ArticlePhilosophical transactions of the Royal Society of London. Series B, Biological sciences2021
Segmentation and shielding of the most vulnerable members of the population as elements of an exit strategy from COVID-19 lockdown.
Article in Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 5 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- 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
- 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
- Caring for People with Rare Diseases: A Systematic Review of the Challenges of, and Strategies for Dealing with, COVID-19.International journal of environmental research and public health · 2023Pooled it
- Informing the public health response to COVID-19: a systematic review of risk factors for disease, severity, and mortality.BMC infectious diseases · 2021Pooled it
- Key questions for modelling COVID-19 exit strategies.Proceedings. Biological sciences · 2020Pooled it
- 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
- Risk of death in England following a positive SARS-CoV-2 test: A retrospective national cohort study (March 2020 to September 2022).PloS one · 2024Article
- Rationale for the shielding policy for clinically vulnerable people in the UK during the COVID-19 pandemic: a qualitative study.BMJ open · 2023Review
- Antigenic evolution of SARS-CoV-2 in immunocompromised hosts.Evolution, medicine, and public health · 2023Article
- Review
- Exit strategies from lockdowns due to COVID-19: a scoping review.BMC public health · 2022Article
- Critical weaknesses in shielding strategies for COVID-19.PLOS global public health · 2022Article
- Cognitive factors influenced physical distancing adherence during the COVID-19 pandemic in a population-specific way.PloS one · 2022Article
- Risk of severe COVID-19 infection in persons with diabetes during the first and second waves in Denmark: A nationwide cohort study.Frontiers in endocrinology · 2022Article
- Impact of visitation and cohorting policies to shield residents from covid-19 spread in care homes: an agent-based model.American journal of infection control · 2021Article
- Ethics of selective restriction of liberty in a pandemic.Journal of medical ethics · 2021Article
- Comparison of COVID-19 outcomes among shielded and non-shielded populations.Scientific reports · 2021Article
- Modelling that shaped the early COVID-19 pandemic response in the UK.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2021Article
- Individual and community-level risk for COVID-19 mortality in the United States.Nature medicine · 2021Article
- Risk of COVID-19 in shielded and nursing care home patients: a cohort study in general practice.BJGP open · 2021Article
Corrections and comments
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Authors and funding
16 authors.
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Abstract
This study demonstrates that an adoption of a segmenting and shielding strategy could increase the scope to partially exit COVID-19 lockdown while limiting the risk of an overwhelming second wave of infection. We illustrate this using a mathematical model that segments the vulnerable population and their closest contacts, the 'shielders'. Effects of extending the duration of lockdown and faster or slower transition to post-lockdown conditions and, most importantly, the trade-off between increased protection of the vulnerable segment and fewer restrictions on the general population are explored. Our study shows that the most important determinants of outcome are: (i) post-lockdown transmission rates within the general and between the general and vulnerable segments; (ii) fractions of the population in the vulnerable and shielder segments; (iii) adherence to protective measures; and (iv) build-up of population immunity. Additionally, we found that effective measures in the shielder segment, e.g. intensive routine screening, allow further relaxations in the general population. We find that the outcome of any future policy is strongly influenced by the contact matrix between segments and the relationships between physical distancing measures and transmission rates. This strategy has potential applications for any infectious disease for which there are defined proportions of the population who cannot be treated or who are at risk of severe outcomes. This article is part of the theme issue 'Modelling that shaped the early COVID-19 pandemic response in the UK'.
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