scholarly journals Modelling the impact of lockdown easing measures on cumulative COVID-19 cases and deaths in England

2020 ◽  
Author(s):  
H Ziauddeen ◽  
N Subramaniam ◽  
D Gurdasani
Keyword(s):  
Bayesian Model ◽  
Added Value ◽  
Reproductive Number ◽  
Baseline Scenario ◽  
Community Transmission ◽  
Uk Government ◽  
The Uk ◽  
Incident Cases ◽  
The Impact ◽  
Death Data

AbstractBackgroundAs countries begin to ease the lockdown measures instituted to control the COVID-19 pandemic, there is a risk of a resurgence of the pandemic. The UK started easing lockdown in England when levels of community transmission remained high, which could have a major impact on case numbers and deaths. Using a Bayesian model we assessed the potential impacts of successive lockdown easing measures in England, focussing on scenarios where the reproductive number (R) remains ≤1 in line with the UK government’s stated aim.MethodsWe developed a Bayesian model to infer incident cases and R in England, from incident death data from the Office of National Statistics. We then used this to forecast excess cases and deaths in multiple plausible scenarios in which R increases at one or more time points, compared to a baseline scenario where R remains unchanged by the easing of lockdown.FindingsThe model inferred an R of 0.81 on the 13th May when England first started easing lockdown. In the most conservative scenario where R increases to 0.85 as lockdown was eased further on 1st June and then remained constant, the model predicts an excess 400 (95% CI 34-1988) deaths and 56,019 (95% CI 4768-278,083) cumulative cases over 90 days. In the scenario with maximal increases in R (but staying ≤1) with successive easing of lockdown, the model predicts 1,946 (95% CI 165-9,667) excess cumulative deaths and 351,460 (95% CI 29,894-1,747,026) excess cases.InterpretationWhen levels of transmission are high, even small changes in R with easing of lockdown can have significant impacts on expected cases and deaths, even if R remains ≤1. This will have a major impact on tracing systems and health care services in England. This model can be updated with incoming death data to refine predictions over time.FundingNone.Research in contextEvidence before this studyThe impact of social distancing and lockdown measures on controlling the COVID-19 pandemic has been studied extensively over the last few months. However there has been little examination of the likely impact of easing lockdown measures in a staged manner as is being currently carried out in England, UK. We searched PubMed, medRxiv, bioRxiv, arXiv, and Wellcome Open Research for peer-reviewed articles, preprints, and research reports using the terms “COVID-19”, “United Kingdom” and “lockdown” for research examining these impacts, but found no relevant research that could inform the impact of phased easing of lockdown within England, UK.Added value of this studyDecisions around timing of easing lockdown need to be informed by current scientific evidence. In this context, this study provides urgently needed information about the potential impact of lockdown easing at this point within the COVID-19 pandemic in England. Using an epidemiological approach with Bayesian inference, we specifically assess several plausible scenarios of increase in R from baseline as a result of easing lockdown measures at levels of current community transmission, even when the R is maintained ≤1, which is the stated aim of the UK government. We provide a comparison of these scenarios, with a baseline scenario where R remains constant, as well as against elimination strategies, where transmission is aggressively suppressed to the lowest level possible. As our code is publicly available, these methods can be easily applied to accruing data, and to any number of scenarios to better understand the implications for public health policy.Implications of all the available evidenceEasing lockdown at a point of relatively high community transmission within the UK would lead to substantial excesses of deaths, and cases, even if R is maintained at ≤1. As expected, these increases are more marked, when R rises above 1, which is a distinct possibility, given recent estimates of R by a UK government advisory group.1 Our findings suggest that an elimination strategy would be more appropriate at this point, to allow suppression of community transmission to a point where easing of lockdown would not have the same impact, as with current transmission, and would likely not overwhelm systems of test, trace and isolate, and health services within England.

scholarly journals Modelling the impact of lockdown-easing measures on cumulative COVID-19 cases and deaths in England

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e042483
Author(s):  
Hisham Ziauddeen ◽  
Naresh Subramaniam ◽  
Deepti Gurdasani
Keyword(s):  
Bayesian Model ◽  
Primary Outcome ◽  
Reproduction Number ◽  
Healthcare Services ◽  
Baseline Scenario ◽  
Time Points ◽  
Community Transmission ◽  
Incident Cases ◽  
The Impact ◽  
Death Data

