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Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people

Syed Ahmar Shah Orcid Logo, Sinead Brophy Orcid Logo, Jonathan Kennedy, Louis Fisher, Alex Walker, Brian Mackenna, Helen Curtis, Peter Inglesby, Simon Davy, Seb Bacon, Ben Goldacre, Utkarsh Agrawal Orcid Logo, Emily Moore, Colin R Simpson, John Macleod, Roxanne Cooksey Orcid Logo, Aziz Sheikh, Srinivasa Vittal Katikireddi

eClinicalMedicine, Volume: 49, Start page: 101462

Swansea University Authors: Sinead Brophy Orcid Logo, Jonathan Kennedy, Roxanne Cooksey Orcid Logo

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DOI (Published version): 10.1016/j.eclinm.2022.101462

Abstract

Background: Uncontrolled infection and lockdown measures introduced in response have resulted in an unprecedented challenge for health systems internationally. Whether such unprecedented impact was due to lockdown itself and recedes when such measures are lifted is unclear. We assessed the short- an...

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Published in: eClinicalMedicine
ISSN: 2589-5370
Published: Elsevier BV 2022
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2026-02-03T11:05:40.6736118</datestamp><bib-version>v2</bib-version><id>71378</id><entry>2026-02-03</entry><title>Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people</title><swanseaauthors><author><sid>84f5661b35a729f55047f9e793d8798b</sid><ORCID>0000-0001-7417-2858</ORCID><firstname>Sinead</firstname><surname>Brophy</surname><name>Sinead Brophy</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>08163d1f58d7fefcb1c695bcc2e0ef68</sid><ORCID/><firstname>Jonathan</firstname><surname>Kennedy</surname><name>Jonathan Kennedy</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>df63826249b712dcb03cb0161d0f3daf</sid><ORCID>0000-0002-6763-9373</ORCID><firstname>Roxanne</firstname><surname>Cooksey</surname><name>Roxanne Cooksey</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2026-02-03</date><deptcode>MEDS</deptcode><abstract>Background: Uncontrolled infection and lockdown measures introduced in response have resulted in an unprecedented challenge for health systems internationally. Whether such unprecedented impact was due to lockdown itself and recedes when such measures are lifted is unclear. We assessed the short- and medium-term impacts of the first lockdown measures on hospital care for tracer non-COVID-19 conditions in England, Scotland and Wales across diseases, sexes, and socioeconomic and ethnic groups. Methods: We used OpenSAFELY (for England), EAVEII (Scotland), and SAIL Databank (Wales) to extract weekly hospital admission rates for cancer, cardiovascular and respiratory conditions (excluding COVID-19) from the pre-pandemic period until 25/10/2020 and conducted a controlled interrupted time series analysis. We undertook stratified analyses and assessed admission rates over seven months during which lockdown restrictions were gradually lifted. Findings: Our combined dataset included 32 million people who contributed over 74 million person-years. Admission rates for all three conditions fell by 34.2% (Confidence Interval (CI): -43.0, -25.3) in England, 20.9% (CI: -27.8, -14.1) in Scotland, and 24.7% (CI: -36.7, -12.7) in Wales, with falls across every stratum considered. In all three nations, cancer-related admissions fell the most while respiratory-related admissions fell the least (e.g., rates fell by 40.5% (CI: -47.4, -33.6), 21.9% (CI: -35.4, -8.4), and 19.0% (CI: -30.6, -7.4) in England for cancer, cardiovascular-related, and respiratory-related admissions respectively). Unscheduled admissions rates fell more in the most than the least deprived quintile across all three nations. Some ethnic minority groups experienced greater falls in admissions (e.g., in England, unscheduled admissions fell by 9.5% (CI: -20.2, 1.2) for Whites, but 44.3% (CI: -71.0, -17.6), 34.6% (CI: -63.8, -5.3), and 25.6% (CI: -45.0, -6.3) for Mixed, Other and Black ethnic groups respectively). Despite easing of restrictions, the overall admission rates remained lower in England, Scotland, and Wales by 20.8%, 21.6%, and 22.0%, respectively when compared to the same period (August-September) during the pre-pandemic years. This corresponds to a reduction of 26.2, 23.8 and 30.2 admissions per 100,000 people in England, Scotland, and Wales respectively. Interpretation: Hospital care for non-COVID diseases fell substantially across England, Scotland, and Wales during the first lockdown, with reductions persisting for at least six months. The most deprived and minority ethnic groups were impacted more severely.