Key epidemiological drivers and impact of interventions in the 2020 SARS-CoV-2 epidemic in England
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
We fitted a model of SARS-CoV-2 transmission in care homes and the community to regional surveillance data for England. Compared with other approaches, our model provides a synthesis of multiple surveillance data streams into a single coherent modelling framework allowing transmission and severity to be disentangled from features of the surveillance system. Of the control measures implemented, only national lockdown brought the reproduction number (Rteff ) below 1 consistently; if introduced one week earlier it could have reduced deaths in the first wave from an estimated 48,600 to 25,600 (95% credible interval [95%CrI]: 15,900-38,400). The infection fatality ratio decreased from 1.00% (95%CrI: 0.85%-1.21%) to 0.79% (95%CrI: 0.63%-0.99%), suggesting improved clinical care. The infection fatality ratio was higher in the elderly residing in care homes (23.3%, 95%CrI: 14.7%-35.2%) than those residing in the community (7.9%, 95%CrI: 5.9%-10.3%). On 2nd December 2020 England was still far from herd immunity, with regional cumulative infection incidence between 7.6% (95%CrI: 5.4%-10.2%) and 22.3% (95%CrI: 19.4%-25.4%) of the population. Therefore, any vaccination campaign will need to achieve high coverage and a high degree of protection in vaccinated individuals to allow non-pharmaceutical interventions to be lifted without a resurgence of transmission.
Date Issued
2021-07-14
Date Acceptance
2021-06-16
Citation
Science Translational Medicine, 2021, 13 (602), pp.1-12
ISSN
1946-6234
Publisher
American Association for the Advancement of Science
Start Page
1
End Page
12
Journal / Book Title
Science Translational Medicine
Volume
13
Issue
602
Copyright Statement
© 2021, American Association for the Advancement of Science https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Sponsor
United States Agency for International Development (USAID)
Medical Research Council (MRC)
National Institute for Health Research
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34158411
PII: scitranslmed.abg4262
Grant Number
AID-OAA-F-16-00115
MR/R015600/1
NIHR200908
Subjects
Aged
COVID-19
Communicable Disease Control
England
Epidemics
Humans
SARS-CoV-2
Humans
Communicable Disease Control
Aged
England
Epidemics
COVID-19
SARS-CoV-2
06 Biological Sciences
11 Medical and Health Sciences
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2021-07-14