Swansea University Medical School, Swansea, UK
PRIME Centre Wales, Swansea University Medical School, Swansea, UK.
BMJ Open. 2022 Sep 8;12(9):e059813. doi: 10.1136/bmjopen-2021-059813.
Shielding aimed to protect those predicted to be at highest risk from COVID-19 and was uniquely implemented in the UK during the COVID-19 pandemic. Clinically extremely vulnerable people identified through algorithms and screening of routine National Health Service (NHS) data were individually and strongly advised to stay at home and strictly self-isolate even from others in their household. This study will generate a logic model of the intervention and evaluate the effects and costs of shielding to inform policy development and delivery during future pandemics.
This is a quasiexperimental study undertaken in Wales where records for people who were identified for shielding were already anonymously linked into integrated data systems for public health decision-making. We will: interview policy-makers to understand rationale for shielding advice to inform analysis and interpretation of results; use anonymised individual-level data to select people identified for shielding advice in March 2020 and a matched cohort, from routine electronic health data sources, to compare outcomes; survey a stratified random sample of each group about activities and quality of life at 12 months; use routine and newly collected blood data to assess immunity; interview people who were identified for shielding and their carers and NHS staff who delivered healthcare during shielding, to explore compliance and experiences; collect healthcare resource use data to calculate implementation costs and cost-consequences. Our team includes people who were shielding, who used their experience to help design and deliver this study.
The study has received approval from the Newcastle North Tyneside 2 Research Ethics Committee (IRAS 295050). We will disseminate results directly to UK government policy-makers, publish in peer-reviewed journals, present at scientific and policy conferences and share accessible summaries of results online and through public and patient networks.
屏蔽旨在保护那些预测到 COVID-19 风险最高的人，在 COVID-19 大流行期间，英国独特地实施了这种措施。通过算法和对常规国民保健制度（NHS）数据的筛选，确定了临床极为脆弱的人，他们被单独并强烈建议待在家里，严格自我隔离，即使是与家中的其他人也要隔离。本研究将生成干预措施的逻辑模型，并评估屏蔽的效果和成本，为未来大流行期间的政策制定和实施提供信息。
这是在威尔士进行的一项准实验研究，那里已经将被确定为需要屏蔽的人的记录匿名链接到公共卫生决策的综合数据系统中。我们将：采访政策制定者，了解屏蔽建议的基本原理，以分析和解释结果；使用匿名的个人层面数据，从常规电子健康数据来源中选择 2020 年 3 月被确定为屏蔽建议的人和匹配队列，以比较结果；在 12 个月时对每组进行分层随机抽样调查，了解活动和生活质量情况；使用常规和新收集的血液数据评估免疫情况；对被确定为需要屏蔽的人和他们的照顾者以及在屏蔽期间提供医疗保健的 NHS 工作人员进行访谈，以探讨遵守情况和体验；收集医疗资源使用数据，计算实施成本和成本效益。我们的团队包括正在被屏蔽的人，他们利用自己的经验帮助设计和实施这项研究。
该研究已获得纽卡斯尔北泰恩赛德 2 号研究伦理委员会（IRAS 295050）的批准。我们将直接向英国政府政策制定者传播结果，在同行评议的期刊上发表，在科学和政策会议上展示，并通过在线和公共和患者网络分享结果的易访问摘要。
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