Agility and sustainability: A qualitative evaluation of COVID-19 Non-pharmaceutical Interventions (NPIs) in the UK logistics sector

Background: The emergence of SARS-CoV-2 triggered a chain of public health responses that radically changed our way of living and working. Non-healthcare sectors, such as the logistics sector, play a key role in such responses. This research aims to qualitatively evaluate the non-pharmaceutical interventions (NPIs) implemented in the UK logistics sector during the COVID-19 pandemic. Methods: We conducted nine semi-structured interviews in July-August 2020 and May-June 2021. In total 11 interviewees represented six companies occupying a range of positions in the UK logistics sector, including takeaway food delivery, large and small goods delivery and home appliance installation, and logistics technology providers. Inductive thematic analysis was completed using NVivo12 to generate emerging themes and subthemes. Themes/subthemes relevant to interventions were mapped deductively onto an adapted Hierarchy of Control (HoC) framework, focusing on delivery workers. Themes/subthemes relevant to the process of implementation were analyzed to understand the barriers and facilitators of rapid responses. Results: HoC analysis suggests the sector has implemented a wide range of risk mitigation measures, with each company developing their own portfolio of measures. Contact-free delivery was the most commonly implemented measure and perceived effective. In addition, a broad range of measures were implemented, including social distancing, internal contact tracing, communication and collaboration with other key stakeholders of the sector. Process evaluation identified facilitators of rapid responses including capacity to develop interventions internally, localized government support, overwhelming external mandates, effective communication, leadership support and financial support for self-isolation, while barriers included unclear government guidance, shortage of testing capacity and supply, high costs and diversified language and cultural backgrounds. Main sustainability issues included compliance fatigue, and the possible mental health impacts of a prolonged rapid response. Conclusions: This research identified drivers and obstacles of rapid implementation of NPIs in response to a respiratory infection pandemic. Existing implementation process models do not consider speed to respond and the absence or lack of guidance in emergency situations such as the COVID-19. We recommend the development of a rapid response model to inform the design of effective and sustainable infection prevention and control policies and to focus future research priorities.