EVALUATING THE IMPACTS OF TIERED RESTRICTIONS INTRODUCED IN ENGLAND, DURING OCTOBER AND DECEMBER 2020 ON COVID-19 CASES: A SYNTHETIC CONTROL STUDY

Zhang, Xingna ORCID: 0000-0002-8849-2112, Owen, Gwilym, Green, Mark ORCID: 0000-0002-0942-6628, Buchan, Iain ORCID: 0000-0003-3392-1650 and Barr, Ben ORCID: 0000-0002-4208-9475 (2021) EVALUATING THE IMPACTS OF TIERED RESTRICTIONS INTRODUCED IN ENGLAND, DURING OCTOBER AND DECEMBER 2020 ON COVID-19 CASES: A SYNTHETIC CONTROL STUDY JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 75 (Suppl ). A1-A1. ISSN 0143-005X, 1470-2738

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Abstract

In 2020, a second wave of COVID-19 cases unevenly affected places in England leading to the introduction of a tiered system of controls with different geographical areas subject to different levels of restrictions. Whilst previous research has examined the impact of national lockdowns on transmission, there has been limited research examining the marginal effect of differences in localised restrictions or how these effects vary between socioeconomic contexts. We therefore examined how Tier 3 restrictions in England implemented between October-December 2020, which included additional restrictions on the hospitality sector and people meeting outdoors affected COVID-19 case rates, compared to Tier 2 restrictions, and how these effects varied by level of deprivation. We used data on weekly reported COVID-19 cases for 7201 neighbourhoods in England and adjusted these for changing case-detection rates to provide an estimate of weekly SARS-CoV-2 infections in each neighbourhood. We identified those areas that entered Tier 3 restrictions at two time points in October and December, and constructed a synthetic control group of similar places that had entered Tier 2 restrictions, using calibration weights to match them on a wide range of covariates that may influence transmission. We then compared the change in weekly infections between those entering Tier 3 to the synthetic control group to estimate the proportional reduction of cases resulting from Tier 3 restrictions compared to Tier 2 restrictions, over a 4-week period. We further used interaction analysis to estimate whether this effect differed based on the level of socioeconomic deprivation in each neighbourhood and whether effects were modified by the prevalence of a new more infectious variant of SARS-CoV-2 (B.1.1.7) in each area. The introduction of Tier 3 restrictions in October and December was associated with a 14% (95% CI 10% to 19%) and 20% (95% CI 13% to 29%) reduction in infections respectively, compared to the rates expected if only Tier 2 restrictions had been in place in those areas. We found that effects were similar across levels of deprivation and limited evidence that Tier 3 restrictions had a greater effect in areas where the new more infectious variant was more prevalent. Compared to Tier 2 restrictions, additional restrictions on hospitality and meeting outdoors introduced in Tier 3 areas in England had a moderate effect on transmission and these restrictions did not appear to increase inequalities.

Item Type:	Article
Uncontrolled Keywords:	4202 Epidemiology, 4206 Public Health, 42 Health Sciences, Infectious Diseases, Emerging Infectious Diseases, Coronaviruses, 3 Good Health and Well Being
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Population Health
Depositing User:	Symplectic Admin
Date Deposited:	23 Feb 2022 10:07
Last Modified:	16 Jun 2026 09:30
DOI:	10.1136/jech-2021-SSMabstracts.1
Open Access URL:	https://jech.bmj.com/content/75/Suppl_1/A1.1
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3149486
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