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Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? Results of EVITE Immunity, a linked data retrospective study

Helen Snooks Orcid Logo, Alan Watkins Orcid Logo, Jane Lyons, Ashley Akbari Orcid Logo, Rowena Bailey, L. Bethell, A. Carson-Stevens, A. Edwards, Helena Emery, Bridie Evans, S. Jolles, Ann John Orcid Logo, Mark Kingston Orcid Logo, Alison Porter Orcid Logo, Berni Sewell Orcid Logo, Victoria Williams, Ronan Lyons Orcid Logo

Public Health, Volume: 218, Pages: 12 - 20

Swansea University Authors: Helen Snooks Orcid Logo, Alan Watkins Orcid Logo, Jane Lyons, Ashley Akbari Orcid Logo, Rowena Bailey, Helena Emery, Bridie Evans, Ann John Orcid Logo, Mark Kingston Orcid Logo, Alison Porter Orcid Logo, Berni Sewell Orcid Logo, Victoria Williams, Ronan Lyons Orcid Logo

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DOI (Published version): 10.1016/j.puhe.2023.02.008

Abstract

Introduction: The UK shielding policy intended to protect people at highest risk of harm from COVID-19infection. We aimed to describe intervention effects in Wales at 1 year.Methods: Retrospective comparison of linked demographic and clinical data for cohorts comprisingpeople identified for shieldin...

