The Lancet Public Health

BackgroundHong Kong, has operated under a zero-Covid policy in the past few years. As a result, population immunity from natural infections has been low. The fifth wave in Hong Kong, caused by the Omicron variant, grew substantially in February 2022 during the transition from winter into spring. The daily number of reported cases began to decline quickly in a few days after social distancing regulations were tightened and rapid antigen test (RAT) kits were largely distributed. How the non-pharm...

BackgroundDiagnostic testing forms a major part of the UKs response to the current COVID-19 pandemic with tests offered to people with a continuous cough, high temperature or anosmia. Testing capacity must be sufficient during the winter respiratory season when levels of cough and fever are high due to non-COVID-19 causes. This study aims to make predictions about the contribution of baseline cough or fever to future testing demand in the UK. MethodsIn this analysis of the Bug Watch prospective...

BackgroundA range of public health measures have been implemented to delay and reduce local transmission of COVID-19 in Hong Kong, and there have been major changes in behaviours of the general public. We examined the effect of these interventions and behavioral changes on the incidence of COVID-19 as well as on influenza virus infections which may share some aspects of transmission dynamics with COVID-19. MethodsWe reviewed policy interventions and measured changes in population behaviours thr...

In the UK the epidemic of COVID-19 continues to pose a significant threat to public health. On the 14th October the English government introduced a tier system for control of the epidemic but just 3 weeks later a National lockdown across all areas of England was implemented. When English areas emerged from Lockdown many were placed in different tiers (most typically moved up at least one tier). However, the effectiveness of the tier system has been challenged by the emergence of a new variant of...

BackgroundDuring the early phase of the Covid-19 pandemic in England, people with pre-existing conditions that put them at severe clinical risk if infected were advised to drastically reduce face-to-face contacts in a policy known as "shielding". The impact of this policy in preventing COVID-19 hospitalisations and deaths has not been evaluated at the national level using transmission-dynamic modelling. MethodsWith the approval of NHS England, we present a retrospective cohort evaluation of the...

BackgroundEpidemiological data from the COVID-19 pandemic has demonstrated variability in attack rates by age, and country-to-country variability in case fatality ratio (CFR). ObjectiveTo use direct and indirect standardization for insights into the impact of age-specific under-reporting on between-country variability in CFR, and apparent size of COVID-19 epidemics. DesignPost-hoc secondary data analysis ("case studies"), and mathematical modeling. SettingChina, global. InterventionsNone. M...

BackgroundAccurate and representative data is vital for precisely reporting the impact of influenza in healthcare systems. Northern hemisphere winter 2022/23 experienced the most substantial influenza wave since the COVID-19 pandemic began in 2020. Simultaneously, new data streams become available within health services because of the pandemic. Comparing these data, surveillance and administrative, supports the accurate monitoring of population level disease trends. MethodsWe analysed admission...

BackgroundDespite relatively few reports of residential case clusters of COVID-19, building-wide compulsory testing notices on residential apartment blocks are frequently applied in Hong Kong with the aim of identifying cases and reducing transmission. MethodsWe aimed to describe the frequency of residential case clusters and the efficiency of compulsory testing notices in identifying cases. The residences of locally infected COVID-19 cases in Hong Kong were grouped to quantify the number of ca...

ObjectivesTo develop a regional model of COVID-19 dynamics, for use in estimating the number of infections, deaths and required acute and intensive care (IC) beds using the South West of England (SW) as an example case. DesignOpen-source age-structured variant of a susceptible-exposed-infectious-recovered (SEIR) deterministic compartmental mathematical model. Latin hypercube sampling and maximum likelihood estimation were used to calibrate to cumulative cases and cumulative deaths. SettingSW a...

BACKGROUNDIn December 2019, a novel strain of SARS-CoV-2 emerged in Wuhan, China. Since then, the city of Wuhan has taken unprecedented measures and efforts in response to the outbreak. METHODSWe quantified the effects of control measures on population contact patterns in Wuhan, China, to assess their effects on the progression of the outbreak. We included the latest estimates of epidemic parameters from a transmission model fitted to data on local and internationally exported cases from Wuhan ...

