102 results on '"Kovar, Jana"'
Search Results
2. Differential Risk of SARS-CoV-2 Infection by Occupation: Evidence from the Virus Watch prospective cohort study in England and Wales
- Author
-
Beale, Sarah, Hoskins, Susan, Byrne, Thomas, Fong, Wing Lam Erica, Fragaszy, Ellen, Geismar, Cyril, Kovar, Jana, Navaratnam, Annalan M. D., Nguyen, Vincent, Patel, Parth, Yavlinsky, Alexei, Johnson, Anne M., Van Tongeren, Martie, Aldridge, Robert W., and Hayward, Andrew
- Published
- 2023
- Full Text
- View/download PDF
3. Eyeglasses and risk of COVID-19 transmission—analysis of the Virus Watch Community Cohort study
- Author
-
Michie, Susan, Hardelid, Pia, Wijlaars, Linda, Nastouli, Eleni, Spyer, Moira, Killingley, Ben, Cox, Ingemar, Lampos, Vasileios, McKendry, Rachel A., Cheng, Tao, Liu, Yunzhe, Gibbs, Jo, Gilson, Richard, Rogers, Alison, Johnson, Anne M., Navaratnam, Annalan M.D., O'Callaghan, Christopher, Beale, Sarah, Nguyen, Vincent, Aryee, Anna, Braithwaite, Isobel, Byrne, Thomas E., Fong, Wing Lam Erica, Fragaszy, Ellen, Geismar, Cyril, Hoskins, Susan, Kovar, Jana, Patel, Parth, Shrotri, Madhumita, Weber, Sophie, Yavlinsky, Alexei, Aldridge, Robert W., and Hayward, Andrew C.
- Published
- 2024
- Full Text
- View/download PDF
4. The incidence of COVID-19-related hospitalisation in migrants in the UK: Findings from the Virus Watch prospective community cohort study
- Author
-
Fong, Wing Lam Erica, Nguyen, Vincent G, Burns, Rachel, Boukari, Yamina, Beale, Sarah, Braithwaite, Isobel, Byrne, Thomas E, Geismar, Cyril, Fragaszy, Ellen, Hoskins, Susan, Kovar, Jana, Navaratnam, Annalan MD, Oskrochi, Youssof, Patel, Parth, Tweed, Sam, Yavlinsky, Alexei, Hayward, Andrew C, and Aldridge, Robert W
- Published
- 2024
- Full Text
- View/download PDF
5. Bayesian reconstruction of SARS-CoV-2 transmissions highlights substantial proportion of negative serial intervals
- Author
-
Geismar, Cyril, Nguyen, Vincent, Fragaszy, Ellen, Shrotri, Madhumita, Navaratnam, Annalan M.D., Beale, Sarah, Byrne, Thomas E., Fong, Wing Lam Erica, Yavlinsky, Alexei, Kovar, Jana, Hoskins, Susan, Braithwaite, Isobel, Aldridge, Robert W., Hayward, Andrew C., White, Peter J., Jombart, Thibaut, and Cori, Anne
- Published
- 2023
- Full Text
- View/download PDF
6. Long-Term Outcomes of SARS-CoV-2 Variants and Other Respiratory Infections: Evidence from the Virus Watch Prospective Cohort in England
- Author
-
Beale, Sarah, primary, Yavlinsky, Alexei, additional, Fong, Wing Lam Erica, additional, Nguyen, Vincent Grigori, additional, Kovar, Jana, additional, Vos, Theo, additional, Wulf-Hanson, Sarah, additional, Hayward, Andrew C, additional, Abubakar, Ibrahim, additional, and Aldridge, Robert W, additional
- Published
- 2024
- Full Text
- View/download PDF
7. Nucleocapsid and spike antibody responses following virologically confirmed SARS-CoV-2 infection: an observational analysis in the Virus Watch community cohort
- Author
-
Michie, Susan, Hardelid, Pia, Wijlaars, Linda, Nastouli, Eleni, Spyer, Moira, Killingley, Ben, Cox, Ingemar, Lampos, Vasileios, McKendry, Rachel A, Cheng, Tao, Liu, Yunzhe, Gibbs, Jo, Gilson, Richard, Johnson, Anne M, Navaratnam, Annalan M D, Shrotri, Madhumita, Nguyen, Vincent, Braithwaite, Isobel, Beale, Sarah, Byrne, Thomas E, Fong, Wing Lam Erica, Fragaszy, Ellen, Geismar, Cyril, Hoskins, Susan, Kovar, Jana, Patel, Parth, Yavlinsky, Alexei, Aryee, Anna, Rodger, Alison, Hayward, Andrew C, and Aldridge, Robert W
- Published
- 2022
- Full Text
- View/download PDF
8. Spike-antibody responses to COVID-19 vaccination by demographic and clinical factors in a prospective community cohort study
- Author
-
Shrotri, Madhumita, Fragaszy, Ellen, Nguyen, Vincent, Navaratnam, Annalan M. D., Geismar, Cyril, Beale, Sarah, Kovar, Jana, Byrne, Thomas E., Fong, Wing Lam Erica, Patel, Parth, Aryee, Anna, Braithwaite, Isobel, Johnson, Anne M., Rodger, Alison, Hayward, Andrew C., and Aldridge, Robert W.
- Published
- 2022
- Full Text
- View/download PDF
9. SARS-CoV-2 antibodies and breakthrough infections in the Virus Watch cohort
- Author
-
Aldridge, Robert W., Yavlinsky, Alexei, Nguyen, Vincent, Eyre, Max T., Shrotri, Madhumita, Navaratnam, Annalan M. D., Beale, Sarah, Braithwaite, Isobel, Byrne, Thomas, Kovar, Jana, Fragaszy, Ellen, Fong, Wing Lam Erica, Geismar, Cyril, Patel, Parth, Rodger, Alison, Johnson, Anne M., and Hayward, Andrew
- Published
- 2022
- Full Text
- View/download PDF
10. Eyeglasses and risk of COVID-19 transmission—analysis of the Virus Watch Community Cohort study
- Author
-
Navaratnam, Annalan M.D., primary, O'Callaghan, Christopher, additional, Beale, Sarah, additional, Nguyen, Vincent, additional, Aryee, Anna, additional, Braithwaite, Isobel, additional, Byrne, Thomas E., additional, Fong, Wing Lam Erica, additional, Fragaszy, Ellen, additional, Geismar, Cyril, additional, Hoskins, Susan, additional, Kovar, Jana, additional, Patel, Parth, additional, Shrotri, Madhumita, additional, Weber, Sophie, additional, Yavlinsky, Alexei, additional, Aldridge, Robert W., additional, Hayward, Andrew C., additional, Michie, Susan, additional, Hardelid, Pia, additional, Wijlaars, Linda, additional, Nastouli, Eleni, additional, Spyer, Moira, additional, Killingley, Ben, additional, Cox, Ingemar, additional, Lampos, Vasileios, additional, McKendry, Rachel A., additional, Cheng, Tao, additional, Liu, Yunzhe, additional, Gibbs, Jo, additional, Gilson, Richard, additional, Rogers, Alison, additional, and Johnson, Anne M., additional
