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Key epidemiological drivers and impact of interventions in the 2020 SARS-CoV-2 epidemic in England

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Title: Key epidemiological drivers and impact of interventions in the 2020 SARS-CoV-2 epidemic in England
Authors: Knock, ES
Whittles, LK
Lees, JA
Perez-Guzman, PN
Verity, R
FitzJohn, RG
Gaythorpe, KAM
Imai, N
Hinsley, W
Okell, LC
Rosello, A
Kantas, N
Walters, CE
Bhatia, S
Watson, OJ
Whittaker, C
Cattarino, L
Boonyasiri, A
Djaafara, BA
Fraser, K
Fu, H
Wang, H
Xi, X
Donnelly, CA
Jauneikaite, E
Laydon, DJ
White, PJ
Ghani, AC
Ferguson, NM
Cori, A
Baguelin, M
Item 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.
Issue Date: 14-Jul-2021
Date of Acceptance: 16-Jun-2021
URI: http://hdl.handle.net/10044/1/90018
DOI: 10.1126/scitranslmed.abg4262
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.
Sponsor/Funder: United States Agency for International Development (USAID)
Medical Research Council (MRC)
National Institute for Health Research
Funder's Grant Number: AID-OAA-F-16-00115
Keywords: Aged
Communicable Disease Control
Communicable Disease Control
06 Biological Sciences
11 Medical and Health Sciences
Publication Status: Published
Conference Place: United States
Online Publication Date: 2021-07-14
Appears in Collections:Department of Infectious Diseases
Faculty of Medicine
Imperial College London COVID-19
School of Public Health
Faculty of Natural Sciences

This item is licensed under a Creative Commons License Creative Commons