaimer The views expressed in this publication are those of the authors, not necessarily Health and Care Research Wales. The WCEC and authors of this work declare that they have no conflict of interest. #### TOPLINE SUMMARY ##### What is a Rapid Review? What is a Rapid Review? Our rapid reviews use a variation of the systematic review approach, abbreviating or omitting some components to generate the evidence to inform stakeholders promptly whilst maintaining attention to bias. They follow the methodological recommendations and minimum standards for conducting and reporting rapid reviews, including a structured protocol, systematic search, screening, data extraction, critical appraisal, and evidence synthesis to answer a specific question and identify key research gaps. They take 1-2 months, depending on the breadth and complexity of the research topic/ question(s), extent of the evidence base, and type of analysis required for synthesis. ##### Who is this summary for? Who is this summary for? Welsh Government ##### Background / Aim of Rapid Review Background / Aim of Rapid Review Testing for COVID-19 has been deployed globally as a tool to interrupt transmission through isolating positive contacts from the broader population. Financial support systems have been deployed to increase the isolation compliance, there is uncertainty as to the effectiveness of these measures. ##### Key Findings Key Findings Three reviews were identified, as well as four primary studies that were published after the review search dates. Due to the diversity and paucity of evidence identified, the primary studies included in the reviews (n = 5) were extracted and reported alongside the other primary evidence. This resulted in 9 primary studies extracted and summarised in this report. ###### Extent of the evidence base Extent of the evidence base ###### Recency of the evidence base Recency of the evidence base ###### Evidence of effectiveness Evidence of effectiveness ##### Policy Implications Policy Implications ##### Strength of Evidence Strength of Evidence The overall certainty in the evidence is relatively low. Most studies relied on participant reported data on preference or behaviour, and where observational data were used there were issues with data quality and unobserved cofounders. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Health Technology Wales was funded for this work by the Wales Covid-19 Evidence Centre, itself funded by Health & Care Research Wales on behalf of Welsh Government ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors * Acronym : Full Description COVID-19 : Coronavirus disease 2019 CI : Confidence interval OR : Odds ratio DCE : Discrete choice experiment FFCRA : Families first coronavirus response act AE : Aux’ silio Emergencial (Financial support program) RCT : Randomised control trials