- Published
- 2024
- Full Text
- View/download PDF
11. Estimating the household secondary attack rate and serial interval of COVID-19 using social media.
- Author
-
Dhiman, Aarzoo, Yom-Tov, Elad, Pellis, Lorenzo, Edelstein, Michael, Pebody, Richard, Hayward, Andrew, House, Thomas, Finnie, Thomas, Guzman, David, Lampos, Vasileios, Virus Watch Consortium, Aldridge, Rob, Beale, Sarah, Byrne, Thomas, Kovar, Jana, Braithwaite, Isobel, Fragaszy, Ellen, Fong, Wing Lam Erica, Geismar, Cyril, and Hoskins, Susan
- Subjects
SOCIAL media ,HOME environment ,INFECTION ,DESCRIPTIVE statistics ,LONGITUDINAL method ,EPIDEMIOLOGY ,CONFIDENCE intervals ,MIXED infections ,COVID-19 - Abstract
We propose a method to estimate the household secondary attack rate (hSAR) of COVID-19 in the United Kingdom based on activity on the social media platform X, formerly known as Twitter. Conventional methods of hSAR estimation are resource intensive, requiring regular contact tracing of COVID-19 cases. Our proposed framework provides a complementary method that does not rely on conventional contact tracing or laboratory involvement, including the collection, processing, and analysis of biological samples. We use a text classifier to identify reports of people tweeting about themselves and/or members of their household having COVID-19 infections. A probabilistic analysis is then performed to estimate the hSAR based on the number of self or household, and self and household tweets of COVID-19 infection. The analysis includes adjustments for a reluctance of Twitter users to tweet about household members, and the possibility that the secondary infection was not acquired within the household. Experimental results for the UK, both monthly and weekly, are reported for the period from January 2020 to February 2022. Our results agree with previously reported hSAR estimates, varying with the primary variants of concern, e.g. delta and omicron. The serial interval (SI) is based on the time between the two tweets that indicate a primary and secondary infection. Experimental results, though larger than the consensus, are qualitatively similar. The estimation of hSAR and SI using social media data constitutes a new tool that may help in characterizing, forecasting and managing outbreaks and pandemics in a faster, affordable, and more efficient manner. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
12. Deprivation, essential and non-essential activities and SARS-CoV-2 infection following the lifting of national public health restrictions in England and Wales
- Author
-
Hoskins, Susan, primary, Beale, Sarah, additional, Nguyen, Vincent, additional, Boukari, Yamina, additional, Yavlinsky, Alexei, additional, Kovar, Jana, additional, Byrne, Thomas, additional, Fong, Wing Lam Erica, additional, Geismar, Cyril, additional, Patel, Parth, additional, Johnson, Anne, additional, Aldridge, Robert, additional, and Hayward, Andrew, additional
- Published
- 2023
- Full Text
- View/download PDF
13. Cohort Profile: Virus Watch—understanding community incidence, symptom profiles and transmission of COVID-19 in relation to population movement and behaviour
- Author
-
Byrne, Thomas, primary, Kovar, Jana, additional, Beale, Sarah, additional, Braithwaite, Isobel, additional, Fragaszy, Ellen, additional, Fong, Wing Lam Erica, additional, Geismar, Cyril, additional, Hoskins, Susan, additional, Navaratnam, Annalan M D, additional, Nguyen, Vincent, additional, Patel, Parth, additional, Shrotri, Madhumita, additional, Yavlinsky, Alexei, additional, Hardelid, Pia, additional, Wijlaars, Linda, additional, Nastouli, Eleni, additional, Spyer, Moira, additional, Aryee, Anna, additional, Cox, Ingemar, additional, Lampos, Vasileios, additional, Mckendry, Rachel A, additional, Cheng, Tao, additional, Johnson, Anne M, additional, Michie, Susan, additional, Gibbs, Jo, additional, Gilson, Richard, additional, Rodger, Alison, additional, Abubakar, Ibrahim, additional, Hayward, Andrew, additional, and Aldridge, Robert W, additional
- Published
- 2023
- Full Text
- View/download PDF
14. Cohort Profile:Virus Watch - understanding community incidence, symptom profiles and transmission of COVID-19 in relation to population movement and behaviour
- Author
-
Byrne, Thomas, Kovar, Jana, Beale, Sarah, Braithwaite, Isobel, Fragaszy, Ellen, Fong, Wing Lam Erica, Geismar, Cyril, Hoskins, Susan, Navaratnam, Annalan M.D., Nguyen, Vincent, Patel, Parth, Shrotri, Madhumita, Yavlinsky, Alexei, Hardelid, Pia, Wijlaars, Linda, Nastouli, Eleni, Spyer, Moira, Aryee, Anna, Cox, Ingemar, Lampos, Vasileios, McKendry, Rachel A., Cheng, Tao, Johnson, Anne M., Michie, Susan, Gibbs, Jo, Gilson, Richard, Rodger, Alison, Abubakar, Ibrahim, Hayward, Andrew, Aldridge, Robert W., Byrne, Thomas, Kovar, Jana, Beale, Sarah, Braithwaite, Isobel, Fragaszy, Ellen, Fong, Wing Lam Erica, Geismar, Cyril, Hoskins, Susan, Navaratnam, Annalan M.D., Nguyen, Vincent, Patel, Parth, Shrotri, Madhumita, Yavlinsky, Alexei, Hardelid, Pia, Wijlaars, Linda, Nastouli, Eleni, Spyer, Moira, Aryee, Anna, Cox, Ingemar, Lampos, Vasileios, McKendry, Rachel A., Cheng, Tao, Johnson, Anne M., Michie, Susan, Gibbs, Jo, Gilson, Richard, Rodger, Alison, Abubakar, Ibrahim, Hayward, Andrew, and Aldridge, Robert W.
- Abstract
This article aims to provide evidence on which public health approaches are most likely to be effective in reducing the spread and impact of the virus and investigates community incidence, symptom profiles and transmission of COVID-19 in relation to population movement and behaviour. In all, 28,527 households and 58,628 participants of age (0-98 years, mean age 48), were recruited between June 2020 and March 2022. Data collected include demographics and details of occupation, comorbidities, medications and infection-prevention behaviours. Households are followed up weekly with illness surveys capturing symptoms and their severity, activities in the week prior to symptom onset and any COVID-19 test results. Additional occasional surveys capture household finance, employment, mental health, access to health care, vaccination uptake, activities and contacts. Data have been linked to Hospital Episode Statistics (HES), inpatient and critical care episodes, outpatient visits, emergency care contacts, mortality, virology testing and vaccination data held by National Health Service (NHS) Digital. Nested within Virus Watch are a serology and Polymerase Chain Reaction (PCR) cohort study (n=12,877) and a vaccine evaluation study (n=19,555).
