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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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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
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa62664
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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 >= 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.
Item Description: Correction to article found here: https://doi.org/10.1016/j.puhe.2023.06.001
Keywords: Covid-19, pandemic
College: Faculty of Medicine, Health and Life Sciences
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.
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