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Published in: Public Health
ISSN: 0033-3506
Published: Elsevier BV 2023
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Results of EVITE Immunity, a linked data retrospective study</title><swanseaauthors><author><sid>ab23c5e0111b88427a155a1f495861d9</sid><ORCID>0000-0003-0173-8843</ORCID><firstname>Helen</firstname><surname>Snooks</surname><name>Helen Snooks</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>81fc05c9333d9df41b041157437bcc2f</sid><ORCID>0000-0003-3804-1943</ORCID><firstname>Alan</firstname><surname>Watkins</surname><name>Alan Watkins</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>1b74fa5125a88451c52c45bcf20e0b47</sid><ORCID/><firstname>Jane</firstname><surname>Lyons</surname><name>Jane Lyons</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>aa1b025ec0243f708bb5eb0a93d6fb52</sid><ORCID>0000-0003-0814-0801</ORCID><firstname>Ashley</firstname><surname>Akbari</surname><name>Ashley Akbari</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>455e2c1e6193448f6269b9e72acaf865</sid><firstname>Rowena</firstname><surname>Bailey</surname><name>Rowena Bailey</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>ddcdeaa3de5b3256ab5832a9a7377f1b</sid><firstname>Helena</firstname><surname>Emery</surname><name>Helena Emery</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>6098eddc58e31ac2f3e070cb839faa6a</sid><firstname>Bridie</firstname><surname>Evans</surname><name>Bridie Evans</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>ed8a9c37bd7b7235b762d941ef18ee55</sid><ORCID>0000-0002-5657-6995</ORCID><firstname>Ann</firstname><surname>John</surname><name>Ann John</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>3442763d6ff0467963e0792d2b5404fa</sid><ORCID>0000-0003-2242-4210</ORCID><firstname>Mark</firstname><surname>Kingston</surname><name>Mark Kingston</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>fcc861ec479a79f7fb9befb13192238b</sid><ORCID>0000-0002-3408-7007</ORCID><firstname>Alison</firstname><surname>Porter</surname><name>Alison Porter</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>f6a4af2cfa4275d2a8ebba292fa14421</sid><ORCID>0000-0001-5471-922X</ORCID><firstname>Berni</firstname><surname>Sewell</surname><name>Berni Sewell</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>e9bb438bfaaf693c0376c20c9e4529d2</sid><ORCID/><firstname>Victoria</firstname><surname>Williams</surname><name>Victoria Williams</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>83efcf2a9dfcf8b55586999d3d152ac6</sid><ORCID>0000-0001-5225-000X</ORCID><firstname>Ronan</firstname><surname>Lyons</surname><name>Ronan Lyons</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2023-02-15</date><deptcode>HDAT</deptcode><abstract>Introduction: The UK shielding policy intended to protect people at highest risk of harm from COVID-19infection. We aimed to describe intervention effects in Wales at 1 year.Methods: Retrospective comparison of linked demographic and clinical data for cohorts comprisingpeople identified for shielding from 23rd March to 21st May 2020; and the rest of the population.Health records were extracted with event dates between 23rd March 2020 and 22nd March2021 for the comparator cohort and from the date of inclusion until one year later for theshielded cohort.Results: The shielded cohort included 117,415 people, with 3,086,385 in the comparator cohort. Thelargest clinical categories in the shielded cohort were severe respiratory condition (35.5%),immunosuppressive therapy (25.9%) and cancer (18.6%). People in the shielded cohort weremore likely to be female, aged &gt;= 50, living in relatively deprived areas, care home residentsand frail.The proportion of people tested for COVID-19 was higher in the shielded cohort (OR 1.616;95% CI 1.597 -1.637), with lower positivity rate IRR 0.716 (95% CI 0.697 – 0.736). The knowninfection rate was higher in the shielded cohort (5.9% versus 5.7%).People in the shielded cohort were more likely to die (OR 3.683; 95% CI: 3.583 – 3.786); havea critical care admission (OR 3.339; 95% CI: 3.111 – 3.583), hospital emergency admission(OR 2.883; 95% CI: 2.837 – 2.930), Emergency Department attendance (OR 1.893; 95% CI:1.867 – 1.919) and Common Mental Disorder (OR 1.762; 95% CI: 1.735 – 1.789).Conclusion: Deaths and healthcare utilisation were higher amongst shielded people than the generalpopulation, as would be expected in the sicker population. Differences in testing rates,deprivation and pre-existing health are potential confounders, however lack of clear impact oninfection rates raises questions about the success of shielding and indicates that furtherresearch is required to fully evaluate this national policy intervention.</abstract><type>Journal Article</type><journal>Public Health</journal><volume>218</volume><journalNumber/><paginationStart>12</paginationStart><paginationEnd>20</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0033-3506</issnPrint><issnElectronic/><keywords>Covid-19, pandemic</keywords><publishedDay>1</publishedDay><publishedMonth>5</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-05-01</publishedDate><doi>10.1016/j.puhe.2023.02.008</doi><url/><notes>Correction to article found here: https://doi.org/10.1016/j.puhe.2023.06.001</notes><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm>SU Library paid the OA fee (TA Institutional Deal)</apcterm><funders>National Core Studies Immunity programme (led from Birmingham University), in turn funded by the Medical Research Council [MR/V028367/1]; Health Data Research UK [HDR-9006] which receives its funding from the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust; and Administrative Data Research UK which is funded by the Economic and Social Research Council [grant ES/S007393/1]. This work was supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales.</funders><projectreference/><lastEdited>2024-03-07T13:21:10.2274052</lastEdited><Created>2023-02-15T10:35:55.0916225</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Helen</firstname><surname>Snooks</surname><orcid>0000-0003-0173-8843</orcid><order>1</order></author><author><firstname>Alan</firstname><surname>Watkins</surname><orcid>0000-0003-3804-1943</orcid><order>2</order></author><author><firstname>Jane</firstname><surname>Lyons</surname><orcid/><order>3</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>4</order></author><author><firstname>Rowena</firstname><surname>Bailey</surname><order>5</order></author><author><firstname>L.</firstname><surname>Bethell</surname><order>6</order></author><author><firstname>A.</firstname><surname>Carson-Stevens</surname><order>7</order></author><author><firstname>A.</firstname><surname>Edwards</surname><order>8</order></author><author><firstname>Helena</firstname><surname>Emery</surname><order>9</order></author><author><firstname>Bridie</firstname><surname>Evans</surname><order>10</order></author><author><firstname>S.</firstname><surname>Jolles</surname><order>11</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>12</order></author><author><firstname>Mark</firstname><surname>Kingston</surname><orcid>0000-0003-2242-4210</orcid><order>13</order></author><author><firstname>Alison</firstname><surname>Porter</surname><orcid>0000-0002-3408-7007</orcid><order>14</order></author><author><firstname>Berni</firstname><surname>Sewell</surname><orcid>0000-0001-5471-922X</orcid><order>15</order></author><author><firstname>Victoria</firstname><surname>Williams</surname><orcid/><order>16</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><orcid>0000-0001-5225-000X</orcid><order>17</order></author></authors><documents><document><filename>62664__27202__d9f5dcdeb43b4aa39ad096ac566771f6.pdf</filename><originalFilename>62664.VOR.pdf</originalFilename><uploaded>2023-04-25T16:16:20.9764352</uploaded><type>Output</type><contentLength>489902</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Distributed under the terms of a Creative Commons Attribution 4.0 License (CC-BY).</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling v2 62664 2023-02-15 Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? Results of EVITE Immunity, a linked data retrospective study ab23c5e0111b88427a155a1f495861d9 0000-0003-0173-8843 Helen Snooks Helen Snooks true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false 1b74fa5125a88451c52c45bcf20e0b47 Jane Lyons Jane Lyons true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 455e2c1e6193448f6269b9e72acaf865 Rowena Bailey Rowena Bailey true false ddcdeaa3de5b3256ab5832a9a7377f1b Helena Emery Helena Emery true false 6098eddc58e31ac2f3e070cb839faa6a Bridie Evans Bridie Evans true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 3442763d6ff0467963e0792d2b5404fa 0000-0003-2242-4210 Mark Kingston Mark Kingston true false fcc861ec479a79f7fb9befb13192238b 0000-0002-3408-7007 Alison Porter Alison Porter true false f6a4af2cfa4275d2a8ebba292fa14421 0000-0001-5471-922X Berni Sewell Berni Sewell true false e9bb438bfaaf693c0376c20c9e4529d2 Victoria Williams Victoria Williams true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2023-02-15 HDAT Introduction: The UK shielding policy intended to protect people at highest risk of harm from COVID-19infection. We aimed to describe intervention effects in Wales at 1 year.Methods: Retrospective comparison of linked demographic and clinical data for cohorts comprisingpeople identified for shielding from 23rd March to 21st May 2020; and the rest of the population.Health records were extracted with event dates between 23rd March 2020 and 22nd March2021 for the comparator cohort and from the date of inclusion until one year later for theshielded cohort.Results: The shielded cohort included 117,415 people, with 3,086,385 in the comparator cohort. Thelargest clinical categories in the shielded cohort were severe respiratory condition (35.5%),immunosuppressive therapy (25.9%) and cancer (18.6%). People in the shielded cohort weremore likely to be female, aged >= 50, living in relatively deprived areas, care home residentsand frail.The proportion of people tested for COVID-19 was higher in the shielded cohort (OR 1.616;95% CI 1.597 -1.637), with lower positivity rate IRR 0.716 (95% CI 0.697 – 0.736). The knowninfection rate was higher in the shielded cohort (5.9% versus 5.7%).People in the shielded cohort were more likely to die (OR 3.683; 95% CI: 3.583 – 3.786); havea critical care admission (OR 3.339; 95% CI: 3.111 – 3.583), hospital emergency admission(OR 2.883; 95% CI: 2.837 – 2.930), Emergency Department attendance (OR 1.893; 95% CI:1.867 – 1.919) and Common Mental Disorder (OR 1.762; 95% CI: 1.735 – 1.789).Conclusion: Deaths and healthcare utilisation were higher amongst shielded people than the generalpopulation, as would be expected in the sicker population. Differences in testing rates,deprivation and pre-existing health are potential confounders, however lack of clear impact oninfection rates raises questions about the success of shielding and indicates that furtherresearch is required to fully evaluate this national policy intervention. Journal Article Public Health 218 12 20 Elsevier BV 0033-3506 Covid-19, pandemic 1 5 2023 2023-05-01 10.1016/j.puhe.2023.02.008 Correction to article found here: https://doi.org/10.1016/j.puhe.2023.06.001 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University SU Library paid the OA fee (TA Institutional Deal) National Core Studies Immunity programme (led from Birmingham University), in turn funded by the Medical Research Council [MR/V028367/1]; Health Data Research UK [HDR-9006] which receives its funding from the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust; and Administrative Data Research UK which is funded by the Economic and Social Research Council [grant ES/S007393/1]. This work was supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales. 2024-03-07T13:21:10.2274052 2023-02-15T10:35:55.0916225 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Helen Snooks 0000-0003-0173-8843 1 Alan Watkins 0000-0003-3804-1943 2 Jane Lyons 3 Ashley Akbari 0000-0003-0814-0801 4 Rowena Bailey 5 L. Bethell 6 A. Carson-Stevens 7 A. Edwards 8 Helena Emery 9 Bridie Evans 10 S. Jolles 11 Ann John 0000-0002-5657-6995 12 Mark Kingston 0000-0003-2242-4210 13 Alison Porter 0000-0002-3408-7007 14 Berni Sewell 0000-0001-5471-922X 15 Victoria Williams 16 Ronan Lyons 0000-0001-5225-000X 17 62664__27202__d9f5dcdeb43b4aa39ad096ac566771f6.pdf 62664.VOR.pdf 2023-04-25T16:16:20.9764352 Output 489902 application/pdf Version of Record true Distributed under the terms of a Creative Commons Attribution 4.0 License (CC-BY). true eng https://creativecommons.org/licenses/by/4.0/
title Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? Results of EVITE Immunity, a linked data retrospective study
spellingShingle Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? Results of EVITE Immunity, a linked data retrospective study
Helen Snooks
Alan Watkins
Jane Lyons
Ashley Akbari
Rowena Bailey
Helena Emery
Bridie Evans
Ann John
Mark Kingston
Alison Porter
Berni Sewell
Victoria Williams
Ronan Lyons
title_short Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? Results of EVITE Immunity, a linked data retrospective study
title_full Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? Results of EVITE Immunity, a linked data retrospective study
title_fullStr Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? Results of EVITE Immunity, a linked data retrospective study
title_full_unstemmed Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? Results of EVITE Immunity, a linked data retrospective study
title_sort Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? Results of EVITE Immunity, a linked data retrospective study
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author_id_fullname_str_mv ab23c5e0111b88427a155a1f495861d9_***_Helen Snooks
81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins
1b74fa5125a88451c52c45bcf20e0b47_***_Jane Lyons
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
455e2c1e6193448f6269b9e72acaf865_***_Rowena Bailey
ddcdeaa3de5b3256ab5832a9a7377f1b_***_Helena Emery
6098eddc58e31ac2f3e070cb839faa6a_***_Bridie Evans
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
3442763d6ff0467963e0792d2b5404fa_***_Mark Kingston
fcc861ec479a79f7fb9befb13192238b_***_Alison Porter
f6a4af2cfa4275d2a8ebba292fa14421_***_Berni Sewell
e9bb438bfaaf693c0376c20c9e4529d2_***_Victoria Williams
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
author Helen Snooks
Alan Watkins
Jane Lyons
Ashley Akbari
Rowena Bailey
Helena Emery
Bridie Evans
Ann John
Mark Kingston
Alison Porter
Berni Sewell
Victoria Williams
Ronan Lyons
author2 Helen Snooks
Alan Watkins
Jane Lyons
Ashley Akbari
Rowena Bailey
L. Bethell
A. Carson-Stevens
A. Edwards
Helena Emery
Bridie Evans
S. Jolles
Ann John
Mark Kingston
Alison Porter
Berni Sewell
Victoria Williams
Ronan Lyons
format Journal article
container_title Public Health
container_volume 218
container_start_page 12
publishDate 2023
institution Swansea University
issn 0033-3506
doi_str_mv 10.1016/j.puhe.2023.02.008
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description Introduction: The UK shielding policy intended to protect people at highest risk of harm from COVID-19infection. We aimed to describe intervention effects in Wales at 1 year.Methods: Retrospective comparison of linked demographic and clinical data for cohorts comprisingpeople identified for shielding from 23rd March to 21st May 2020; and the rest of the population.Health records were extracted with event dates between 23rd March 2020 and 22nd March2021 for the comparator cohort and from the date of inclusion until one year later for theshielded cohort.Results: The shielded cohort included 117,415 people, with 3,086,385 in the comparator cohort. Thelargest clinical categories in the shielded cohort were severe respiratory condition (35.5%),immunosuppressive therapy (25.9%) and cancer (18.6%). People in the shielded cohort weremore likely to be female, aged >= 50, living in relatively deprived areas, care home residentsand frail.The proportion of people tested for COVID-19 was higher in the shielded cohort (OR 1.616;95% CI 1.597 -1.637), with lower positivity rate IRR 0.716 (95% CI 0.697 – 0.736). The knowninfection rate was higher in the shielded cohort (5.9% versus 5.7%).People in the shielded cohort were more likely to die (OR 3.683; 95% CI: 3.583 – 3.786); havea critical care admission (OR 3.339; 95% CI: 3.111 – 3.583), hospital emergency admission(OR 2.883; 95% CI: 2.837 – 2.930), Emergency Department attendance (OR 1.893; 95% CI:1.867 – 1.919) and Common Mental Disorder (OR 1.762; 95% CI: 1.735 – 1.789).Conclusion: Deaths and healthcare utilisation were higher amongst shielded people than the generalpopulation, as would be expected in the sicker population. Differences in testing rates,deprivation and pre-existing health are potential confounders, however lack of clear impact oninfection rates raises questions about the success of shielding and indicates that furtherresearch is required to fully evaluate this national policy intervention.
published_date 2023-05-01T13:21:07Z
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score 11.037166

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