- Published
- 2023
15. Comparative effectiveness of different primary vaccination courses on mRNA-based booster vaccines against SARs-COV-2 infections: a time-varying cohort analysis using trial emulation in the Virus Watch community cohort
- Author
-
Nguyen, Vincent Grigori, primary, Yavlinsky, Alexei, additional, Beale, Sarah, additional, Hoskins, Susan, additional, Byrne, Thomas E, additional, Lampos, Vasileios, additional, Braithwaite, Isobel, additional, Fong, Wing Lam Erica, additional, Fragaszy, Ellen, additional, Geismar, Cyril, additional, Kovar, Jana, additional, Navaratnam, Annalan M D, additional, Patel, Parth, additional, Shrotri, Madhumita, additional, Weber, Sophie, additional, Hayward, Andrew C, additional, and Aldridge, Robert W, additional
- Published
- 2023
- Full Text
- View/download PDF
16. Relative contribution of essential and non-essential activities to SARS-CoV-2 transmission following the lifting of public health restrictions in England and Wales
- Author
-
Hoskins, Susan, primary, Beale, Sarah, additional, Nguyen, Vincent, additional, Boukari, Yamina, additional, Yavlinsky, Alexei, additional, Kovar, Jana, additional, Byrne, Thomas, additional, Fragaszy, Ellen, additional, Fong, Wing Lam Erica, additional, Geismar, Cyril, additional, Patel, Parth, additional, Navaratnam, Annalan M. D., additional, van Tongeren, Martie, additional, Johnson, Anne M., additional, Aldridge, Robert W., additional, and Hayward, Andrew, additional
- Published
- 2022
- Full Text
- View/download PDF
17. Settings for non-household transmission of SARS-CoV-2 during the second lockdown in England and Wales – analysis of the Virus Watch household community cohort study
- Author
-
Hoskins, Susan, Beale, Sarah, Nguyen, Vincent, Fragaszy, Ellen, Navaratnam, Annalan MD, Smith, Colette, French, Clare, Kovar, Jana, Byrne, Thomas, Fong, Wing Lam Erica, Geismar, Cyril, Patel, Parth, Yavlinksy, Alexei, Johnson, Anne M, Aldridge, Robert W, Hayward, Andrew, and Virus Watch Collaborative
- Abstract
BACKGROUND: “Lockdowns” to control serious respiratory virus pandemics were widely used during the coronavirus disease 2019 (COVID-19) pandemic. However, there is limited information to understand the settings in which most transmission occurs during lockdowns, to support refinement of similar policies for future pandemics. METHODS: Among Virus Watch household cohort participants we identified those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outside the household. Using survey activity data, we undertook multivariable logistic regressions assessing the contribution of activities on non-household infection risk. We calculated adjusted population attributable fractions (APAF) to estimate which activity accounted for the greatest proportion of non-household infections during the pandemic’s second wave. RESULTS: Among 10,858 adults, 18% of cases were likely due to household transmission. Among 10,475 participants (household-acquired cases excluded), including 874 non-household-acquired infections, infection was associated with: leaving home for work or education (AOR 1.20 (1.02 – 1.42), APAF 6.9%); public transport (more than once per week AOR 1.82 (1.49 – 2.23), public transport APAF 12.42%); and shopping (more than once per week AOR 1.69 (1.29 – 2.21), shopping APAF 34.56%). Other non-household activities were rare and not significantly associated with infection. CONCLUSIONS: During lockdown, going to work and using public or shared transport independently increased infection risk, however only a minority did these activities. Most participants visited shops, accounting for one-third of non-household transmission. Transmission in restricted hospitality and leisure settings was minimal suggesting these restrictions were effective. If future respiratory infection pandemics emerge these findings highlight the value of working from home, using forms of transport that minimise exposure to others, minimising exposure to shops and restricting non-essential activities.
- Published
- 2022
18. Nucleocapsid and spike antibody responses following virologically confirmed SARS-CoV-2 infection: an observational analysis in the Virus Watch community cohort
- Author
-
Navaratnam, Annalan M D, primary, Shrotri, Madhumita, additional, Nguyen, Vincent, additional, Braithwaite, Isobel, additional, Beale, Sarah, additional, Byrne, Thomas E, additional, Fong, Wing Lam Erica, additional, Fragaszy, Ellen, additional, Geismar, Cyril, additional, Hoskins, Susan, additional, Kovar, Jana, additional, Patel, Parth, additional, Yavlinsky, Alexei, additional, Aryee, Anna, additional, Rodger, Alison, additional, Hayward, Andrew C, additional, Aldridge, Robert W, additional, Michie, Susan, additional, Hardelid, Pia, additional, Wijlaars, Linda, additional, Nastouli, Eleni, additional, Spyer, Moira, additional, Killingley, Ben, additional, Cox, Ingemar, additional, Lampos, Vasileios, additional, McKendry, Rachel A, additional, Cheng, Tao, additional, Liu, Yunzhe, additional, Gibbs, Jo, additional, Gilson, Richard, additional, and Johnson, Anne M, additional
- Published
- 2022
- Full Text
- View/download PDF
19. Between-occupation differences in work-related COVID-19 mitigation strategies over time: Analysis of the Virus Watch Cohort in England and Wales.
- Author
-
Beale, Sarah, Yavlinsky, Alexei, Hoskins, Susan, Nguyen, Vincent, Byrne, Thomas, Wing Lam Erica Fong, Kovar, Jana, Van Tongeren, Martie, Aldridge, Robert W., and Hayward, Andrew
- Subjects
MEDICAL personnel ,COVID-19 ,SOCIAL distancing ,HAND care & hygiene ,OCCUPATIONAL roles - Abstract
Objectives COVID-19 mitigations have had a profound impact on workplaces, however, multisectoral comparisons of how work-related mitigations were applied are limited. This study aimed to investigate (i) occupational differences in the usage of key work-related mitigations over time and (ii) workers' perceptions of these mitigations. Methods Employed/self-employed Virus Watch study participants (N=6279) responded to a mitigation-related online survey covering the periods of December 2020-February 2022. Logistic regression was used to investigate occupation- and time-related differences in the usage of work-related mitigation methods. Participants' perceptions of mitigation methods were investigated descriptively using proportions. Results Usage of work-related mitigation methods differed between occupations and over time, likely reflecting variation in job roles, workplace environments, legislation and guidance. Healthcare workers had the highest predicted probabilities for several mitigations, including reporting frequent hand hygiene [predicted probability across all survey periods 0.61 (95% CI 0.56-0.66)] and always wearing face coverings [predicted probability range 0.71 (95% CI 0.66-0.75) - 0.80 (95% CI 0.76-0.84) across survey periods]. There were significant crossoccupational trends towards reduced mitigations during periods of less stringent national restrictions. The majority of participants across occupations (55-88%) agreed that most mitigations were reasonable and worthwhile even after the relaxation of national restrictions; agreement was lower for physical distancing (39-44%). Conclusions While usage of work-related mitigations appeared to vary alongside stringency of national restrictions, agreement that most mitigations were reasonable and worthwhile remained substantial. Further investigation into the factors underlying between-occupational differences could assist pandemic planning and prevention of workplace COVID-19 transmission. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
20. Workplace contact patterns in England during the COVID-19 pandemic: Analysis of the Virus Watch prospective cohort study
- Author
-
Beale, Sarah, Hoskins, Susan, Byrne, Thomas, Fong, Wing Lam Erica, Fragaszy, Ellen, Geismar, Cyril, Kovar, Jana, Navaratnam, Annalan MD, Nguyen, Vincent, Patel, Parth, Yavlinsky, Alexei, Johnson, Anne M, Van Tongeren, Martie, Aldridge, Robert W, Hayward, Andrew, and Virus Watch Collaborative
- Abstract
BACKGROUND: Workplaces are an important potential source of SARS-CoV-2 exposure; however, investigation into workplace contact patterns is lacking. This study aimed to investigate how workplace attendance and features of contact varied between occupations across the COVID-19 pandemic in England. METHODS: Data were obtained from electronic contact diaries (November 2020-November 2021) submitted by employed/self-employed prospective cohort study participants (n=4,616). We used mixed models to investigate the effects of occupation and time for: workplace attendance, number of people sharing workspace, time spent sharing workspace, number of close contacts, and usage of face coverings. FINDINGS: Workplace attendance and contact patterns varied across occupations and time. The predicted probability of intense space sharing during the day was highest for healthcare (78% [95% CI: 75-81%]) and education workers (64% [59%-69%]), who also had the highest probabilities for larger numbers of close contacts (36% [32%-40%] and 38% [33%-43%] respectively). Education workers also demonstrated relatively low predicted probability (51% [44%-57%]) of wearing a face covering during close contact. Across all occupational groups, workspace sharing and close contact increased and usage of face coverings decreased during phases of less stringent restrictions. INTERPRETATION: Major variations in workplace contact patterns and mask use likely contribute to differential COVID-19 risk. Patterns of variation by occupation and restriction phase may inform interventions for future waves of COVID-19 or other respiratory epidemics. Across occupations, increasing workplace contact and reduced face covering usage is concerning given ongoing high levels of community transmission and emergence of variants. FUNDING: Medical Research Council; HM Government; Wellcome Trust.
