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Evaluating the impacts of tiered restrictions introduced in England, during October and December 2020 on COVID-19 cases: a synthetic control study
OBJECTIVES: To analyse the impact on SARS-CoV-2 transmission of tier 3 restrictions introduced in October and December 2020 in England, compared with tier 2 restrictions. We further investigate whether these effects varied between small areas by deprivation. DESIGN: Synthetic control analysis. SETTI...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006191/ https://www.ncbi.nlm.nih.gov/pubmed/35414548 http://dx.doi.org/10.1136/bmjopen-2021-054101 |
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author | Zhang, Xingna Owen, Gwilym Green, Mark A Buchan, Iain Barr, Ben |
author_facet | Zhang, Xingna Owen, Gwilym Green, Mark A Buchan, Iain Barr, Ben |
author_sort | Zhang, Xingna |
collection | PubMed |
description | OBJECTIVES: To analyse the impact on SARS-CoV-2 transmission of tier 3 restrictions introduced in October and December 2020 in England, compared with tier 2 restrictions. We further investigate whether these effects varied between small areas by deprivation. DESIGN: Synthetic control analysis. SETTING: We identified areas introducing tier 3 restrictions in October and December, constructed a synthetic control group of places under tier 2 restrictions and compared changes in weekly infections over a 4-week period. Using interaction analysis, we estimated whether this effect varied by deprivation and the prevalence of a new variant (B.1.1.7). INTERVENTIONS: In both October and December, no indoor between-household mixing was permitted in either tier 2 or 3. In October, no between-household mixing was permitted in private gardens and pubs and restaurants remained open only if they served a ‘substantial meal’ in tier 3, while in tier 2 meeting with up to six people in private gardens were allowed and all pubs and restaurants remained open. In December, in tier 3, pubs and restaurants were closed, while in tier 2, only those serving food remained open. The differences in restrictions between tier 2 and 3 on meeting outside remained the same as in October. MAIN OUTCOME MEASURE: Weekly reported cases adjusted for changing case detection rates for neighbourhoods in England. RESULTS: Introducing tier 3 restrictions in October and December was associated with a 14% (95% CI 10% to 19%) and 20% (95% CI 13% to 29%) reduction in infections, respectively, compared with the rates expected with tier 2 restrictions only. The effects were similar across levels of deprivation and by the prevalence of the new variant. CONCLUSIONS: Compared with tier 2 restrictions, additional restrictions in tier 3 areas in England had a moderate effect on transmission, which did not appear to increase socioeconomic inequalities in COVID-19 cases. |
format | Online Article Text |
id | pubmed-9006191 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-90061912022-04-15 Evaluating the impacts of tiered restrictions introduced in England, during October and December 2020 on COVID-19 cases: a synthetic control study Zhang, Xingna Owen, Gwilym Green, Mark A Buchan, Iain Barr, Ben BMJ Open Infectious Diseases OBJECTIVES: To analyse the impact on SARS-CoV-2 transmission of tier 3 restrictions introduced in October and December 2020 in England, compared with tier 2 restrictions. We further investigate whether these effects varied between small areas by deprivation. DESIGN: Synthetic control analysis. SETTING: We identified areas introducing tier 3 restrictions in October and December, constructed a synthetic control group of places under tier 2 restrictions and compared changes in weekly infections over a 4-week period. Using interaction analysis, we estimated whether this effect varied by deprivation and the prevalence of a new variant (B.1.1.7). INTERVENTIONS: In both October and December, no indoor between-household mixing was permitted in either tier 2 or 3. In October, no between-household mixing was permitted in private gardens and pubs and restaurants remained open only if they served a ‘substantial meal’ in tier 3, while in tier 2 meeting with up to six people in private gardens were allowed and all pubs and restaurants remained open. In December, in tier 3, pubs and restaurants were closed, while in tier 2, only those serving food remained open. The differences in restrictions between tier 2 and 3 on meeting outside remained the same as in October. MAIN OUTCOME MEASURE: Weekly reported cases adjusted for changing case detection rates for neighbourhoods in England. RESULTS: Introducing tier 3 restrictions in October and December was associated with a 14% (95% CI 10% to 19%) and 20% (95% CI 13% to 29%) reduction in infections, respectively, compared with the rates expected with tier 2 restrictions only. The effects were similar across levels of deprivation and by the prevalence of the new variant. CONCLUSIONS: Compared with tier 2 restrictions, additional restrictions in tier 3 areas in England had a moderate effect on transmission, which did not appear to increase socioeconomic inequalities in COVID-19 cases. BMJ Publishing Group 2022-04-11 /pmc/articles/PMC9006191/ /pubmed/35414548 http://dx.doi.org/10.1136/bmjopen-2021-054101 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Infectious Diseases Zhang, Xingna Owen, Gwilym Green, Mark A Buchan, Iain Barr, Ben Evaluating the impacts of tiered restrictions introduced in England, during October and December 2020 on COVID-19 cases: a synthetic control study |
title | Evaluating the impacts of tiered restrictions introduced in England, during October and December 2020 on COVID-19 cases: a synthetic control study |
title_full | Evaluating the impacts of tiered restrictions introduced in England, during October and December 2020 on COVID-19 cases: a synthetic control study |
title_fullStr | Evaluating the impacts of tiered restrictions introduced in England, during October and December 2020 on COVID-19 cases: a synthetic control study |
title_full_unstemmed | Evaluating the impacts of tiered restrictions introduced in England, during October and December 2020 on COVID-19 cases: a synthetic control study |
title_short | Evaluating the impacts of tiered restrictions introduced in England, during October and December 2020 on COVID-19 cases: a synthetic control study |
title_sort | evaluating the impacts of tiered restrictions introduced in england, during october and december 2020 on covid-19 cases: a synthetic control study |
topic | Infectious Diseases |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006191/ https://www.ncbi.nlm.nih.gov/pubmed/35414548 http://dx.doi.org/10.1136/bmjopen-2021-054101 |
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