ObjectivesTo assess the potential impacts of successive lockdown-easing measures in England, at a point in the COVID-19 pandemic when community transmission levels were relatively high.DesignWe developed a Bayesian model to infer incident cases and reproduction number (R) in England, from incident death data. We then used this to forecast excess cases and deaths in multiple plausible scenarios in which R increases at one or more time points.SettingEngland.ParticipantsPublicly available national incident death data for COVID-19 were examined.Primary outcomeExcess cumulative cases and deaths forecast at 90 days, in simulated scenarios of plausible increases in R after successive easing of lockdown in England, compared with a baseline scenario where R remained constant.ResultsOur model inferred an R of 0.75 on 13 May when England first started easing lockdown. In the most conservative scenario modelled where R increased to 0.80 as lockdown was eased further on 1 June and then remained constant, the model predicted an excess 257 (95% CI 108 to 492) deaths and 26 447 (95% CI 11 105 to 50 549) cumulative cases over 90 days. In the scenario with maximal increases in R (but staying ≤1), the model predicts 3174 (95% CI 1334 to 6060) excess cumulative deaths and 421 310 (95% CI 177 012 to 804 811) cases. Observed data from the forecasting period aligned most closely to the scenario in which R increased to 0.85 on 1 June, and 0.9 on 4 July.ConclusionsWhen levels of transmission are high, even small changes in R with easing of lockdown can have significant impacts on expected cases and deaths, even if R remains ≤1. This will have a major impact on population health, tracing systems and healthcare services in England. Following an elimination strategy rather than one of maintenance of R ≤1 would substantially mitigate the impact of the COVID-19 epidemic within England.

scholarly journals Reopening schools without strict COVID-19 mitigation measures risks accelerating the pandemic

2021 ◽  
Author(s):  
Deepti Gurdasani ◽  
Nisreen Alwan ◽  
Trisha Greenhalgh ◽  
Zoë Hyde ◽  
Luke Johnson ◽  
...  
Keyword(s):  
Social Development ◽  
Mitigation Measures ◽  
Children And Families ◽  
Cdc Guidelines ◽  
Community Transmission ◽  
Uk Government ◽  
The Uk ◽  
Returning To School ◽  
The Impact

On 22nd February, the UK government announced schools in England would fully reopen on the 8th March 2021. While returning to school as soon as possible is imperative for the education, social development, and mental and physical welfare of children, not enough has been done to make schools safer for students and staff. Multi-layered mitigations can substantially reduce the risk of transmission within schools and into households. In the Appendix we outline a set of recommendations, in line with CDC guidelines and practiced in many countries, to reduce the risk of transmission in schools and mitigate the impact of COVID-19 on children and families. Making schools safer goes hand in hand with reducing community transmission, and is essential to allow schools to safely reopen and remain open.

Heterogeneity in norovirus shedding duration affects community risk

2013 ◽  
Vol 141 (8) ◽  
pp. 1572-1584 ◽  
Author(s):  
M. O. MILBRATH ◽  
I. H. SPICKNALL ◽  
J. L. ZELNER ◽  
C. L. MOE ◽  
J. N. S. EISENBERG
Keyword(s):  
Attack Rate ◽  
Transmission Model ◽  
Reproductive Number ◽  
Risk Models ◽  
Common Cause ◽  
Viral Shedding ◽  
Duration Data ◽  
Community Risk ◽  
Community Transmission ◽  
The Impact

SUMMARYNorovirus is a common cause of gastroenteritis in all ages. Typical infections cause viral shedding periods of days to weeks, but some individuals can shed for months or years. Most norovirus risk models do not include these long-shedding individuals, and may therefore underestimate risk. We reviewed the literature for norovirus-shedding duration data and stratified these data into two distributions: regular shedding (mean 14–16 days) and long shedding (mean 105–136 days). These distributions were used to inform a norovirus transmission model that predicts the impact of long shedders. Our transmission model predicts that this subpopulation increases the outbreak potential (measured by the reproductive number) by 50–80%, the probability of an outbreak by 33%, the severity of transmission (measured by the attack rate) by 20%, and transmission duration by 100%. Characterizing and understanding shedding duration heterogeneity can provide insights into community transmission that can be useful in mitigating norovirus risk.

scholarly journals Estimating the burden of SARS-CoV-2 in France

Science ◽  
2020 ◽  
Vol 369 (6500) ◽  
pp. 208-211 ◽  
Author(s):  
Henrik Salje ◽  
Cécile Tran Kiem ◽  
Noémie Lefrancq ◽  
Noémie Courtejoie ◽  
Paolo Bosetti ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Credible Interval ◽  
Control Measures ◽  
Reproductive Number ◽  
Infected Population ◽  
Population Immunity ◽  
The Impact ◽  
Second Wave ◽  
Death Data

