Christopher I Jarvis1, Amy Gimma2, Kevin van Zandvoort2, Kerry L M Wong2, W John Edmunds2. 1. Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. Christopher.Jarvis@lshtm.ac.uk. 2. Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Abstract
BACKGROUND: England's COVID-19 response transitioned from a national lockdown to localised interventions. In response to rising cases, these were supplemented by national restrictions on contacts (the Rule of Six), then 10 pm closing for bars and restaurants, and encouragement to work from home. These were quickly followed by a 3-tier system applying different restrictions in different localities. As cases continued to rise, a second national lockdown was declared. We used a national survey to quantify the impact of these restrictions on epidemiologically relevant contacts. METHODS: We compared paired measures on setting-specific contacts before and after each restriction started and tested for differences using paired permutation tests on the mean change in contacts and the proportion of individuals decreasing their contacts. RESULTS: Following the imposition of each measure, individuals tended to report fewer contacts than they had before. However, the magnitude of the changes was relatively small and variable. For instance, although early closure of bars and restaurants appeared to have no measurable effect on contacts, the work from home directive reduced mean daily work contacts by 0.99 (95% confidence interval CI] 0.03-1.94), and the Rule of Six reduced non-work and school contacts by a mean of 0.25 (0.01-0.5) per day. Whilst Tier 3 appeared to also reduce non-work and school contacts, the evidence for an effect of the lesser restrictions (Tiers 1 and 2) was much weaker. There may also have been some evidence of saturation of effects, with those who were in Tier 1 (least restrictive) reducing their contacts markedly when they entered lockdown, which was not reflected in similar changes in those who were already under tighter restrictions (Tiers 2 and 3). CONCLUSIONS: The imposition of various local and national measures in England during the summer and autumn of 2020 has gradually reduced contacts. However, these changes are smaller than the initial lockdown in March. This may partly be because many individuals were already starting from a lower number of contacts.
BACKGROUND: England's COVID-19 response transitioned from a national lockdown to localised interventions. In response to rising cases, these were supplemented by national restrictions on contacts (the Rule of Six), then 10 pm closing for bars and restaurants, and encouragement to work from home. These were quickly followed by a 3-tier system applying different restrictions in different localities. As cases continued to rise, a second national lockdown was declared. We used a national survey to quantify the impact of these restrictions on epidemiologically relevant contacts. METHODS: We compared paired measures on setting-specific contacts before and after each restriction started and tested for differences using paired permutation tests on the mean change in contacts and the proportion of individuals decreasing their contacts. RESULTS: Following the imposition of each measure, individuals tended to report fewer contacts than they had before. However, the magnitude of the changes was relatively small and variable. For instance, although early closure of bars and restaurants appeared to have no measurable effect on contacts, the work from home directive reduced mean daily work contacts by 0.99 (95% confidence interval CI] 0.03-1.94), and the Rule of Six reduced non-work and school contacts by a mean of 0.25 (0.01-0.5) per day. Whilst Tier 3 appeared to also reduce non-work and school contacts, the evidence for an effect of the lesser restrictions (Tiers 1 and 2) was much weaker. There may also have been some evidence of saturation of effects, with those who were in Tier 1 (least restrictive) reducing their contacts markedly when they entered lockdown, which was not reflected in similar changes in those who were already under tighter restrictions (Tiers 2 and 3). CONCLUSIONS: The imposition of various local and national measures in England during the summer and autumn of 2020 has gradually reduced contacts. However, these changes are smaller than the initial lockdown in March. This may partly be because many individuals were already starting from a lower number of contacts.
