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The imposition of various local and national restrictions in England in the summer and fall of 2020 gradually decreased human contact, but those changes were smaller and more varied than during the March lockdown, according to a study published in the open access journal BMC Medicine has been .
A team of researchers from the London School of Hygiene and Tropical Medicine (LSHTM) in the UK combined data from UK participants in the UK CoMix survey and information on local and national restrictions from Gov.uk collected between August 31 and December 7, 2020 . CoMix is an online survey that asks individuals to record details of their direct contacts the day before the survey.
The authors used the data to compare the number of contacts in different settings such as work, school or home reported by individuals before and after the introduction of individual restrictions in England. Restrictions examined included the rule of six (announced Sept. 14), pubs and restaurants closing at 10 p.m. and encouraging people to work from home (Sept. 24), entry to Level 1 , 2 or 3 (October 14) as well as entry into levels 1, 2 or 3 national lockdown from one of the levels in November 2020.
The authors found that the effects of these restrictions on the number of contacts people reported were mixed, with local restrictions and the rule of six associated with modest contact reductions and instructions to work from home with larger reductions, but little evidence of this The 10pm closing time for bars and restaurants had a noticeable impact.
In particular, after the introduction of the rule of six, 1,314 (33.8%) out of a total of 3,884 participants included in the analysis for this restriction reported a reduction in their contacts with no work and no education, while 1,573 (40.5%) participants reported reported the same number of contacts and 997 (25.7%) reported a higher number of contacts. The average number of contacts was two before and after the introduction of the rule of six.
For the 10 o’clock rule, 990 (25.5%) of 3,887 participants included in the analysis had fewer contacts, while 2,054 (52.8%) had the same number of contacts and 843 (21.7%) had one recorded higher number of contacts. The average number of contacts before and after the rule came into force was zero to one.
Under local restrictions, participants reduced their contacts on average and reported an average of 0.69 fewer contacts outside of work and outside of school than before the restrictions. The effects of the tier system were found to be mixed, with tier 1 and 2 having little effect on the average number of contacts, but tier 3 reducing contacts.
The subsequent lockdown in November seemed to have made the biggest difference to those participating in the Level 1 lockdown. 750 (35.8%) of 2,095 Level 1 participants said that they reduced their contacts by an average of about 1.40 contacts per day. The transition from tier 2 or tier 3 to lockdown was less pronounced: 428 (29.4%) of 1212 adults in tier 2 and 85 (26.3%) of 236 adults in tier 3 reported having reduced their contacts.
Dr. Christopher Jarvis, assistant professor at LSHTM and the corresponding author, said, “To put these changes in context, the full national lockdown in March reduced average daily contacts from an estimated 10.8 to 2.8 – a 74% reduction. In absolute terms As the changes after recent restrictions were relatively small, this may indicate that restrictions were applied at a time when individuals had already cut their contacts, not that the restrictions had no effect. “
The authors caution that local restrictions involved a combination of several measures and therefore their effect on the number of contacts is a combination of a number of interventions. The relatively quick change in policy in the fall also means that part of the effect attributed to one intervention may actually be related to one of the others.
Dr. Jarvis said, “We have tried to provide some insight into the hugely pertinent question of whether and how effectively various restrictions work in response to COVID-19. While yes, how effective they are. While we only focused on contacts, the implications the various constraints will have broader societal implications that must be considered for policy change. “
Further examination of the impact of restrictions on different age groups and the potential for regional compliance with national restrictions could help unravel certain factors that may influence the relatively small reduction in contact observed in this study.
The contact patterns changed in response to national COVID-19 guidelines
The Impact of Local and National Restrictions in Response to COVID-19 on Social Interaction in England: A Natural Length Experiment
Jarvis, et al. BMC Medicine 2021, DOI: 10.1186 / s12916-021-01924-7 Provided by BioMed Central
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