France has been heavily affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and went into lockdown on 17 March 2020. Using models applied to hospital and death data, we estimate the impact of the lockdown and current population immunity. We find that 2.9% of infected individuals are hospitalized and 0.5% of those infected die (95% credible interval: 0.3 to 0.9%), ranging from 0.001% in those under 20 years of age to 8.3% in those 80 years of age or older. Across all ages, men are more likely to be hospitalized, enter intensive care, and die than women. The lockdown reduced the reproductive number from 2.90 to 0.67 (77% reduction). By 11 May 2020, when interventions are scheduled to be eased, we project that 3.5 million people (range: 2.1 million to 6.0 million), or 5.3% of the population (range: 3.3 to 9.3%), will have been infected. Population immunity appears to be insufficient to avoid a second wave if all control measures are released at the end of the lockdown.

UK initiatives to reduce antimicrobial resistant infections, 2013-2018

2016 ◽  
Vol 21 (3) ◽  
pp. 131-138 ◽  
Author(s):  
Susan Hopkins
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Government Policy ◽  
Design Methodology ◽  
Antibiotic Use ◽  
Content Type ◽  
Uk Government ◽  
The Many ◽  
The Uk ◽  
The Impact

Purpose – The purpose of this paper is to highlight the local, national and global actions from the UK to reduce the impact of antimicrobial resistance (AMR) on human health. Design/methodology/approach – Synthesis of UK government policy, surveillance and research on AMR. Findings – Activities that are taking place by the UK government, public health and professional organisations are highlighted. Originality/value – This paper describes the development and areas for action of the UK AMR strategy. It highlights the many interventions that are being delivered to reduce antibiotic use and antimicrobial resistant infections.

Prospects for a close EU-UK trade deal are not good

2019 ◽  
Keyword(s):  
United Kingdom ◽  
Financial Services ◽  
Transition Period ◽  
Content Type ◽  
The United Kingdom ◽  
Uk Government ◽  
The Uk ◽  
The Impact ◽  
Limited Period ◽  
The Eu

Subject UK-EU trade talks. Significance The United Kingdom will leave the EU on January 31, 2020, but will abide by EU rules as part of the transition period, which runs to December 31, 2020. During this limited period of time, London and Brussels will seek to negotiate a permanent trading relationship. While the transition deadline can be extended, the UK government has committed not to seek an extension. Impacts The impact of no trade deal or a 'thin' one may force the UK government to increase taxes in order to meet spending pledges. UK financial services will rely on an equivalence deal with the EU; London hopes to agree this by mid-2020. The EU’s future trade policy will focus on having stronger sanction powers as well as legal ones for those that unfairly undercut EU firms.

scholarly journals Gambling in COVID-19 Lockdown in the UK: Depression, Stress, and Anxiety

2021 ◽  
Vol 12 ◽  
Author(s):  
Steve Sharman ◽  
Amanda Roberts ◽  
Henrietta Bowden-Jones ◽  
John Strang
Keyword(s):  
Mental Health ◽  
Problem Gambling ◽  
Potential Problem ◽  
Anxiety Scale ◽  
Effect Sizes ◽  
Online Questionnaire ◽  
Problem Gamblers ◽  
Uk Government ◽  
The Uk ◽  
The Impact

To combat the spread of COVID-19, the UK Government implemented a range of “lockdown” measures. Lockdown has necessarily changed the gambling habits of gamblers in the UK, and the impact of these measures on the mental health of gamblers is unknown. To understand the impact of lockdown on gamblers, in April 2020, after ~6 weeks of lockdown, participants (N = 1,028, 72% female) completed an online questionnaire. Gambling engagement data was collected for pre-lockdown via the Brief Problem Gambling Screen (BPGS) allowing participants to be classified as Non-Gamblers (NG), Non-Problem Gamblers (NPG) or Potential Problem Gamblers (PPG). The Depression, Stress, and Anxiety Scale (DASS21) was used to measure depression, stress, and anxiety scores both pre- and during-lockdown. Results indicate that depression, stress and anxiety has increased across the whole sample. Participants classified in the PPG group reported higher scores on each sub scale at both baseline and during lockdown. Increases were observed on each DASS21 subscale, for each gambler group, however despite variable significance and effect sizes, the magnitude of increases did not differ between groups. Lockdown has had a significant impact on mental health of participants; whilst depression stress and anxiety remain highest in potential problem gamblers, pre-lockdown gambler status did not affect changes in DASS21 scores.

