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Xia Y, Flores Anato JL, Colijn C, Janjua N, Irvine M, Williamson T, Varughese MB, Li M, Osgood N, Earn DJD, Sander B, Cipriano LE, Murty K, Xiu F, Godin A, Buckeridge D, Hurford A, Mishra S, Maheu-Giroux M. Canada's provincial COVID-19 pandemic modelling efforts: A review of mathematical models and their impacts on the responses. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:541-557. [PMID: 39060710 PMCID: PMC11382646 DOI: 10.17269/s41997-024-00910-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 05/31/2024] [Indexed: 07/28/2024]
Abstract
SETTING Mathematical modelling played an important role in the public health response to COVID-19 in Canada. Variability in epidemic trajectories, modelling approaches, and data infrastructure across provinces provides a unique opportunity to understand the factors that shaped modelling strategies. INTERVENTION Provinces implemented stringent pandemic interventions to mitigate SARS-CoV-2 transmission, considering evidence from epidemic models. This study aimed to summarize provincial COVID-19 modelling efforts. We identified modelling teams working with provincial decision-makers, through referrals and membership in Canadian modelling networks. Information on models, data sources, and knowledge translation were abstracted using standardized instruments. OUTCOMES We obtained information from six provinces. For provinces with sustained community transmission, initial modelling efforts focused on projecting epidemic trajectories and healthcare demands, and evaluating impacts of proposed interventions. In provinces with low community transmission, models emphasized quantifying importation risks. Most of the models were compartmental and deterministic, with projection horizons of a few weeks. Models were updated regularly or replaced by new ones, adapting to changing local epidemic dynamics, pathogen characteristics, vaccines, and requests from public health. Surveillance datasets for cases, hospitalizations and deaths, and serological studies were the main data sources for model calibration. Access to data for modelling and the structure for knowledge translation differed markedly between provinces. IMPLICATION Provincial modelling efforts during the COVID-19 pandemic were tailored to local contexts and modulated by available resources. Strengthening Canadian modelling capacity, developing and sustaining collaborations between modellers and governments, and ensuring earlier access to linked and timely surveillance data could help improve pandemic preparedness.
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Affiliation(s)
- Yiqing Xia
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Jorge Luis Flores Anato
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Caroline Colijn
- Department of Mathematics, Faculty of Science, Simon Fraser University, Burnaby, BC, Canada
| | - Naveed Janjua
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control (BCCDC), Vancouver, BC, Canada
| | - Mike Irvine
- British Columbia Centre for Disease Control (BCCDC), Vancouver, BC, Canada
| | - Tyler Williamson
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Centre for Health Informatics, University of Calgary, Calgary, AB, Canada
| | - Marie B Varughese
- Analytics and Performance Reporting Branch, Alberta Health, Edmonton, AB, Canada
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, Canada
| | - Michael Li
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, Canada
| | - Nathaniel Osgood
- Department of Computer Science, University of Saskatchewan, Saskatoon, SK, Canada
| | - David J D Earn
- Department of Mathematics & Statistics, McMaster University, Hamilton, ON, Canada
- M. G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada
| | - Beate Sander
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
- ICES, Toronto, ON, Canada
| | - Lauren E Cipriano
- Ivey Business School, University of Western Ontario, London, ON, Canada
- Departments of Epidemiology & Biostatistics and Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | - Kumar Murty
- Department of Mathematics, University of Toronto, Toronto, ON, Canada
| | - Fanyu Xiu
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Arnaud Godin
- Department of Medicine, Faculty of Medicine and Health Science, McGill University, Montréal, QC, Canada
| | - David Buckeridge
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Amy Hurford
- Department of Biology and Department of Mathematics and Statistics, Faculty of Science, Memorial University of Newfoundland and Labrador, St. John's, NL, Canada
| | - Sharmistha Mishra
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada.