- Published
- 2022
21. Anti-spike antibody trajectories in individuals previously immunised with BNT162b2 or ChAdOx1 following a BNT162b2 booster dose
- Author
-
Yavlinsky, Alexei, primary, Beale, Sarah, additional, Nguyen, Vincent, additional, Shrotri, Madhumita, additional, Byrne, Thomas, additional, Geismar, Cyril, additional, Fragaszy, Ellen, additional, Hoskins, Susan, additional, Fong, Wing Lam Erica, additional, Navaratnam, Annalan M D, additional, Braithwaite, Isobel, additional, Patel, Parth, additional, Kovar, Jana, additional, Hayward, Andrew, additional, and Aldridge, Robert W, additional
- Published
- 2022
- Full Text
- View/download PDF
22. Symptom profiles and accuracy of clinical case definitions for COVID-19 in a community cohort: results from the Virus Watch study
- Author
-
Fragaszy, Ellen, Shrotri, Madhumita, Geismar, Cyril, Aryee, Anna, Beale, Sarah, Braithwaite, Isobel, Byrne, Thomas, Eyre, Max T, Fong, Wing Lam Erica, Gibbs, Jo, Hardelid, Pia, Kovar, Jana, Lampos, Vasileios, Nastouli, Eleni, Navaratnam, Annalan MD, Nguyen, Vincent, Patel, Parth, Aldridge, Robert W, and Hayward, Andrew
- Abstract
Background: Understanding symptomatology and accuracy of clinical case definitions for community COVID-19 cases is important for Test, Trace and Isolate (TTI) and future targeting of early antiviral treatment. \ud Methods: Community cohort participants prospectively recorded daily symptoms and swab results (mainly undertaken through the UK TTI system). We compared symptom frequency, severity, timing, and duration in test positive and negative illnesses. We compared the test performance of the current UK TTI case definition (cough, high temperature, or loss of or altered sense of smell or taste) with a wider definition adding muscle aches, chills, headache, or loss of appetite. \ud Results: Among 9706 swabbed illnesses, including 973 SARS-CoV-2 positives, symptoms were more common, severe and longer lasting in swab positive than negative illnesses. Cough, headache, fatigue, and muscle aches were the most common symptoms in positive illnesses but also common in negative illnesses. Conversely, high temperature, loss or altered sense of smell or taste and loss of appetite were less frequent in positive illnesses, but comparatively even less frequent in negative illnesses. The current UK definition had 81% sensitivity and 47% specificity versus 93% and 27% respectively for the broader definition. 1.7-fold more illnesses met the broader case definition than the current definition. \ud Conclusions: Symptoms alone cannot reliably distinguish COVID-19 from other respiratory illnesses. Adding additional symptoms to case definitions could identify more infections, but with a large increase in the number needing testing and the number of unwell individuals and contacts self-isolating whilst awaiting results.
- Published
- 2022
23. SARS-CoV-2 antibodies and breakthrough infections in the Virus Watch cohort
- Author
-
Aldridge, Robert W, Yavlinsky, Alexei, Nguyen, Vincent, Eyre, Max T, Shrotri, Madhumita, Navaratnam, Annalan M D, Beale, Sarah, Braithwaite, Isobel, Byrne, Thomas, Kovar, Jana, Fragaszy, Ellen, Fong, Wing Lam Erica, Geismar, Cyril, Patel, Parth, Rodger, Alison, Johnson, Anne M, Hayward, Andrew, Aldridge, Robert W, Yavlinsky, Alexei, Nguyen, Vincent, Eyre, Max T, Shrotri, Madhumita, Navaratnam, Annalan M D, Beale, Sarah, Braithwaite, Isobel, Byrne, Thomas, Kovar, Jana, Fragaszy, Ellen, Fong, Wing Lam Erica, Geismar, Cyril, Patel, Parth, Rodger, Alison, Johnson, Anne M, and Hayward, Andrew
- Abstract
A range of studies globally demonstrate that the effectiveness of SARS-CoV-2 vaccines wane over time, but the total effect of anti-S antibody levels on risk of SARS-CoV-2 infection and whether this varies by vaccine type is not well understood. Here we show that anti-S levels peak three to four weeks following the second dose of vaccine and the geometric mean of the samples is nine fold higher for BNT162b2 than ChAdOx1. Increasing anti-S levels are associated with a reduced risk of SARS-CoV-2 infection (Hazard Ratio 0.85; 95%CIs: 0.79-0.92). We do not find evidence that this antibody relationship with risk of infection varies by second dose vaccine type (BNT162b2 vs. ChAdOx1). In keeping with our anti-S antibody data, we find that people vaccinated with ChAdOx1 had 1.64 times the odds (95% confidence interval 1.45-1.85) of a breakthrough infection compared to BNT162b2. We anticipate our findings to be useful in the estimation of the protective effect of anti-S levels on risk of infection due to Delta. Our findings provide evidence about the relationship between antibody levels and protection for different vaccines and will support decisions on optimising the timing of booster vaccinations and identifying individuals who should be prioritised for booster vaccination, including those who are older, clinically extremely vulnerable, or received ChAdOx1 as their primary course. Our finding that risk of infection by anti-S level does not interact with vaccine type, but that individuals vaccinated with ChAdOx1 were at higher risk of infection, provides additional support for the use of using anti-S levels for estimating vaccine efficacy. [Abstract copyright: © 2022. The Author(s).]
- Published
- 2022
24. Symptom profiles and accuracy of clinical case definitions for COVID-19 in a community cohort:results from the Virus Watch study
- Author
-
Fragaszy, Ellen, Shrotri, Madhumita, Geismar, Cyril, Aryee, Anna, Beale, Sarah, Braithwaite, Isobel, Byrne, Thomas, Eyre, Max T, Fong, Wing Lam Erica, Gibbs, Jo, Hardelid, Pia, Kovar, Jana, Lampos, Vasileios, Nastouli, Eleni, Navaratnam, Annalan M D, Nguyen, Vincent, Patel, Parth, Aldridge, Robert W, Hayward, Andrew, Fragaszy, Ellen, Shrotri, Madhumita, Geismar, Cyril, Aryee, Anna, Beale, Sarah, Braithwaite, Isobel, Byrne, Thomas, Eyre, Max T, Fong, Wing Lam Erica, Gibbs, Jo, Hardelid, Pia, Kovar, Jana, Lampos, Vasileios, Nastouli, Eleni, Navaratnam, Annalan M D, Nguyen, Vincent, Patel, Parth, Aldridge, Robert W, and Hayward, Andrew
- Abstract
Background: Understanding symptomatology and accuracy of clinical case definitions for community COVID-19 cases is important for Test, Trace and Isolate (TTI) and future targeting of early antiviral treatment. Methods: Community cohort participants prospectively recorded daily symptoms and swab results (mainly undertaken through the UK TTI system). We compared symptom frequency, severity, timing, and duration in test positive and negative illnesses. We compared the test performance of the current UK TTI case definition (cough, high temperature, or loss of or altered sense of smell or taste) with a wider definition adding muscle aches, chills, headache, or loss of appetite. Results: Among 9706 swabbed illnesses, including 973 SARS-CoV-2 positives, symptoms were more common, severe and longer lasting in swab positive than negative illnesses. Cough, headache, fatigue, and muscle aches were the most common symptoms in positive illnesses but also common in negative illnesses. Conversely, high temperature, loss or altered sense of smell or taste and loss of appetite were less frequent in positive illnesses, but comparatively even less frequent in negative illnesses. The current UK definition had 81% sensitivity and 47% specificity versus 93% and 27% respectively for the broader definition. 1.7-fold more illnesses met the broader case definition than the current definition. Conclusions: Symptoms alone cannot reliably distinguish COVID-19 from other respiratory illnesses. Adding additional symptoms to case definitions could identify more infections, but with a large increase in the number needing testing and the number of unwell individuals and contacts self-isolating whilst awaiting results.