The public's opinion regarding the impact of equine passports on the industry

2006 ◽  
Vol 35 ◽  
pp. 255-258
Author(s):  
S. N. Turnbull ◽  
D. M. Abraham
Keyword(s):  
United Kingdom ◽  
Food Safety ◽  
Human Consumption ◽  
The United Kingdom ◽  
Disease Rates ◽  
Crucial Information ◽  
Uk Government ◽  
The Uk ◽  
The Impact

The equine passport legislation is a comparatively new scheme that requires all horses to have a passport by 28th February 2005 (Defra, 2004). The equine passport is thought to have had a major impact on the industry in the United Kingdom, however the extent of this is, as yet, unknown due to the lack of current research. The UK Government hopes that the passport scheme will monitor horses that have been treated with medication and guarantee that they are not slaughtered for human consumption (Frank, 2003, Defra, 2004). Whilst the scheme originated from European food safety legislation (Ellis, 2003), the UK Government believes that there are other benefits attached to the equine passport, such as gaining comprehensive records about the equine population in the UK, which is crucial information required for epidemiological reasons (Mellor et al., 1999). The information will provide a denominator for the assessment of disease rates, and which areas of the country may be under threat.

scholarly journals The Impact of COVID-19 Vaccination on California's Return to Normalcy

2021 ◽  
Author(s):  
Maria L Daza-Torres ◽  
Yury Elena Garcia Puerta ◽  
Alec J Schmidt ◽  
James L Sharpnack ◽  
Bradley H Pollock ◽  
...  
Keyword(s):  
Transmission Rate ◽  
Realistic Model ◽  
Vaccine Uptake ◽  
Model Parameters ◽  
Baseline Scenario ◽  
Effective Population ◽  
Vaccination Rates ◽  
Population Sizes ◽  
Incident Cases ◽  
The Impact

SARS-CoV-2 has infected nearly 3.7 million and killed 61,722 Californians, as of May 22, 2021. Non-pharmaceutical interventions have been instrumental in mitigating the spread of the coronavirus. However, as we ease restrictions, widespread implementation of COVID-19 vaccines is essential to prevent its resurgence. In this work, we addressed the adequacy and deficiency of vaccine uptake within California and the possibility and severity of resurgence of COVID-19 as restrictions are lifted given the current vaccination rates. We implemented a real-time Bayesian data assimilation approach to provide projections of incident cases and deaths in California following the reopening of its economy on June 15, 2021. We implemented scenarios that vary vaccine uptake prior to reopening, and transmission rates and effective population sizes following the reopening. For comparison purposes, we adopted a baseline scenario using the current vaccination rates, which projects a total 11,429 cases and 429 deaths in a 15-day period after reopening. We used posterior estimates based on CA historical data to provide realistic model parameters after reopening. When the transmission rate is increased after reopening, we projected an increase in cases by 21.8% and deaths by 4.4% above the baseline after reopening. When the effective population is increased after reopening, we observed an increase in cases by 51.8% and deaths by 12.3% above baseline. A 30% reduction in vaccine uptake alone has the potential to increase cases and deaths by 35% and 21.6%, respectively. Conversely, increasing vaccine uptake by 30% could decrease cases and deaths by 26.1% and 17.9%, respectively. As California unfolds its plan to reopen its economy on June 15, 2021, it is critical that social distancing and public behavior changes continue to be promoted, particularly in communities with low vaccine uptake. The Centers of Disease Control's (CDC) recommendation to ease mask-wearing for fully vaccinated individuals despite major inequities in vaccine uptake in counties across the state highlights some of the logistical challenges that society faces as we enthusiastically phase out of this pandemic.

scholarly journals Brexit and the stratified uses of national and European Union citizenship

2021 ◽  
pp. 001139212110485
Author(s):  
Djordje Sredanovic ◽  
Francesco Della Puppa
Keyword(s):  
Added Value ◽  
Freedom Of Movement ◽  
The Social ◽  
Social Meanings ◽  
Union Citizenship ◽  
The Uk ◽  
Migratory Experience ◽  
The Impact ◽  
Depth Interviews ◽  
Do So

In this article the authors explore how Brexit changes the social meanings and uses of formal national and EU citizenship and how these meanings and uses are stratified, including by migratory experience, class and age. They do so through in-depth interviews with Britons in Belgium, EU27 citizens ‘by birth’ residing in the UK, and Bangladeshis who naturalised in Italy before moving to the UK. The article highlights the differences both between the three groups and within the groups, along lines of class and age, in the expectations regarding rights linked to citizenship, in the salience of different rights (e.g. freedom of movement, access to welfare, voting), and in the availability of alternative resources to contain the impact of Brexit. The authors argue that the Brexit process not only highlights the value of citizenship as well as the added value of a citizenship of an EU member state, but that it also reveals how the value of citizenships is internally stratified.

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