</abstract><type>Journal Article</type><journal>eClinicalMedicine</journal><volume>49</volume><journalNumber/><paginationStart>101462</paginationStart><paginationEnd/><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2589-5370</issnElectronic><keywords>SARS-CoV-2; Covid-19; Pandemic; Healthcare Disruption; Interrupted time series analysis; Healthcare Inequalities</keywords><publishedDay>1</publishedDay><publishedMonth>7</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-07-01</publishedDate><doi>10.1016/j.eclinm.2022.101462</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This work was funded by the Medical Research Council as part of the Lifelong Health and Wellbeing study as part of National Core Studies (MC_PC_20030). SVK acknowledges funding from the Medical Research Council (MC_UU_00022/2), and the Scottish Government Chief Scientist Office (SPHSU17). EAVE II is funded by the Medical Research Council (MR/R008345/1) with the support of BREATHE &#x2013; The Health Data Research Hub for Respiratory Health (MC_PC_19004), which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. BG has received research funding from the NHS National Institute for Health Research (NIHR), the Wellcome Trust, Health Data Research UK, Asthma UK, the British Lung Foundation, and the Longitudinal Health and Wellbeing strand of the National Core Studies programme.</funders><projectreference/><lastEdited>2026-02-03T11:05:40.6736118</lastEdited><Created>2026-02-03T10:48:27.7346287</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>Syed Ahmar</firstname><surname>Shah</surname><orcid>0000-0001-5672-0443</orcid><order>1</order></author><author><firstname>Sinead</firstname><surname>Brophy</surname><orcid>0000-0001-7417-2858</orcid><order>2</order></author><author><firstname>Jonathan</firstname><surname>Kennedy</surname><orcid/><order>3</order></author><author><firstname>Louis</firstname><surname>Fisher</surname><order>4</order></author><author><firstname>Alex</firstname><surname>Walker</surname><order>5</order></author><author><firstname>Brian</firstname><surname>Mackenna</surname><order>6</order></author><author><firstname>Helen</firstname><surname>Curtis</surname><order>7</order></author><author><firstname>Peter</firstname><surname>Inglesby</surname><order>8</order></author><author><firstname>Simon</firstname><surname>Davy</surname><order>9</order></author><author><firstname>Seb</firstname><surname>Bacon</surname><order>10</order></author><author><firstname>Ben</firstname><surname>Goldacre</surname><order>11</order></author><author><firstname>Utkarsh</firstname><surname>Agrawal</surname><orcid>0000-0001-5181-6120</orcid><order>12</order></author><author><firstname>Emily</firstname><surname>Moore</surname><order>13</order></author><author><firstname>Colin R</firstname><surname>Simpson</surname><order>14</order></author><author><firstname>John</firstname><surname>Macleod</surname><order>15</order></author><author><firstname>Roxanne</firstname><surname>Cooksey</surname><orcid>0000-0002-6763-9373</orcid><order>16</order></author><author><firstname>Aziz</firstname><surname>Sheikh</surname><order>17</order></author><author><firstname>Srinivasa Vittal</firstname><surname>Katikireddi</surname><order>18</order></author></authors><documents><document><filename>71378__36179__77c62a1a80dd494593a9935f28aed29c.pdf</filename><originalFilename>71378.VOR.pdf</originalFilename><uploaded>2026-02-03T11:02:30.1156139</uploaded><type>Output</type><contentLength>758409</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2022 The Authors. 