What were the effects of the UK’s COVID-19 public health policy “Shielding”? Results of a linked data matched cohort study

Snooks, Helen, Akbari, Ashley, Bethel, L., Carson-Stevens, Andrew ORCID: https://orcid.org/0000-0002-7580-7699, Dale, Jeremy, Dixon, Lucy, Edwards, Adrian ORCID: https://orcid.org/0000-0002-6228-4446, Emery, Helena, John, A., John, Gareth, Jolles, Stephen, Lyons, Jane, Lyons, Ronan A., Kingston, Mark Rhys, Parab, Rakshita, Porter, Alison, Sewell, Bernadette, Watkins, Alan and Williams, V. 2025. What were the effects of the UK’s COVID-19 public health policy “Shielding”? Results of a linked data matched cohort study. The Lancet Item availability restricted.

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Abstract

Objectives: We assessed effects of shielding, introduced during the COVID-19 pandemic across the UK to protect those at highest risk of harm, on health outcomes and behaviours. Study Design: Linked data matched cohort study Methods: We compared individual-level linked routine and self-reported outcomes between people identified for shielding (n=123,293) and comparators (n=120,997) matched by age, sex, and previous health service utilisation. We sent questionnaires to 1500 randomly sampled people in each cohort. Results: At one year 6·1% of shielded people had contracted SARS-CoV-2 compared to 6·2% in the matched cohort (Adjusted Odds Ratio (AOR) 0·970; 95% CI 0·937 to 1·004). Suspected healthcare associated infections were more likely in shielded people (1·1% vs 0·6%; AOR 1·678; 95% CI 1·529 to 1·842). All cause and COVID-19 related deaths were higher in the shielded cohort (7·0% vs 3·5%; AOR 2·280; 95% CI 2·190 to 2·374; and 1·1% vs 0·8%; AOR 1·430; 95% CI 1·308 to 1·563, respectively). About one third completed questionnaires (n=1015), with linkage possible in 752 cases (shielded: n=411; matched: n=341). Shielded respondents reported lower physical and mental health (SF12 PCS difference: -3·752; 95% CI -4·823 to -2·682; SF12 MCS difference: -1·217; 95% CI -2·580 to 0·145). They were more likely to have strictly avoided contact; stayed at home; felt scared to go outside; and were less likely to have gone out for shopping, leisure or travel. Conclusion: Shielding did not protect people from SARS-CoV-2 infection or COVID-19 related mortality. Findings do not support its implementation during a future pandemic.

Item Type:	Article
Status:	In Press
Schools:	Schools > Medicine
Publisher:	Elsevier
ISSN:	0140-6736
Date of First Compliant Deposit:	27 June 2025
Date of Acceptance:	17 April 2025
Last Modified:	03 Jul 2025 11:45
URI:	https://orca.cardiff.ac.uk/id/eprint/179361

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