- Published
- 2022
25. Household overcrowding and risk of SARS-CoV-2: analysis of the Virus Watch prospective community cohort study in England and Wales
- Author
-
Aldridge, Robert W, primary, Pineo, Helen, additional, Fragaszy, Ellen, additional, Eyre, Max T, additional, Kovar, Jana, additional, Nguyen, Vincent, additional, Beale, Sarah, additional, Byrne, Thomas, additional, Aryee, Anna, additional, Smith, Colette, additional, Devakumar, Delan, additional, Taylor, Jonathon, additional, Katikireddi, Srinivasa Vittal, additional, Fong, Wing Lam Erica, additional, Geismar, Cyril, additional, Patel, Parth, additional, Shrotri, Madhumita, additional, Braithwaite, Isobel, additional, Patni, Nicholas, additional, Navaratnam, Annalan M.D., additional, Johnson, Anne M., additional, and Hayward, Andrew, additional
- Published
- 2021
- Full Text
- View/download PDF
26. Deprivation and exposure to public activities during the COVID-19 pandemic in England and Wales
- Author
-
Beale, Sarah, Braithwaite, Isobel, Navaratnam, Annalan Md, Hardelid, Pia, Rodger, Alison, Aryee, Anna, Byrne, Thomas E, Fong, Erica Wing Lam, Fragaszy, Ellen, Geismar, Cyril, Kovar, Jana, Nguyen, Vincent, Patel, Parth, Shrotri, Madhumita, Aldridge, Robert, Hayward, Andrew, and Virus Watch Collaborative
- Abstract
BACKGROUND: Differential exposure to public activities may contribute to stark deprivation-related inequalities in SARS-CoV-2 infection and outcomes but has not been directly investigated. We set out to investigate whether participants in Virus Watch-a large community cohort study based in England and Wales-reported differential exposure to public activities and non-household contacts during the autumn-winter phase of the COVID-19 pandemic according to postcode-level socioeconomic deprivation. METHODS: Participants (n=20 120-25 228 across surveys) reported their daily activities during 3 weekly periods in late November 2020, late December 2020 and mid-February 2021. Deprivation was quantified based on participants' residential postcode using English or Welsh Index of Multiple Deprivation quintiles. We used Poisson mixed-effect models with robust standard errors to estimate the relationship between deprivation and risk of exposure to public activities during each survey period. RESULTS: Relative to participants in the least deprived areas, participants in the most deprived areas exhibited elevated risk of exposure to vehicle sharing (adjusted risk ratio (aRR) range across time points: 1.73-8.52), public transport (aRR: 3.13-5.73), work or education outside of the household (aRR: 1.09-1.21), essential shops (aRR: 1.09-1.13) and non-household contacts (aRR: 1.15-1.19) across multiple survey periods. CONCLUSION: Differential exposure to essential public activities-such as attending workplaces and visiting essential shops-is likely to contribute to inequalities in infection risk and outcomes. Public health interventions to reduce exposure during essential activities and financial and practical support to enable low-paid workers to stay at home during periods of intense transmission may reduce COVID-related inequalities.
- Published
- 2021
27. Trends, patterns and psychological influences on COVID-19 vaccination intention: Findings from a large prospective community cohort study in England and Wales (Virus Watch)
- Author
-
Byrne, Thomas, Patel, Parth, Shrotri, Madhumita, Beale, Sarah, Michie, Susan, Butt, Jabeer, Hawkins, Nicky, Hardelid, Pia, Rodger, Alison, Aryee, Anna, Braithwaite, Isobel, Fong, Wing Lam Erica, Fragaszy, Ellen, Geismar, Cyril, Kovar, Jana, Navaratnam, Annalan MD, Nguyen, Vincent, Hayward, Andrew, Aldridge, Robert W, and Virus Watch Collaborative
- Abstract
BACKGROUND: Vaccination intention is key to the success of any vaccination programme, alongside vaccine availability and access. Public intention to take a COVID-19 vaccine is high in England and Wales compared to other countries, but vaccination rate disparities between ethnic, social and age groups has led to concern. METHODS: Online survey of prospective household community cohort study participants across England and Wales (Virus Watch). Vaccination intention was measured by individual participant responses to 'Would you accept a COVID-19 vaccine if offered?', collected in December 2020 and February 2021. Responses to a 13-item questionnaire collected in January 2021 were analysed using factor analysis to investigate psychological influences on vaccination intention. RESULTS: Survey response rate was 56% (20,785/36,998) in December 2020 and 53% (20,590/38,727) in February 2021, with 14,880 adults reporting across both time points. In December 2020, 1,469 (10%) participants responded 'No' or 'Unsure'. Of these people, 1,266 (86%) changed their mind and responded 'Yes' or 'Already had a COVID-19 vaccine' by February 2021. Vaccination intention increased across all ethnic groups and levels of social deprivation. Age was most strongly associated with vaccination intention, with 16-24-year-olds more likely to respond "Unsure" or "No" versus "Yes" than 65-74-year-olds in December 2020 (OR: 4.63, 95 %CI: 3.42, 6.27 & OR 7.17 95 %CI: 4.26, 12.07 respectively) and February 2021 (OR: 27.92 95 %CI: 13.79, 56.51 & OR 17.16 95 %CI: 4.12, 71.55). The association between ethnicity and vaccination intention weakened, but did not disappear, over time. Both vaccine- and illness-related psychological factors were shown to influence vaccination intention. CONCLUSIONS: Four in five adults (86%) who were reluctant or intending to refuse a COVID-19 vaccine in December 2020 had changed their mind in February 2021 and planned to accept, or had already accepted, a vaccine.
- Published
- 2021
28. Reported exposure to SARS-CoV-2 and relative perceived importance of different settings for SARS-CoV-2 acquisition in England and Wales: Analysis of the Virus Watch Community Cohort
- Author
-
Beale, Sarah, Byrne, Thomas, Fragaszy, Ellen, Kovar, Jana, Nguyen, Vincent, Aryee, Anna, Fong, Wing Lam Erica, Geismar, Cyril, Patel, Parth, Shrotri, Madhumita, Patni, Nicholas, Braithwaite, Isobel, Navaratnam, Annalan, Johnson, Anne M, Aldridge, Robert W, and Hayward, Andrew C
- Abstract
We aimed to assess the relative importance of different settings for SARS-CoV-2 transmission in a large community cohort based on perceived location of infection for self-reported confirmed SARS-COV-2 cases. We demonstrate the importance of home, work and education as perceived venues for transmission. In children, education was most important and in older adults essential shopping was of high importance. Our findings support public health messaging about infection control at home, advice on working from home and restrictions in different venues.
- Published
- 2021
29. Tracking Changes in Mobility Before and After the First SARS-CoV-2 Vaccination Using Global Positioning System Data in England and Wales (Virus Watch): Prospective Observational Community Cohort Study.
