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The Impact of Social and Physical Distancing Measures on COVID-19 Activity in England

37 Pages Posted: 8 Jul 2020

See all articles by Jamie Lopez Bernal

Jamie Lopez Bernal

Public Health England Colindale; UK Health Security Agency - COVID-19 Surveillance Cell

Mary Sinnathamby

Government of the United Kingdom - Public Health England

Suzanne Elgohari

Government of the United Kingdom - Public Health England

Hongxin Zhao

Government of the United Kingdom - Public Health England

Chinelo Obi

Public Health England - Immunisation and Countermeasures Division

Laura Coughlan

Government of the United Kingdom - Public Health England

Vasileos Lampos

University College London - Department of Computer Science

Ruth Simmons

Public Health England Colindale

Elise Tessier

Government of the United Kingdom - Public Health England

Helen Campbell

Government of the United Kingdom - Public Health England

Suzanna McDonald

Government of the United Kingdom - Public Health England

Joanna Ellis

Government of the United Kingdom - Public Health England

Helen Hughes

Government of the United Kingdom - Public Health England

Mark Joy

University of Oxford - Nuffield Department of Primary Care Health Sciences

Manasa Tripathy

University of Oxford - Nuffield Department of Primary Care Health Sciences

Rachel Byford

University of Oxford - Nuffield Department of Primary Care Health Sciences

Filipa Ferreira

University of Oxford - Nuffield Department of Primary Care Health Sciences

Simon de Lusignan

University of Oxford - Nuffield Department of Primary Care Health Sciences

Maria Zambon

Public Health England - Virus Reference Department

Gavin Dabrera

University of Oxford - Nuffield Department of Primary Care Health Sciences

Kevin Brown

Public Health England

Vanessa Saliba

Public Health England - Immunisation and Countermeasures Division

Nick Andrews

Public Health England Colindale; UK Health Security Agency - COVID-19 Surveillance Cell

Gayatri Amirthalingam

Public Health England - Immunisation and Countermeasures Division

Sema Mandal

Government of the United Kingdom - Public Health England

Michael Edelstein

Government of the United Kingdom - Public Health England

Alex J. Elliot

UK Health Security Agency

Mary E. Ramsay

Public Health England - Immunisation, Hepatitis, and Blood Safety Department

More...

Abstract

Background: Mandatory social and physical distancing measures (SPDM) were introduced in the UK on the 23rd March 2020. A multi-tiered surveillance system based on influenza surveillance, was adopted from the early stages of the COVID-19 Epidemic to monitor different stages of disease. We describe how the impact SPDM was detected through each surveillance system and how these systems may be applied to detect increases in COVID-19 activity as SPDM are eased.

Methods: Data from national population surveys, web-based indicators, syndromic surveillance, sentinel swabbing, respiratory outbreaks, secondary care admissions, and mortality indicators from the start of the epidemic to Week 20 2020 were used to identify timing of peaks in the indicator relative to the introduction of SPDM. This was compared to median time from symptom onset to different stages of illness or interactions with healthcare services.

Results: The impact of SPDM was detected within 1 week through population symptom surveys, web search indicators and through GP sentinel swabbing reported by onset date. There were detectable impacts on syndromic surveillance indicators for difficulty breathing, influenza-like illness and COVID-19 coding at 2, 7 and 12 days respectively. This was followed by hospitalisations and critical care admissions (both 12 days), laboratory positivity (14 days), deaths (17 days) and care home outbreaks (4 weeks).

Interpretation: There was a clear impact of SPDM on COVID-19 activity which was detectable within 1 week through community indicators highlighting their importance in early detection of changes in activity. Community swabbing surveillance will be increasingly important as a specific indicator when circulation of seasonal respiratory viruses increases.

Funding Statement: There was no specific funding for this report.

Declaration of Interests: None declared.

Ethics Approval Statement: The surveillance collections included here are approved as Health Protection, under Regulation 3 of The Health Service (Control of Patient Information) Regulations 2002.

Keywords: social distancing; non-pharmaceutical interventions; lockdown; surveillance; Covid19; coronavirus

Suggested Citation

Bernal, Jamie Lopez and Sinnathamby, Mary and Elgohari, Suzanne and Zhao, Hongxin and Obi, Chinelo and Coughlan, Laura and Lampos, Vasileos and Simmons, Ruth and Tessier, Elise and Campbell, Helen and McDonald, Suzanna and Ellis, Joanna and Hughes, Helen and Joy, Mark and Tripathy, Manasa and Byford, Rachel and Ferreira, Filipa and Lusignan, Simon de and Zambon, Maria and Dabrera, Gavin and Brown, Kevin and Saliba, Vanessa and Andrews, Nick and Amirthalingam, Gayatri and Mandal, Sema and Edelstein, Michael and Elliot, Alex J. and Ramsay, Mary E., The Impact of Social and Physical Distancing Measures on COVID-19 Activity in England (5/21/2020). Available at SSRN: https://ssrn.com/abstract=3608109 or http://dx.doi.org/10.2139/ssrn.3608109

Jamie Lopez Bernal (Contact Author)

Public Health England Colindale ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

UK Health Security Agency - COVID-19 Surveillance Cell ( email )

United Kingdom

Mary Sinnathamby

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Suzanne Elgohari

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Hongxin Zhao

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Chinelo Obi

Public Health England - Immunisation and Countermeasures Division

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Laura Coughlan

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Vasileos Lampos

University College London - Department of Computer Science

United Kingdom

Ruth Simmons

Public Health England Colindale

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Elise Tessier

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Helen Campbell

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Suzanna McDonald

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Joanna Ellis

Government of the United Kingdom - Public Health England ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Helen Hughes

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Mark Joy

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

Manasa Tripathy

University of Oxford - Nuffield Department of Primary Care Health Sciences

Oxford
United Kingdom

Rachel Byford

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

Filipa Ferreira

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

Simon de Lusignan

University of Oxford - Nuffield Department of Primary Care Health Sciences

Oxford
United Kingdom

Maria Zambon

Public Health England - Virus Reference Department ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Gavin Dabrera

University of Oxford - Nuffield Department of Primary Care Health Sciences

Oxford
United Kingdom

Kevin Brown

Public Health England ( email )

Wellington House,
133-155 Waterloo Rd,
London, SE1 8UG

Vanessa Saliba

Public Health England - Immunisation and Countermeasures Division

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Nick Andrews

Public Health England Colindale ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

UK Health Security Agency - COVID-19 Surveillance Cell ( email )

United Kingdom

Gayatri Amirthalingam

Public Health England - Immunisation and Countermeasures Division ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Sema Mandal

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Michael Edelstein

Government of the United Kingdom - Public Health England

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Alex J. Elliot

UK Health Security Agency ( email )

23 Stephenson Street
Birmingham, B2 4BH
United Kingdom

Mary E. Ramsay

Public Health England - Immunisation, Hepatitis, and Blood Safety Department ( email )

United Kingdom

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