ImportanceA strategy for preventing further spread of the ongoing COVID-19 epidemic is to detect infections and isolate infected individuals without the need of extensive bio-specimen testing. ObjectivesHere we investigate the prevalence of loss of smell and taste among COVID-19 diagnosed individuals and we identify the combination of symptoms, besides loss of smell and taste, most likely to correspond to a positive COVID-19 diagnosis in non-severe cases. DesignCommunity survey. Setting and P...

1Objectiveto determine the statistical relationship between reported deaths and infections in the UK coronavirus outbreak DesignPublicly available UK government data is used to determine a relationship between reported cases and deaths, taking into account various UK regions, age profiles and prevalence of the variant of concern (VOC) B.1.1.7. Main Outcome MeasuresEstablishing a simple statistical relationship between detected cases and subsequent mortality. ResultsThroughout October and Nove...

To manage the public health risk posed by COVID-19 and assess the impact of interventions, policy makers must be able to closely monitor the epidemics trajectory. Here we present a simple methodology based on basic surveillance metrics for monitoring the spread of COVID-19 and its burden on health services in Scotland. We illustrate how this has been used throughout the epidemic in Scotland and explore the underlying biases that have affected its interpretation.

The NHS Pathways triage system collates data on enquiries to 111 and 999 services in England. Since the 18th of March 2020, these data have been made publically available for potential COVID-19 symptoms self-reported by members of the public. Trends in such reports over time are likely to reflect behaviour of the ongoing epidemic within the wider community, potentially capturing valuable information across a broader severity profile of cases than hospital admission data. We present a fully repro...

The SARS-CoV-2 pandemic had a large impact on social mixing in the UK. This study analysed data from the Office for National Statistics Coronavirus Infection Survey to examine changes in contact patterns and self-reported symptoms through three winter seasons from 2020 to 2023. Using Generalised Additive Models, we estimated levels of various contacts over time, accounting for age, sex, ethnicity, and deprivation percentile, and compared these to trends in self-reported symptoms. Our estimates i...

ObjectiveTo describe cause-specific mortality patterns of banana plantation workers in the French West Indies. MethodsThe study included 11221 farmers and farm workers who had work in banana cultivation in the French West indies (Guadeloupe or Martinique) between 1973 and 1993, followed up from January 1981 to December 2017. We calculated standardized mortality ratios (SMRs), causal mortality ratios (CMRs) and relative standardized mortality ratios (rSMRs) using regional reference rates. Resul...

We aimed to assess the relative importance of different settings for SARS-CoV2 transmission in a large community cohort. We demonstrate the importance of home, work and education as venues for transmission. In children, education was most important and in older adults essential shopping was of high importance. Our findings support public health messaging about infection control at home, advice on working from home and restrictions in different venues.

BackgroundAutomated or partially-automated contact tracing tools are being deployed by many countries to contain SARS-CoV-2; however, the evidence base for their use is not well-established. MethodsWe undertook a rapid systematic review of automated or partially-automated contact tracing, registered with PROSPERO (CRD42020179822). We searched PubMed, EMBASE, OVID Global Health, EBSCO COVID Portal, Cochrane Library, medRxiv, bioRxiv, arXiv and Google Advanced for articles relevant to COVID-19, S...

ObjectiveIn September 2020, records of 15,861 SARS-CoV-2 cases failed to upload from the Second Generation Laboratory Surveillance System (SGSS) to the Contact Tracing Advisory Service (CTAS) tool, resulting in a delay in the contact tracing of these cases. This study used CTAS data to determine the impact of this delay on health outcomes: transmission events, hospitalisations, and mortality. Previously, a modelling study had suggested a substantial impact. DesignObservational study SettingEng...

ImportanceThe emergence of the COVID-19 vaccination has been critical in changing the course of the COVID-19 pandemic, with estimates suggesting vaccinations have prevented millions of deaths worldwide. To ensure protection remains high in vulnerable groups booster vaccinations in the UK have been targeted based on age and clinical vulnerabilities. ObjectiveWe sought to identify adults who had received a booster vaccination as part of the autumn 2022 campaign in England yet remained at increase...