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Evaluation of the UK's COVID-19 public health policy “Shielding: Results of a linked data matched cohort study
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Ashley Akbari ,
L. Bethell,
A. Carson-Stevens,
J. Dale ,
L. Dixon,
A. Edwards ,
Helena Emery,
Ann John ,
G. John,
S. Jolles,
Jane Lyons,
Ronan Lyons,
Mark Kingston ,
R. Parab ,
Alison Porter ,
Berni Sewell,
Alan Watkins ,
Victoria Williams
Public Health, Volume: 244, Start page: 105736
Swansea University Authors:
Helen Snooks , Ashley Akbari , Helena Emery, Ann John , Jane Lyons, Ronan Lyons, Mark Kingston , Alison Porter , Berni Sewell, Alan Watkins , Victoria Williams
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© 2025 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article distributed under the terms of the Creative Commons CC-BY license.
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DOI (Published version): 10.1016/j.puhe.2025.105736
Abstract
Objective: To assess outcomes associated with shielding, introduced during the COVID-19 pandemic across the UK to protect those at highest risk of harm. Study design: Linked data and questionnaires in matched cohorts from the population of Wales, UK. Methods: We compared individual-level linked rout...
| Published in: | Public Health |
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| ISSN: | 0033-3506 1476-5616 |
| Published: |
Elsevier Ltd
2025
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa69548 |
| Abstract: |
Objective: To assess outcomes associated with shielding, introduced during the COVID-19 pandemic across the UK to protect those at highest risk of harm. Study design: Linked data and questionnaires in matched cohorts from the population of Wales, UK. Methods: We compared individual-level linked routine and self-reported outcomes between people identified for shielding (n = 123,293) and comparators (n = 120,997) matched by age, sex, and previous health service utilisation. We sent questionnaires to 1500 randomly sampled people in each cohort. Results: At one year 6·1 % of shielded people had contracted SARS-CoV-2 compared to 6·2 % in the matched cohort (Adjusted Odds Ratio [AOR] 0·970; 95 % confidence interval [CI] 0·937 to 1·004). Suspected healthcare associated infections were more likely in shielded people (1·1 % vs 0·6 %; AOR 1·678; 95 % CI 1·529 to 1·842). All-cause and COVID-19 related deaths were higher in the shielded cohort (7·0 % vs 3·5 %; AOR 2·280; 95 % CI 2·190 to 2·374; and 1·1 % vs 0·8 %; AOR 1·430; 95 % CI 1·308 to 1·563, respectively). About 1/3 completed questionnaires (n = 1015), with linkage possible in 752 cases (shielded: n = 411; matched: n = 341). Shielded respondents reported lower physical and mental health (SF12 PCS difference: −3·752; 95 % CI -4·823 to −2·682; SF12 MCS difference: −1·217; 95 % CI -2·580 to 0·145). They were more likely to have strictly avoided contact; stayed at home; felt scared to go outside; and were less likely to have gone out for shopping, leisure or travel. Conclusion: We found no evidence of a protective effect of shielding on SARS-CoV-2 infections or COVID-19 related mortality, an increased rate of hospital acquired infections and increased self-isolation. Shielding during a future pandemic should only be considered alongside effective measures to reduce healthcare associated infections. |
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| Keywords: |
COVID-19; Pandemic; Shielding; Routine linked data; Self-reported outcomes |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This study was funded through the 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 also supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales. Swansea University sponsored the study. |
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