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Makuza JD, Wong S, Morrow RL, Binka M, Darvishian M, Jeong D, Adu PA, Cua G, Yu A, Velásquez García HA, Bartlett SR, Yoshida E, Ramji A, Krajden M, Janjua NZ. Impact of COVID-19 pandemic on hepatocellular carcinoma surveillance in British Columbia, Canada: An interrupted time series study. J Viral Hepat 2024. [PMID: 38923070 DOI: 10.1111/jvh.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/12/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024]
Abstract
We assessed the impact of the COVID-19 pandemic on hepatocellular carcinoma (HCC) surveillance among individuals with HCV diagnosed with cirrhosis in British Columbia (BC), Canada. We used data from the British Columbia Hepatitis Testers Cohort (BC-HTC), including all individuals in the province tested for or diagnosed with HCV from 1 January 1990 to 31 December 2015, to assess HCC surveillance. To analyse the impact of the pandemic on HCC surveillance, we used pre-policy (January 2018 to February 2020) and post-policy (March to December 2020) periods. We conducted interrupted time series (ITS) analysis using a segmented linear regression model and included first-order autocorrelation terms. From January 2018 to December 2020, 6546 HCC screenings were performed among 3429 individuals with HCV and cirrhosis. The ITS model showed an immediate decrease in HCC screenings in March and April 2020, with an overall level change of -71 screenings [95% confidence interval (CI): -105.9, -18.9]. We observed a significant decrease in HCC surveillance among study participants, regardless of HCV treatment status and age group, with the sharpest decrease among untreated HCV patients. A recovery of HCC surveillance followed this decline, reflected in an increasing trend of 7.8 screenings (95% CI: 0.6, 13.5) per month during the post-policy period. There was no level or trend change in the number of individuals diagnosed with HCC. We observed a sharp decline in HCC surveillance among people living with HCV and cirrhosis in BC following the COVID-19 pandemic control measures. HCC screening returned to pre-pandemic levels by mid-2020.
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Affiliation(s)
- Jean Damascene Makuza
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Stanley Wong
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- University of British Columbia Centre for Disease Control, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Richard L Morrow
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Mawuena Binka
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Maryam Darvishian
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Dahn Jeong
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Prince A Adu
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Georgine Cua
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- University of British Columbia Centre for Disease Control, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Amanda Yu
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Hector A Velásquez García
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- University of British Columbia Centre for Disease Control, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sofia R Bartlett
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Eric Yoshida
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Dublin, Ohio, USA
| | - Alnoor Ramji
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Dublin, Ohio, USA
| | - Mel Krajden
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Naveed Z Janjua
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- University of British Columbia Centre for Disease Control, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Advancing Health, St. Paul's Hospital, Vancouver, British Columbia, Canada
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Ershadi MM, Rise ZR. Uncertain SEIAR system dynamics modeling for improved community health management of respiratory virus diseases: A COVID-19 case study. Heliyon 2024; 10:e24711. [PMID: 38317963 PMCID: PMC10839611 DOI: 10.1016/j.heliyon.2024.e24711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 02/07/2024] Open
Abstract
The study investigates the significance of employing advanced systemic models in community health management, with a focus on COVID-19 as a respiratory virus. Through the development of a system dynamics model integrating an uncertain SEIAR model, our research addresses the critical issue of parameter uncertainty using Ensemble Kalman Filter (EnKF) and Metropolis-Hastings (MH) algorithms. We present a case study using real COVID-19 outbreaks in Iran, offering insights into effective outbreak control scenarios and considering the global impact of respiratory viruses. The research yields distinctive results, showcasing variable mortality rates (40,500 to 436,500) across scenarios in Iran. Model accuracy is rigorously evaluated using the Normalized Root-Mean-Square Deviation (NRMSD) for new cases, deaths, and recoveries (0.2 %, 1.2 %, and 0.6 % respectively). The outcomes not only contribute to the existing body of knowledge but also offer practical implications for healthcare policies, economic considerations, and sensitivity assessments related to respiratory diseases. This study stands out from others in its approach to modeling and addressing uncertainty within a system dynamics framework. The integration of EnKF and MH algorithms provides a nuanced understanding of parameter uncertainty, adding a layer of sophistication to the analysis. The application of the model to real-world COVID-19 outbreaks in Iran further enhances the study's relevance and applicability. In conclusion, the research introduces an uncertain SEIAR system dynamics model with unique contributions to policymaking, economic considerations, and sensitivity assessments for respiratory diseases. The outcomes and insights derived from the study not only advance our understanding of disease dynamics but also provide actionable information for effective public health management.