- Author
-
Nguyen, Vincent, Yunzhe Liu, Mumford, Richard, Flanagan, Benjamin, Patel, Parth, Braithwaite, Isobel, Shrotri, Madhumita, Byrne, Thomas, Beale, Sarah, Aryee, Anna, Fong, Wing Lam Erica, Fragaszy, Ellen, Geismar, Cyril, Navaratnam, Annalan M. D., Hardelid, Pia, Kovar, Jana, Pope, Addy, Tao Cheng, Hayward, Andrew, and Aldridge, Robert
- Published
- 2023
- Full Text
- View/download PDF
30. Relative contribution of essential and non-essential activities to SARS-CoV-2 transmission following the lifting of public health restrictions in England and Wales.
- Author
-
Hoskins, Susan, Beale, Sarah, Nguyen, Vincent, Boukari, Yamina, Yavlinsky, Alexei, Kovar, Jana, Byrne, Thomas, Fragaszy, Ellen, Fong, Wing Lam Erica, Geismar, Cyril, Patel, Parth, Navaratnam, Annalan M. D., Tongeren, Martie van, Johnson, Anne M., Aldridge, Robert W., and Hayward, Andrew
- Abstract
Purpose We aimed to understand which non-household activities increased infection odds and contributed greatest to SARS-CoV-2 infections following the lifting of public health restrictions in England and Wales. Procedures We undertook multivariable logistic regressions assessing the contribution to infections of activities reported by adult Virus Watch Community Cohort Study participants. We calculated adjusted weighted population attributable fractions (aPAF) estimating which activity contributed greatest to infections. Findings Among 11 413 participants (493 infections), infection was associated with: leaving home for work (aOR 1.35 (1.11–1.64), aPAF 17%), public transport (aOR 1.27 (1.04–1.57), aPAF 12%), shopping once (aOR 1.83 (1.36–2.45)) vs. more than three times a week, indoor leisure (aOR 1.24 (1.02–1.51), aPAF 10%) and indoor hospitality (aOR 1.21 (0.98–1.48), aPAF 7%). We found no association for outdoor hospitality (1.14 (0.94–1.39), aPAF 5%) or outdoor leisure (1.14 (0.82–1.59), aPAF 1%). Conclusion Essential activities (work and public transport) carried the greatest risk and were the dominant contributors to infections. Non-essential indoor activities (hospitality and leisure) increased risk but contributed less. Outdoor activities carried no statistical risk and contributed to fewer infections. As countries aim to 'live with COVID', mitigating transmission in essential and indoor venues becomes increasingly relevant. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
31. Risk factors, symptom reporting, healthcare-seeking behaviour and adherence to public health guidance: protocol for Virus Watch, a prospective community cohort study
- Author
-
Hayward, Andrew, primary, Fragaszy, Ellen, additional, Kovar, Jana, additional, Nguyen, Vincent, additional, Beale, Sarah, additional, Byrne, Thomas, additional, Aryee, Anna, additional, Hardelid, Pia, additional, Wijlaars, Linda, additional, Fong, Wing Lam Erica, additional, Geismar, Cyril, additional, Patel, Parth, additional, Shrotri, Madhumita, additional, Navaratnam, Annalan M D, additional, Nastouli, Eleni, additional, Spyer, Moira, additional, Killingley, Ben, additional, Cox, Ingemar, additional, Lampos, Vasileios, additional, McKendry, Rachel A, additional, Liu, Yunzhe, additional, Cheng, Tao, additional, Johnson, Anne M, additional, Michie, Susan, additional, Gibbs, Jo, additional, Gilson, Richard, additional, Rodger, Alison, additional, and Aldridge, Robert W, additional
- Published
- 2021
- Full Text
- View/download PDF
32. Lung Morphometry after Repetitive Antenatal Glucocorticoid Treatment in Preterm Sheep
- Author
-
WILLET, KAREN E., JOBE, ALAN H., IKEGAMI, MACHIKO, KOVAR, JANA, and SLY, PETER D.
- Published
- 2001
- Full Text
- View/download PDF
33. Effects of school closures, 2008 winter influenza season, Hong Kong
- Author
-
Cowling, Benjamin J., Lau, Eric H.Y., Lam, Conrad L.H., Cheng, Calvin K.Y., Kovar, Jana, Chan, Kwok Hung, Peiris, J.S. Malik, and Leung, Gabriel M.
- Subjects
Influenza -- Diagnosis ,Influenza -- Risk factors ,Children -- Health aspects ,Elementary schools -- China ,Elementary schools -- Facility closures - Abstract
In winter 2008, kindergartens and primary schools in Hong Kong were closed for 2 weeks after media coverage indicated that 3 children had died, apparently from influenza. We examined prospective [...]
- Published
- 2008
34. Cohort Profile: The Flu Watch Study
- Author
-
Fragaszy, Ellen B, Warren-Gash, Charlotte, Wang, Lili, Copas, Andrew, Dukes, Oliver, Edmunds, W John, Goonetilleke, Nilu, Harvey, Gabrielle, Johnson, Anne M, Kovar, Jana, Lim, Megan Sc, McMichael, Andrew, Millett, Elizabeth Rc, Nazareth, Irwin, Nguyen-Van-Tam, Jonathan S, Tabassum, Faiza, Watson, John M, Wurie, Fatima, Zambon, Maria, Hayward, Andrew C, and Flu Watch Group
- Published
- 2016
35. Cohort Profile: The Flu Watch Study.
- Author
-
Fragaszy, Ellen B., Warren-Gash, Charlotte, Lili Wang, Copas, Andrew, Dukes, Oliver, Edmunds, W. John, Goonetilleke, Nilu, Harvey, Gabrielle, Johnson, Anne M., Kovar, Jana, C. Lim, Megan S., McMichael, Andrew, Millett, Elizabeth R. C., Nazareth, Irwin, Nguyen-Van-Tam, Jonathan S., Tabassum, Faiza, Watson, John M., Fatima Wurie, Zambon, Maria, and Hayward, Andrew C.
