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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Effects on mortality of shielding clinically extremely vulnerable patients in Liverpool, UK, during the COVID-19 pandemic
AU - Filipe, Luís
AU - Barnett, Lauren A.
AU - Piroddi, Roberta
AU - Buchan, Iain
AU - Duckworth, Helen
AU - Barr, Benjamin
PY - 2023/9/30
Y1 - 2023/9/30
N2 - Objective This study evaluates the impact of England's COVID-19 shielding programme on mortality in the City of Liverpool in North West England. Study design Shielded and non-shielded people are compared using data from linked routine health records on all people registered with a general practitioner in Liverpool from April 2020 to June 2021. Methods A discrete time hazard model and interactions between the shielding status and the periods of higher risk of transmission are used to explore the effects of shielding across the major phases of the COVID-19 pandemic. Results Shielding was associated with a 34% reduction in the risk of dying (HR = 0.66, 95% CI: 0.58 to 0.76) compared with a propensity-matched non-shielded group. Shielding appeared to reduce mortality during the first and third waves, but not during the second wave, where shielding was not mandated by the government. The effects were similar for males and females, but more protective for those living in the least deprived areas of Liverpool. Conclusions It is likely that the shielding programme in Liverpool saved lives, although this seems to have been a little less effective in more deprived areas. A comprehensive programme for identifying vulnerable groups and providing them with advice and support is likely to be important for future respiratory virus pandemics. Additional support may be necessary for socio-economically disadvantaged groups to avoid increased inequalities.
AB - Objective This study evaluates the impact of England's COVID-19 shielding programme on mortality in the City of Liverpool in North West England. Study design Shielded and non-shielded people are compared using data from linked routine health records on all people registered with a general practitioner in Liverpool from April 2020 to June 2021. Methods A discrete time hazard model and interactions between the shielding status and the periods of higher risk of transmission are used to explore the effects of shielding across the major phases of the COVID-19 pandemic. Results Shielding was associated with a 34% reduction in the risk of dying (HR = 0.66, 95% CI: 0.58 to 0.76) compared with a propensity-matched non-shielded group. Shielding appeared to reduce mortality during the first and third waves, but not during the second wave, where shielding was not mandated by the government. The effects were similar for males and females, but more protective for those living in the least deprived areas of Liverpool. Conclusions It is likely that the shielding programme in Liverpool saved lives, although this seems to have been a little less effective in more deprived areas. A comprehensive programme for identifying vulnerable groups and providing them with advice and support is likely to be important for future respiratory virus pandemics. Additional support may be necessary for socio-economically disadvantaged groups to avoid increased inequalities.
KW - COVID-19 pandemic
KW - Shielding Programme| Mortality Risk
KW - Lives saved
U2 - 10.1016/j.puhe.2023.06.037
DO - 10.1016/j.puhe.2023.06.037
M3 - Journal article
VL - 222
SP - 54
EP - 59
JO - Public Health
JF - Public Health
SN - 0033-3506
ER -