Authors: Seth Flaxman; Swapnil Mishra; Axel Gandy; H Juliette T Unwin; Thomas A Mellan; Helen Coupland; Charles Whittaker; Harrison Zhu; Tresnia Berah; Jeffrey W Eaton; Mélodie Monod; Azra C Ghani; Christl A Donnelly; Steven Riley; Michaela A C Vollmer; Neil M Ferguson; Lucy C Okell; Samir Bhatt Journal: Nature Date: 2020-06-08 Impact factor: 49.962
Authors: Christopher I Jarvis; Kevin Van Zandvoort; Amy Gimma; Kiesha Prem; Petra Klepac; G James Rubin; W John Edmunds Journal: BMC Med Date: 2020-05-07 Impact factor: 8.775
Authors: Amy Gimma; James D Munday; Kerry L M Wong; Pietro Coletti; Kevin van Zandvoort; Kiesha Prem; Petra Klepac; G James Rubin; Sebastian Funk; W John Edmunds; Christopher I Jarvis Journal: PLoS Med Date: 2022-03-01 Impact factor: 11.069
Authors: Francisco Javier Candel; Jesús San-Román; Pablo Barreiro; Jesús Canora; Antonio Zapatero; Mar Carretero; Antonio Lastra; Francisco Javier Martínez-Peromingo Journal: Lancet Reg Health Eur Date: 2021-01-23
Authors: Andria Mousa; Peter Winskill; Oliver John Watson; Oliver Ratmann; Mélodie Monod; Marco Ajelli; Aldiouma Diallo; Peter J Dodd; Carlos G Grijalva; Moses Chapa Kiti; Anand Krishnan; Rakesh Kumar; Supriya Kumar; Kin O Kwok; Claudio F Lanata; Olivier Le Polain de Waroux; Kathy Leung; Wiriya Mahikul; Alessia Melegaro; Carl D Morrow; Joël Mossong; Eleanor Fg Neal; D James Nokes; Wirichada Pan-Ngum; Gail E Potter; Fiona M Russell; Siddhartha Saha; Jonathan D Sugimoto; Wan In Wei; Robin R Wood; Joseph Wu; Juanjuan Zhang; Patrick Walker; Charles Whittaker Journal: Elife Date: 2021-11-25 Impact factor: 8.713
Authors: Kathleen M O'Reilly; Frank Sandman; David Allen; Christopher I Jarvis; Amy Gimma; Amy Douglas; Lesley Larkin; Kerry L M Wong; Marc Baguelin; Ralph S Baric; Lisa C Lindesmith; Richard A Goldstein; Judith Breuer; W John Edmunds Journal: BMC Med Date: 2021-11-09 Impact factor: 8.775
Authors: George E Richardson; Conor S Gillespie; Soham Bandyopadhyay; Emma J Norton; Jigi M Joshi; Orla Mantle; Catinca Ciuculete; Armin Nazari; John Ong; Ajitesh Anand; Jay Park; Rosaline De Koning; Setthasorn Zhi Yang Ooi; Joshua Erhabor; Harmani K Daler; Bailint Borbas; Zeluleko Sibanda; Illectra Lerou; Alvaro Y Touzet; Phil Mcelnay; Suzanne Murray; Peter J Hutchinson; Alistair Jenkins Journal: Cureus Date: 2022-01-12
Authors: Bettina Moltrecht; Simone de Cassan; Elizabeth Rapa; Jeffrey R Hanna; Clare Law; Louise J Dalton Journal: BMC Health Serv Res Date: 2022-08-12 Impact factor: 2.908
Authors: Andria Mousa; Peter Winskill; Oliver J Watson; Oliver Ratmann; Mélodie Monod; Marco Ajelli; Aldiouma Diallo; Peter J Dodd; Carlos G Grijalva; Moses Chapa Kiti; Anand Krishnan; Rakesh Kumar; Supriya Kumar; Kin On Kwok; Claudio F Lanata; Olivier Le Polain de Waroux; Kathy Leung; Wiriya Mahikul; Alessia Melegaro; Carl D Morrow; Joël Mossong; Eleanor Fg Neal; David J Nokes; Wirichada Pan-Ngum; Gail E Potter; Fiona M Russell; Siddhartha Saha; Jonathan D Sugimoto; Wan In Wei; Robin R Wood; Joseph T Wu; Juanjuan Zhang; Patrick Gt Walker; Charles Whittaker Journal: medRxiv Date: 2021-06-15