- Subjects
INFLUENZA ,RESPIRATORY infections ,T cells ,IMMUNOGLOBULIN producing cells ,MEDICAL care - Published
- 2017
- Full Text
- View/download PDF
36. Impact of postnatal glucocorticoids on early lung development
- Author
-
Kovar, Jana, primary, Willet, Karen E., additional, Hislop, Alison, additional, and Sly, Peter D., additional
- Published
- 2005
- Full Text
- View/download PDF
37. Postnatal alveolar development of the rabbit
- Author
-
Kovar, Jana, primary, Sly, Peter D., additional, and Willet, Karen E., additional
- Published
- 2002
- Full Text
- View/download PDF
38. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study
- Author
-
Hayward, Andrew C., Fragaszy, Ellen B., Bermingham, Alison, Wang, Lili, Copas, Andrew, Edmunds, W. John, Ferguson, Neil, Goonetilleke, Nilu, Harvey, Gabrielle, Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nguyen-Van-Tam, J.S, Nazareth, Irwin, Pebody, Richard, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Johnson, Anne M., Zambon, Maria, Hayward, Andrew C., Fragaszy, Ellen B., Bermingham, Alison, Wang, Lili, Copas, Andrew, Edmunds, W. John, Ferguson, Neil, Goonetilleke, Nilu, Harvey, Gabrielle, Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nguyen-Van-Tam, J.S, Nazareth, Irwin, Pebody, Richard, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Johnson, Anne M., and Zambon, Maria
- Abstract
BACKGROUND: Assessment of the effect of influenza on populations, including risk of infection, illness if infected, illness severity, and consultation rates, is essential to inform future control and prevention. We aimed to compare the community burden and severity of seasonal and pandemic influenza across different age groups and study years and gain insight into the extent to which traditional surveillance underestimates this burden. METHODS: Using preseason and postseason serology, weekly illness reporting, and RT-PCR identification of influenza from nasal swabs, we tracked the course of seasonal and pandemic influenza over five successive cohorts (England 2006-11; 5448 person-seasons' follow-up). We compared burden and severity of seasonal and pandemic strains. We weighted analyses to the age and regional structure of England to give nationally representative estimates. We compared symptom profiles over the first week of illness for different strains of PCR-confirmed influenza and non-influenza viruses using ordinal logistic regression with symptom severity grade as the outcome variable. FINDINGS: Based on four-fold titre rises in strain-specific serology, on average influenza infected 18% (95% CI 16-22) of unvaccinated people each winter. Of those infected there were 69 respiratory illnesses per 100 person-influenza-seasons compared with 44 per 100 in those not infected with influenza. The age-adjusted attributable rate of illness if infected was 23 illnesses per 100 person-seasons (13-34), suggesting most influenza infections are asymptomatic. 25% (18-35) of all people with serologically confirmed infections had PCR-confirmed disease. 17% (10-26) of people with PCR-confirmed influenza had medically attended illness. These figures did not differ significantly when comparing pandemic with seasonal influenza. Of PCR-confirmed cases, people infected with the 2009 pandemic strain had markedly less severe symptoms than those infected with seasonal H3N2. INTERPRETATI
- Full Text
- View/download PDF
39. Cohort profile: the Flu Watch Study
- Author
-
Fragaszy, Ellen B., Warren-Gash, Charlotte, Wang, Lili, Copas, Andrew, Dukes, Oliver, Edmunds, W. John, Goonetilleke, Nile, Harvey, Gabrielle, Johnson, Anne M., Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nazareth, Irwin, Nguyen-Van-Tam, Jonathan, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Zambon, Maria, Hayward, Andrew C., Fragaszy, Ellen B., Warren-Gash, Charlotte, Wang, Lili, Copas, Andrew, Dukes, Oliver, Edmunds, W. John, Goonetilleke, Nile, Harvey, Gabrielle, Johnson, Anne M., Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nazareth, Irwin, Nguyen-Van-Tam, Jonathan, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Zambon, Maria, and Hayward, Andrew C.
- Abstract
Influenza is a common, highly contagious respiratory virus which infects all age groups, causing a range of outcomes from asymptomatic infection and mild respiratory disease to severe respiratory disease and death.1 If infected, the adaptive immune system produces a humoral (antibody) and cell-mediated (T cell) immune response to fight the infection.2 Influenza viruses continually evolve through antigenic drift, resulting in slightly different ‘seasonal’ influenza strains circulating each year. Population-level antibody immunity to these seasonal viruses builds up over time, so in any given season only a proportion of the population is susceptible to the circulating strains. Occasionally, influenza A viruses evolve rapidly through antigenic shift by swapping genes with influenza viruses usually circulating in animals. This process creates an immunologically distinct virus to which the population may have little to no antibody immunity. The virus can result in a pandemic if a large portion of the population is susceptible and the virus is easily spread.
- Full Text
- View/download PDF
40. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study
- Author
-
Hayward, Andrew C., Fragaszy, Ellen B., Bermingham, Alison, Wang, Lili, Copas, Andrew, Edmunds, W. John, Ferguson, Neil, Goonetilleke, Nilu, Harvey, Gabrielle, Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nguyen-Van-Tam, J.S, Nazareth, Irwin, Pebody, Richard, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Johnson, Anne M., Zambon, Maria, Hayward, Andrew C., Fragaszy, Ellen B., Bermingham, Alison, Wang, Lili, Copas, Andrew, Edmunds, W. John, Ferguson, Neil, Goonetilleke, Nilu, Harvey, Gabrielle, Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nguyen-Van-Tam, J.S, Nazareth, Irwin, Pebody, Richard, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Johnson, Anne M., and Zambon, Maria
- Abstract
BACKGROUND: Assessment of the effect of influenza on populations, including risk of infection, illness if infected, illness severity, and consultation rates, is essential to inform future control and prevention. We aimed to compare the community burden and severity of seasonal and pandemic influenza across different age groups and study years and gain insight into the extent to which traditional surveillance underestimates this burden. METHODS: Using preseason and postseason serology, weekly illness reporting, and RT-PCR identification of influenza from nasal swabs, we tracked the course of seasonal and pandemic influenza over five successive cohorts (England 2006-11; 5448 person-seasons' follow-up). We compared burden and severity of seasonal and pandemic strains. We weighted analyses to the age and regional structure of England to give nationally representative estimates. We compared symptom profiles over the first week of illness for different strains of PCR-confirmed influenza and non-influenza viruses using ordinal logistic regression with symptom severity grade as the outcome variable. FINDINGS: Based on four-fold titre rises in strain-specific serology, on average influenza infected 18% (95% CI 16-22) of unvaccinated people each winter. Of those infected there were 69 respiratory illnesses per 100 person-influenza-seasons compared with 44 per 100 in those not infected with influenza. The age-adjusted attributable rate of illness if infected was 23 illnesses per 100 person-seasons (13-34), suggesting most influenza infections are asymptomatic. 25% (18-35) of all people with serologically confirmed infections had PCR-confirmed disease. 17% (10-26) of people with PCR-confirmed influenza had medically attended illness. These figures did not differ significantly when comparing pandemic with seasonal influenza. Of PCR-confirmed cases, people infected with the 2009 pandemic strain had markedly less severe symptoms than those infected with seasonal H3N2. INTERPRETATI
- Full Text
- View/download PDF
41. Cohort profile: the Flu Watch Study
- Author
-
Fragaszy, Ellen B., Warren-Gash, Charlotte, Wang, Lili, Copas, Andrew, Dukes, Oliver, Edmunds, W. John, Goonetilleke, Nile, Harvey, Gabrielle, Johnson, Anne M., Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nazareth, Irwin, Nguyen-Van-Tam, Jonathan, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Zambon, Maria, Hayward, Andrew C., Fragaszy, Ellen B., Warren-Gash, Charlotte, Wang, Lili, Copas, Andrew, Dukes, Oliver, Edmunds, W. John, Goonetilleke, Nile, Harvey, Gabrielle, Johnson, Anne M., Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nazareth, Irwin, Nguyen-Van-Tam, Jonathan, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Zambon, Maria, and Hayward, Andrew C.
- Abstract
Influenza is a common, highly contagious respiratory virus which infects all age groups, causing a range of outcomes from asymptomatic infection and mild respiratory disease to severe respiratory disease and death.1 If infected, the adaptive immune system produces a humoral (antibody) and cell-mediated (T cell) immune response to fight the infection.2 Influenza viruses continually evolve through antigenic drift, resulting in slightly different ‘seasonal’ influenza strains circulating each year. Population-level antibody immunity to these seasonal viruses builds up over time, so in any given season only a proportion of the population is susceptible to the circulating strains. Occasionally, influenza A viruses evolve rapidly through antigenic shift by swapping genes with influenza viruses usually circulating in animals. This process creates an immunologically distinct virus to which the population may have little to no antibody immunity. The virus can result in a pandemic if a large portion of the population is susceptible and the virus is easily spread.