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spelling 2026-02-03T11:05:40.6736118 v2 71378 2026-02-03 Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people 84f5661b35a729f55047f9e793d8798b 0000-0001-7417-2858 Sinead Brophy Sinead Brophy true false 08163d1f58d7fefcb1c695bcc2e0ef68 Jonathan Kennedy Jonathan Kennedy true false df63826249b712dcb03cb0161d0f3daf 0000-0002-6763-9373 Roxanne Cooksey Roxanne Cooksey true false 2026-02-03 MEDS Background: Uncontrolled infection and lockdown measures introduced in response have resulted in an unprecedented challenge for health systems internationally. Whether such unprecedented impact was due to lockdown itself and recedes when such measures are lifted is unclear. We assessed the short- and medium-term impacts of the first lockdown measures on hospital care for tracer non-COVID-19 conditions in England, Scotland and Wales across diseases, sexes, and socioeconomic and ethnic groups. Methods: We used OpenSAFELY (for England), EAVEII (Scotland), and SAIL Databank (Wales) to extract weekly hospital admission rates for cancer, cardiovascular and respiratory conditions (excluding COVID-19) from the pre-pandemic period until 25/10/2020 and conducted a controlled interrupted time series analysis. We undertook stratified analyses and assessed admission rates over seven months during which lockdown restrictions were gradually lifted. Findings: Our combined dataset included 32 million people who contributed over 74 million person-years. Admission rates for all three conditions fell by 34.2% (Confidence Interval (CI): -43.0, -25.3) in England, 20.9% (CI: -27.8, -14.1) in Scotland, and 24.7% (CI: -36.7, -12.7) in Wales, with falls across every stratum considered. In all three nations, cancer-related admissions fell the most while respiratory-related admissions fell the least (e.g., rates fell by 40.5% (CI: -47.4, -33.6), 21.9% (CI: -35.4, -8.4), and 19.0% (CI: -30.6, -7.4) in England for cancer, cardiovascular-related, and respiratory-related admissions respectively). Unscheduled admissions rates fell more in the most than the least deprived quintile across all three nations. Some ethnic minority groups experienced greater falls in admissions (e.g., in England, unscheduled admissions fell by 9.5% (CI: -20.2, 1.2) for Whites, but 44.3% (CI: -71.0, -17.6), 34.6% (CI: -63.8, -5.3), and 25.6% (CI: -45.0, -6.3) for Mixed, Other and Black ethnic groups respectively). Despite easing of restrictions, the overall admission rates remained lower in England, Scotland, and Wales by 20.8%, 21.6%, and 22.0%, respectively when compared to the same period (August-September) during the pre-pandemic years. This corresponds to a reduction of 26.2, 23.8 and 30.2 admissions per 100,000 people in England, Scotland, and Wales respectively. Interpretation: Hospital care for non-COVID diseases fell substantially across England, Scotland, and Wales during the first lockdown, with reductions persisting for at least six months. The most deprived and minority ethnic groups were impacted more severely. Journal Article eClinicalMedicine 49 101462 Elsevier BV 2589-5370 SARS-CoV-2; Covid-19; Pandemic; Healthcare Disruption; Interrupted time series analysis; Healthcare Inequalities 1 7 2022 2022-07-01 10.1016/j.eclinm.2022.101462 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This work was funded by the Medical Research Council as part of the Lifelong Health and Wellbeing study as part of National Core Studies (MC_PC_20030). SVK acknowledges funding from the Medical Research Council (MC_UU_00022/2), and the Scottish Government Chief Scientist Office (SPHSU17). EAVE II is funded by the Medical Research Council (MR/R008345/1) with the support of BREATHE – The Health Data Research Hub for Respiratory Health (MC_PC_19004), which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. BG has received research funding from the NHS National Institute for Health Research (NIHR), the Wellcome Trust, Health Data Research UK, Asthma UK, the British Lung Foundation, and the Longitudinal Health and Wellbeing strand of the National Core Studies programme. 2026-02-03T11:05:40.6736118 2026-02-03T10:48:27.7346287 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Syed Ahmar Shah 0000-0001-5672-0443 1 Sinead Brophy 0000-0001-7417-2858 2 Jonathan Kennedy 3 Louis Fisher 4 Alex Walker 5 Brian Mackenna 6 Helen Curtis 7 Peter Inglesby 8 Simon Davy 9 Seb Bacon 10 Ben Goldacre 11 Utkarsh Agrawal 0000-0001-5181-6120 12 Emily Moore 13 Colin R Simpson 14 John Macleod 15 Roxanne Cooksey 0000-0002-6763-9373 16 Aziz Sheikh 17 Srinivasa Vittal Katikireddi 18 71378__36179__77c62a1a80dd494593a9935f28aed29c.pdf 71378.VOR.pdf 2026-02-03T11:02:30.1156139 Output 758409 application/pdf Version of Record true © 2022 The Authors. This is an open access article under the CC BY-NC-ND license. true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
title Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people
spellingShingle Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people
Sinead Brophy
Jonathan Kennedy
Roxanne Cooksey
title_short Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people
title_full Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people
title_fullStr Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people
title_full_unstemmed Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people
title_sort Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people
author_id_str_mv 84f5661b35a729f55047f9e793d8798b
08163d1f58d7fefcb1c695bcc2e0ef68
df63826249b712dcb03cb0161d0f3daf
author_id_fullname_str_mv 84f5661b35a729f55047f9e793d8798b_***_Sinead Brophy
08163d1f58d7fefcb1c695bcc2e0ef68_***_Jonathan Kennedy
df63826249b712dcb03cb0161d0f3daf_***_Roxanne Cooksey
author Sinead Brophy
Jonathan Kennedy
Roxanne Cooksey
author2 Syed Ahmar Shah
Sinead Brophy
Jonathan Kennedy
Louis Fisher
Alex Walker
Brian Mackenna
Helen Curtis
Peter Inglesby
Simon Davy
Seb Bacon
Ben Goldacre
Utkarsh Agrawal
Emily Moore
Colin R Simpson
John Macleod
Roxanne Cooksey
Aziz Sheikh
Srinivasa Vittal Katikireddi
format Journal article
container_title eClinicalMedicine
container_volume 49
container_start_page 101462
publishDate 2022
institution Swansea University
issn 2589-5370
doi_str_mv 10.1016/j.eclinm.2022.101462
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 Background: Uncontrolled infection and lockdown measures introduced in response have resulted in an unprecedented challenge for health systems internationally. Whether such unprecedented impact was due to lockdown itself and recedes when such measures are lifted is unclear. We assessed the short- and medium-term impacts of the first lockdown measures on hospital care for tracer non-COVID-19 conditions in England, Scotland and Wales across diseases, sexes, and socioeconomic and ethnic groups. Methods: We used OpenSAFELY (for England), EAVEII (Scotland), and SAIL Databank (Wales) to extract weekly hospital admission rates for cancer, cardiovascular and respiratory conditions (excluding COVID-19) from the pre-pandemic period until 25/10/2020 and conducted a controlled interrupted time series analysis. We undertook stratified analyses and assessed admission rates over seven months during which lockdown restrictions were gradually lifted. Findings: Our combined dataset included 32 million people who contributed over 74 million person-years. Admission rates for all three conditions fell by 34.2% (Confidence Interval (CI): -43.0, -25.3) in England, 20.9% (CI: -27.8, -14.1) in Scotland, and 24.7% (CI: -36.7, -12.7) in Wales, with falls across every stratum considered. In all three nations, cancer-related admissions fell the most while respiratory-related admissions fell the least (e.g., rates fell by 40.5% (CI: -47.4, -33.6), 21.9% (CI: -35.4, -8.4), and 19.0% (CI: -30.6, -7.4) in England for cancer, cardiovascular-related, and respiratory-related admissions respectively). Unscheduled admissions rates fell more in the most than the least deprived quintile across all three nations. Some ethnic minority groups experienced greater falls in admissions (e.g., in England, unscheduled admissions fell by 9.5% (CI: -20.2, 1.2) for Whites, but 44.3% (CI: -71.0, -17.6), 34.6% (CI: -63.8, -5.3), and 25.6% (CI: -45.0, -6.3) for Mixed, Other and Black ethnic groups respectively). Despite easing of restrictions, the overall admission rates remained lower in England, Scotland, and Wales by 20.8%, 21.6%, and 22.0%, respectively when compared to the same period (August-September) during the pre-pandemic years. This corresponds to a reduction of 26.2, 23.8 and 30.2 admissions per 100,000 people in England, Scotland, and Wales respectively. Interpretation: Hospital care for non-COVID diseases fell substantially across England, Scotland, and Wales during the first lockdown, with reductions persisting for at least six months. The most deprived and minority ethnic groups were impacted more severely.
published_date 2022-07-01T05:32:15Z
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