UK Closures and Restrictions: How Well Do They Work?

The COVID-19 situation in the United Kingdom (UK) has been particularly alarming. In late 2020, cases surged, hospitals became overwhelmed, and the crisis care was utilized. The situation became so dire, that the UK Government implemented control measures, such as a curfew, restrictions on those from different households mixing, and people making unnecessary trips.

On November 5, England went into a large scale lockdown to help curb the spread of the virus. This resurgence wasn’t unique to the UK though, but many have questioned the efficacy of such lockdowns, especially second ones. Moreover, how does a tiered restriction work in addition to a second lockdown?

To better understand the efficacy of a second lockdown and a tiered approach to restrictions, a research team assessed COVID-19 deaths and hospital admissions via a modeling study. The authors noted that they utilized 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.”

The research team also utilized mobility data to help assess the impact of these restrictions and include awareness of behavior changes. Mobility data was pulled from Google Community Mobility data as well as that from the CoMix study.

After utilizing the fitted model to assess community transmission dynamics during the first and second waves, the team reproduced several data points, like hospital admissions and region-specific infections. Assumptions included no waning immunity and no season increase in contacts, which is an interesting dynamic considering more people tend to gather in the winter months.

Following this modeling study, the research team noted that tier 3 restrictions were associated with a better reduction in mobility than lower tiered restrictions. Tier 3 restrictions included additional measures like closing hospitality and leisure venues like restaurants and bars.

When comparing tiered restrictions to lockdowns, they also found that they had a stronger reduction in mobility than tier 3 restrictions. The authors shared that “In turn, these reductions in mobility are estimated to reduce the effective reproduction number (Rt) by 2% (95% CrI 0–4) for tier 2, 10% (6–14) for tier 3, 35% (30–41) for a Northern Ireland-stringency lockdown with schools closed, and 44% (37–49) for a Wales-stringency lockdown with schools closed.”

The researchers also noted that starting on November 5, a lockdown with schools remaining open, was projected to help decrease hospital admissions to 157 000 and deaths to 30 300. A projected impact from October 1, 2020 to March 31, 2021 without any restrictions or lockdowns would result in 280 000 hospital admissions and 48 600 deaths.

Ultimately, this points to a significant impact that tiered restrictions and lockdowns have on hospitalizations and deaths. Moreover, adding another 4 weeks to the lockdown would help reduce pressure on hospitals. As countries weigh the efficacy and implications of these measures, more studies like this will be necessary to understand the implications.