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Affiliation(s)
- Mohammad Mahdi Ershadi
- Department of Industrial Engineering and Management Systems, Amirkabir University of Technology, Tehran, Iran
| | - Zeinab Rahimi Rise
- Department of Industrial Engineering and Management Systems, Amirkabir University of Technology, Tehran, Iran
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Adu PA, Iyaniwura SA, Mahmood B, Jeong D, Makuza JD, Cua G, Binka M, García HAV, Ringa N, Wong S, Yu A, Irvine MA, Otterstatter M, Janjua NZ. Association between close interpersonal contact and vaccine hesitancy: Findings from a population-based survey in Canada. Front Public Health 2022; 10:971333. [PMID: 36267997 PMCID: PMC9577316 DOI: 10.3389/fpubh.2022.971333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/26/2022] [Indexed: 01/25/2023] Open
Abstract
Background Vaccine hesitancy threatens efforts to bring the coronavirus disease 2019 (COVID-19) pandemic to an end. Given that social or interpersonal contact is an important driver for COVID-19 transmission, understanding the relationship between contact rates and vaccine hesitancy may help identify appropriate targets for strategic intervention. The purpose of this study was to assess the association between interpersonal contact and COVID-19 vaccine hesitancy among a sample of unvaccinated adults in the Canadian province of British Columbia (BC). Methods Unvaccinated individuals participating in the BC COVID-19 Population Mixing Patterns Survey (BC-Mix) were asked to indicate their level of agreement to the statement, "I plan to get the COVID-19 vaccine." Multivariable multinomial logistic regression was used to assess the association between self-reported interpersonal contact and vaccine hesitancy, adjusting for age, sex, ethnicity, educational attainment, occupation, household size and region of residence. All analyses incorporated survey sampling weights based on age, sex, geography, and ethnicity. Results Results were based on survey responses collected between March 8, 2021 and December 6, 2021, by a total of 4,515 adults aged 18 years and older. Overall, 56.7% of respondents reported that they were willing to get the COVID-19 vaccine, 27.0% were unwilling and 16.3% were undecided. We found a dose-response association between interpersonal contact and vaccine hesitancy. Compared to individuals in the lowest quartile (least contact), those in the fourth quartile (highest contact), third quartile and second quartile groups were more likely to be vaccine hesitant, with adjusted odd ratios (aORs) of 2.85 (95% CI: 2.02, 4.00), 1.91(95% CI: 1.38, 2.64), 1.78 (95% CI: 1.13, 2.82), respectively. Conclusion Study findings show that among unvaccinated people in BC, vaccine hesitancy is greater among those who have high contact rates, and hence potentially at higher risk of acquiring and transmitting infection. This may also impact future uptake of booster doses.
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Affiliation(s)
- Prince A. Adu
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Sarafa A. Iyaniwura
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- Department of Mathematics, University of British Columbia, Vancouver, BC, Canada
| | - Bushra Mahmood
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Dahn Jeong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jean Damascene Makuza
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Georgine Cua
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Mawuena Binka
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Héctor A. Velásquez García
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Notice Ringa
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Stanley Wong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Amanda Yu
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Mike A. Irvine
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Michael Otterstatter
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Naveed Z. Janjua
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Evaluation & Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada
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5
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Adu PA, Binka M, Mahmood B, Jeong D, Buller-Taylor T, Damascene MJ, Iyaniwura S, Ringa N, Velásquez García HA, Wong S, Yu A, Bartlett S, Wilton J, Irvine MA, Otterstatter M, Janjua NZ. Cohort profile: the British Columbia COVID-19 Population Mixing Patterns Survey (BC-Mix). BMJ Open 2022; 12:e056615. [PMID: 36002217 PMCID: PMC9412046 DOI: 10.1136/bmjopen-2021-056615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Several non-pharmaceutical interventions, such as physical distancing, handwashing, self-isolation, and school and business closures, were implemented in British Columbia (BC) following the first laboratory-confirmed case of COVID-19 on 26 January 2020, to minimise in-person contacts that could spread infections. The BC COVID-19 Population Mixing Patterns Survey (BC-Mix) was established as a surveillance system to measure behaviour and contact patterns in BC over time to inform the timing of the easing/re-imposition of control measures. In this paper, we describe the BC-Mix survey design and the demographic characteristics of respondents. PARTICIPANTS The ongoing repeated online survey was launched in September 2020. Participants are mainly recruited through social media platforms (including Instagram, Facebook, YouTube, WhatsApp). A follow-up survey is sent to participants 2-4 weeks after completing the baseline survey. Survey responses are weighted to BC's population by age, sex, geography and ethnicity to obtain generalisable estimates. Additional indices such as the Material and Social Deprivation Index, residential instability, economic dependency, and others are generated using census and location data. FINDINGS TO DATE As of 26 July 2021, over 61 000 baseline survey responses were received of which 41 375 were eligible for analysis. Of the eligible participants, about 60% consented to follow-up and about 27% provided their personal health numbers for linkage with healthcare databases. Approximately 83.5% of respondents were female, 58.7% were 55 years or older, 87.5% identified as white and 45.9% had at least a university degree. After weighting, approximately 50% were female, 39% were 55 years or older, 65% identified as white and 50% had at least a university degree. FUTURE PLANS Multiple papers describing contact patterns, physical distancing measures, regular handwashing and facemask wearing, modelling looking at impact of physical distancing measures and vaccine acceptance, hesitancy and uptake are either in progress or have been published.
