Evidence map›Paper›PMID 36933354›Full record

ArticlePublic health2023

Did the UK's public health shielding policy protect the clinically extremely vulnerable during the COVID-19 pandemic in Wales? Results of EVITE Immunity, a linked data retrospective study.

H Snooks, A Watkins, J Lyons, A Akbari, R Bailey, L Bethell, A Carson-Stevens, A Edwards, H Emery, B A Evans and 7 more

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Coproducing data-driven organizational safety with patients: development and cognitive testing of a multisetting patient-reported safety concern tool.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2025
    Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

H SnooksSwansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: h.a.snooks@swansea.ac.uk.
A WatkinsSwansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: a.watkins@swansea.ac.uk.
J LyonsPopulation Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: j.lyons@swansea.ac.uk.
A AkbariPopulation Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: a.akbari@swansea.ac.uk.
R BaileyPopulation Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: r.bailey@swansea.ac.uk.
L BethellSwansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: lesleybethell@gmail.com.
A Carson-StevensCardiff University, Division of Population Medicine, Neuadd Meirionnydd, University Hospital of Wales, Heath Park, Cardiff, CF14 4YS, UK. Electronic address: carson-stevensap@cardiff.ac.uk.
A EdwardsCardiff University, Division of Population Medicine, Neuadd Meirionnydd, University Hospital of Wales, Heath Park, Cardiff, CF14 4YS, UK. Electronic address: edwardsag@cardiff.ac.uk.
H EmerySwansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: Helena.emery@swansea.ac.uk.
B A EvansSwansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: b.a.evans@swansea.ac.uk.
S JollesImmunodeficiency Centre for Wales, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK. Electronic address: jollessr@cardiff.ac.uk.
A JohnPopulation Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: a.john@swansea.ac.uk.
M KingstonSwansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: m.r.kingston@swansea.ac.uk.
A PorterSwansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: A.M.Porter@swansea.ac.uk.
B SewellSwansea University, School of Health and Social Care, Vivian Tower, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: b.diethart@swansea.ac.uk.
V WilliamsSwansea University, Medical School, ILS 2, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: v.a.williams@swansea.ac.uk.
R A LyonsPopulation Data Science, Swansea University, Medical School, Data Science Building, Singleton Park, Swansea, SA2 8PP, UK. Electronic address: r.a.lyons@swansea.ac.uk.

Funding

Medical Research Council MC_PC_20031Medical Research Council MC_PC_20060Medical Research Council MR/V028367/1
6 · The paper itself

Abstract

introductionThe UK shielding policy intended to protect people at the highest risk of harm from COVID-19 infection. We aimed to describe intervention effects in Wales at 1 year.

methodsRetrospective comparison of linked demographic and clinical data for cohorts comprising people identified for shielding from 23 March to 21 May 2020; and the rest of the population. Health records were extracted with event dates between 23 March 2020 and 22 March 2021 for the comparator cohort and from the date of inclusion until 1 year later for the shielded cohort.

resultsThe shielded cohort included 117,415 people, with 3,086,385 in the comparator cohort. The largest clinical categories in the shielded cohort were severe respiratory condition (35.5%), immunosuppressive therapy (25.9%) and cancer (18.6%). People in the shielded cohort were more likely to be female, aged ≥50 years, living in relatively deprived areas, care home residents and frail. The proportion of people tested for COVID-19 was higher in the shielded cohort (odds ratio [OR] 1.616; 95% confidence interval [CI] 1.597-1.637), with lower positivity rate incident rate ratios 0.716 (95% CI 0.697-0.736). The known infection rate was higher in the shielded cohort (5.9% vs 5.7%). People in the shielded cohort were more likely to die (OR 3.683; 95% CI: 3.583-3.786), have a critical care admission (OR 3.339; 95% CI: 3.111-3.583), hospital emergency admission (OR 2.883; 95% CI: 2.837-2.930), emergency department attendance (OR 1.893; 95% CI: 1.867-1.919) and common mental disorder (OR 1.762; 95% CI: 1.735-1.789).

conclusionDeaths and healthcare utilisation were higher amongst shielded people than the general population, as would be expected in the sicker population. Differences in testing rates, deprivation and pre-existing health are potential confounders; however, lack of clear impact on infection rates raises questions about the success of shielding and indicates that further research is required to fully evaluate this national policy intervention.

Indexed as

COVID-19FemaleHumansMalePandemicsPublic HealthPublic PolicyRetrospective StudiesSemantic WebWalesCOVID-19Pandemic

Identifiers

PMID36933354
PMCPMC9928733

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.