Division of Health Research, Faculty of Health and Medicine, Lancaster University, UK.
Frontier Science (Scotland) Ltd, UK.
Public Health. 2023 Sep;222:54-59. doi: 10.1016/j.puhe.2023.06.037. Epub 2023 Jul 5.
This study evaluates the impact of England's COVID-19 shielding programme on mortality in the City of Liverpool in North West England.
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.
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.
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.
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.
本研究评估了英格兰 COVID-19 保护计划对英格兰西北部利物浦市死亡率的影响。
利用 2020 年 4 月至 2021 年 6 月期间利物浦所有在注册全科医生处登记的人员的相关常规健康记录数据，对受保护者和未受保护者进行比较。
使用离散时间风险模型和保护状态与传播风险较高时期之间的相互作用，探讨了 COVID-19 大流行的主要阶段中保护的效果。
与匹配倾向的未受保护组相比，受保护者的死亡风险降低了 34%（HR=0.66，95%CI：0.58 至 0.76）。保护似乎在第一波和第三波中降低了死亡率，但在第二波中没有，因为政府没有强制要求进行保护。男性和女性的效果相似，但在利物浦最贫困地区的保护效果更好。
利物浦的保护计划可能挽救了生命，尽管在贫困地区的效果略差。对于未来的呼吸道病毒大流行，识别弱势群体并为其提供建议和支持的综合计划可能很重要。可能需要为社会经济弱势群体提供额外的支持，以避免不平等加剧。