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Affiliation(s)
- Prince A Adu
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mawuena Binka
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Bushra Mahmood
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Dahn Jeong
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Makuza Jean Damascene
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarafa Iyaniwura
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Mathematics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Notice Ringa
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Héctor A Velásquez García
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Stanley Wong
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Amanda Yu
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Sofia Bartlett
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - James Wilton
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Mike A Irvine
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Michael Otterstatter
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Naveed Zafar Janjua
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation & Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia, Canada
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Smith LE, Potts HWW, Amlȏt R, Fear NT, Michie S, Rubin GJ. Patterns of social mixing in England changed in line with restrictions during the COVID-19 pandemic (September 2020 to April 2022). Sci Rep 2022; 12:10436. [PMID: 35729196 PMCID: PMC9212204 DOI: 10.1038/s41598-022-14431-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/07/2022] [Indexed: 11/20/2022] Open
Abstract
Social mixing contributes to the transmission of SARS-CoV-2. We developed a composite measure for risky social mixing, investigating changes during the pandemic and factors associated with risky mixing. Forty-five waves of online cross-sectional surveys were used (n = 78,917 responses; 14 September 2020 to 13 April 2022). We investigated socio-demographic, contextual and psychological factors associated with engaging in highest risk social mixing in England at seven timepoints. Patterns of social mixing varied over time, broadly in line with changes in restrictions. Engaging in highest risk social mixing was associated with being younger, less worried about COVID-19, perceiving a lower risk of COVID-19, perceiving COVID-19 to be a less severe illness, thinking the risks of COVID-19 were being exaggerated, not agreeing that one's personal behaviour had an impact on how COVID-19 spreads, and not agreeing that information from the UK Government about COVID-19 can be trusted. Our composite measure for risky social mixing varied in line with restrictions in place at the time of data collection, providing some validation of the measure. While messages targeting psychological factors may reduce higher risk social mixing, achieving a large change in risky social mixing in a short space of time may necessitate a reimposition of restrictions.
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Affiliation(s)
- Louise E Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Weston Education Centre, King's College London, Cutcombe Road, London, SE5 9RJ, UK.
- Department of Psychological Medicine, Weston Education Centre, King's College London, Cutcombe Road, London, SE5 9RJ, UK.
| | - Henry W W Potts
- Institute of Health Informatics, University College London, 222 Euston Road, London, NW1 2DA, UK
| | - Richard Amlȏt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Weston Education Centre, King's College London, Cutcombe Road, London, SE5 9RJ, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, Wiltshire, Salisbury, SP4 0JG, UK
| | - Nicola T Fear
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, London, UK
- Department of Psychological Medicine, Weston Education Centre, King's College London, Cutcombe Road, London, SE5 9RJ, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - G James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Weston Education Centre, King's College London, Cutcombe Road, London, SE5 9RJ, UK
- Department of Psychological Medicine, Weston Education Centre, King's College London, Cutcombe Road, London, SE5 9RJ, UK
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