ArticleThe Lancet. Infectious diseases2021
Association of tiered restrictions and a second lockdown with COVID-19 deaths and hospital admissions in England: a modelling study.
Article in The Lancet. Infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 4 of them syntheses that pooled it.
What it found
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Who cites it
83 citing papers in PubMed, 4 syntheses or guidelines pooled it, 164 citations in OpenAlex.
- Effectiveness of non-pharmaceutical interventions as implemented in the UK during the COVID-19 pandemic: a rapid review.Journal of public health (Oxford, England) · 2025Pooled it
- Incorporating Social Determinants of Health in Infectious Disease Models: A Systematic Review of Guidelines.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Pooled it
- Effects of non-pharmaceutical interventions on COVID-19 transmission: rapid review of evidence from Italy, the United States, the United Kingdom, and China.Frontiers in public health · 2024Pooled it
- Epidemics, Lockdown Measures and Vulnerable Populations: A Mixed-Methods Systematic Review of the Evidence of Impacts on Mother and Child Health in Low-and Lower-Middle-Income Countries.International journal of health policy and management · 2022Pooled it
- Intraindividual variability in non-household contacts: a German longitudinal study, April 2020-December 2021.BMC infectious diseases · 2026Article
- The impact of COVID-19 non-pharmaceutical interventions on notifiable infectious diseases in Poland: a comprehensive analysis from 2014-2022.BMC infectious diseases · 2026Article
- Mobility-driven synthetic contact matrices as a scalable solution for real-time pandemic response modeling.Nature communications · 2026Article
- Individual and neighborhood based socioeconomic factors relevant for contact behaviour and epidemic control.Communications medicine · 2025Article
- Optimization of school closures during an Omicron epidemic in Hong Kong: a modelling study.Interface focus · 2025Article
- Trends in Avoidable Hospitalizations Before and During the COVID-19 Pandemic: Multiple Cross-Sectional Study Using Administrative Data From Beijing, China.JMIR public health and surveillance · 2025Article
- Explaining international differences in excess mortality due to Covid-19.Scientific reports · 2025Article
- Impact of non-pharmacological interventions on the first wave of COVID-19 in Portugal 2020.Heliyon · 2025Article
- Impact of tiered restrictions in December 2020 on COVID-19 hospitalisations in England: a synthetic control study.BMJ open · 2025Observational
- Central Precocious Puberty During the COVID-19 Pandemic Period: A Systematic Review of Literature.Cureus · 2024Review
- Patients' use of Danish emergency medical services before and during the COVID-19 pandemic: a register-based study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Effects of mobility, immunity and vaccination on SARS-CoV-2 transmission in the Dominican Republic: a modelling study.Lancet regional health. Americas · 2024Article
- Non-pharmaceutical interventions to reduce COVID-19 transmission in the UK: a rapid mapping review and interactive evidence gap map.Journal of public health (Oxford, England) · 2024Review
- Is a tiered restrictions system an effective intervention for COVID-19 control? Results from Portugal, November-December 2020.BMC public health · 2024Article
- Article
- "I'll meet you at our bench": adaptation, innovation and resilience among VCSE organisations who supported marginalised and minoritised communities during the Covid-19 pandemic in Northern England - a qualitative focus group study.BMC health services research · 2024Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundA second wave of COVID-19 cases in autumn, 2020, in England led to localised, tiered restrictions (so-called alert levels) and, subsequently, a second national lockdown. We examined the impact of these tiered restrictions, and alternatives for lockdown stringency, timing, and duration, on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and hospital admissions and deaths from COVID-19.
methodsWe fit an age-structured mathematical model of SARS-CoV-2 transmission to data on hospital admissions and hospital bed occupancy (ISARIC4C/COVID-19 Clinical Information Network, National Health Service [NHS] England), seroprevalence (Office for National Statistics, UK Biobank, REACT-2 study), virology (REACT-1 study), and deaths (Public Health England) across the seven NHS England regions from March 1, to Oct 13, 2020. We analysed mobility (Google Community Mobility) and social contact (CoMix study) data to estimate the effect of tiered restrictions implemented in England, and of lockdowns implemented in Northern Ireland and Wales, in October, 2020, and projected epidemiological scenarios for England up to March 31, 2021.
findingsWe estimated a reduction in the effective reproduction number (R
interpretationLockdown measures outperform less stringent restrictions in reducing cumulative deaths. We projected that the lockdown policy announced to commence in England on Nov 5, with a similar stringency to the lockdown adopted in Wales, would reduce pressure on the health service and would be well timed to suppress deaths over the winter period, while allowing schools to remain open. Following completion of the analysis, we analysed new data from November, 2020, and found that despite similarities in policy, the second lockdown in England had a smaller impact on behaviour than did the second lockdown in Wales, resulting in more deaths and hospitalisations than we originally projected when focusing on a Wales-stringency scenario for the lockdown.
fundingHorizon 2020, UK Medical Research Council, and the National Institute for Health Research.
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Registered trials
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