- Full Text
- View/download PDF
42. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study
- Author
-
Hayward, Andrew C., Fragaszy, Ellen B., Bermingham, Alison, Wang, Lili, Copas, Andrew, Edmunds, W. John, Ferguson, Neil, Goonetilleke, Nilu, Harvey, Gabrielle, Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nguyen-Van-Tam, J.S, Nazareth, Irwin, Pebody, Richard, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Johnson, Anne M., Zambon, Maria, Hayward, Andrew C., Fragaszy, Ellen B., Bermingham, Alison, Wang, Lili, Copas, Andrew, Edmunds, W. John, Ferguson, Neil, Goonetilleke, Nilu, Harvey, Gabrielle, Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nguyen-Van-Tam, J.S, Nazareth, Irwin, Pebody, Richard, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Johnson, Anne M., and Zambon, Maria
- Abstract
BACKGROUND: Assessment of the effect of influenza on populations, including risk of infection, illness if infected, illness severity, and consultation rates, is essential to inform future control and prevention. We aimed to compare the community burden and severity of seasonal and pandemic influenza across different age groups and study years and gain insight into the extent to which traditional surveillance underestimates this burden. METHODS: Using preseason and postseason serology, weekly illness reporting, and RT-PCR identification of influenza from nasal swabs, we tracked the course of seasonal and pandemic influenza over five successive cohorts (England 2006-11; 5448 person-seasons' follow-up). We compared burden and severity of seasonal and pandemic strains. We weighted analyses to the age and regional structure of England to give nationally representative estimates. We compared symptom profiles over the first week of illness for different strains of PCR-confirmed influenza and non-influenza viruses using ordinal logistic regression with symptom severity grade as the outcome variable. FINDINGS: Based on four-fold titre rises in strain-specific serology, on average influenza infected 18% (95% CI 16-22) of unvaccinated people each winter. Of those infected there were 69 respiratory illnesses per 100 person-influenza-seasons compared with 44 per 100 in those not infected with influenza. The age-adjusted attributable rate of illness if infected was 23 illnesses per 100 person-seasons (13-34), suggesting most influenza infections are asymptomatic. 25% (18-35) of all people with serologically confirmed infections had PCR-confirmed disease. 17% (10-26) of people with PCR-confirmed influenza had medically attended illness. These figures did not differ significantly when comparing pandemic with seasonal influenza. Of PCR-confirmed cases, people infected with the 2009 pandemic strain had markedly less severe symptoms than those infected with seasonal H3N2. INTERPRETATI
- Full Text
- View/download PDF
43. Cohort profile: the Flu Watch Study
- Author
-
Fragaszy, Ellen B., Warren-Gash, Charlotte, Wang, Lili, Copas, Andrew, Dukes, Oliver, Edmunds, W. John, Goonetilleke, Nile, Harvey, Gabrielle, Johnson, Anne M., Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nazareth, Irwin, Nguyen-Van-Tam, Jonathan, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Zambon, Maria, Hayward, Andrew C., Fragaszy, Ellen B., Warren-Gash, Charlotte, Wang, Lili, Copas, Andrew, Dukes, Oliver, Edmunds, W. John, Goonetilleke, Nile, Harvey, Gabrielle, Johnson, Anne M., Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nazareth, Irwin, Nguyen-Van-Tam, Jonathan, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Zambon, Maria, and Hayward, Andrew C.
- Abstract
Influenza is a common, highly contagious respiratory virus which infects all age groups, causing a range of outcomes from asymptomatic infection and mild respiratory disease to severe respiratory disease and death.1 If infected, the adaptive immune system produces a humoral (antibody) and cell-mediated (T cell) immune response to fight the infection.2 Influenza viruses continually evolve through antigenic drift, resulting in slightly different ‘seasonal’ influenza strains circulating each year. Population-level antibody immunity to these seasonal viruses builds up over time, so in any given season only a proportion of the population is susceptible to the circulating strains. Occasionally, influenza A viruses evolve rapidly through antigenic shift by swapping genes with influenza viruses usually circulating in animals. This process creates an immunologically distinct virus to which the population may have little to no antibody immunity. The virus can result in a pandemic if a large portion of the population is susceptible and the virus is easily spread.
- Full Text
- View/download PDF
44. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study
- Author
-
Hayward, Andrew C., Fragaszy, Ellen B., Bermingham, Alison, Wang, Lili, Copas, Andrew, Edmunds, W. John, Ferguson, Neil, Goonetilleke, Nilu, Harvey, Gabrielle, Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nguyen-Van-Tam, J.S, Nazareth, Irwin, Pebody, Richard, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Johnson, Anne M., Zambon, Maria, Hayward, Andrew C., Fragaszy, Ellen B., Bermingham, Alison, Wang, Lili, Copas, Andrew, Edmunds, W. John, Ferguson, Neil, Goonetilleke, Nilu, Harvey, Gabrielle, Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nguyen-Van-Tam, J.S, Nazareth, Irwin, Pebody, Richard, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Johnson, Anne M., and Zambon, Maria
- Abstract
BACKGROUND: Assessment of the effect of influenza on populations, including risk of infection, illness if infected, illness severity, and consultation rates, is essential to inform future control and prevention. We aimed to compare the community burden and severity of seasonal and pandemic influenza across different age groups and study years and gain insight into the extent to which traditional surveillance underestimates this burden. METHODS: Using preseason and postseason serology, weekly illness reporting, and RT-PCR identification of influenza from nasal swabs, we tracked the course of seasonal and pandemic influenza over five successive cohorts (England 2006-11; 5448 person-seasons' follow-up). We compared burden and severity of seasonal and pandemic strains. We weighted analyses to the age and regional structure of England to give nationally representative estimates. We compared symptom profiles over the first week of illness for different strains of PCR-confirmed influenza and non-influenza viruses using ordinal logistic regression with symptom severity grade as the outcome variable. FINDINGS: Based on four-fold titre rises in strain-specific serology, on average influenza infected 18% (95% CI 16-22) of unvaccinated people each winter. Of those infected there were 69 respiratory illnesses per 100 person-influenza-seasons compared with 44 per 100 in those not infected with influenza. The age-adjusted attributable rate of illness if infected was 23 illnesses per 100 person-seasons (13-34), suggesting most influenza infections are asymptomatic. 25% (18-35) of all people with serologically confirmed infections had PCR-confirmed disease. 17% (10-26) of people with PCR-confirmed influenza had medically attended illness. These figures did not differ significantly when comparing pandemic with seasonal influenza. Of PCR-confirmed cases, people infected with the 2009 pandemic strain had markedly less severe symptoms than those infected with seasonal H3N2. INTERPRETATI
- Full Text
- View/download PDF
45. Cohort profile: the Flu Watch Study
- Author
-
Fragaszy, Ellen B., Warren-Gash, Charlotte, Wang, Lili, Copas, Andrew, Dukes, Oliver, Edmunds, W. John, Goonetilleke, Nile, Harvey, Gabrielle, Johnson, Anne M., Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nazareth, Irwin, Nguyen-Van-Tam, Jonathan, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Zambon, Maria, Hayward, Andrew C., Fragaszy, Ellen B., Warren-Gash, Charlotte, Wang, Lili, Copas, Andrew, Dukes, Oliver, Edmunds, W. John, Goonetilleke, Nile, Harvey, Gabrielle, Johnson, Anne M., Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nazareth, Irwin, Nguyen-Van-Tam, Jonathan, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Zambon, Maria, and Hayward, Andrew C.
- Abstract
Influenza is a common, highly contagious respiratory virus which infects all age groups, causing a range of outcomes from asymptomatic infection and mild respiratory disease to severe respiratory disease and death.1 If infected, the adaptive immune system produces a humoral (antibody) and cell-mediated (T cell) immune response to fight the infection.2 Influenza viruses continually evolve through antigenic drift, resulting in slightly different ‘seasonal’ influenza strains circulating each year. Population-level antibody immunity to these seasonal viruses builds up over time, so in any given season only a proportion of the population is susceptible to the circulating strains. Occasionally, influenza A viruses evolve rapidly through antigenic shift by swapping genes with influenza viruses usually circulating in animals. This process creates an immunologically distinct virus to which the population may have little to no antibody immunity. The virus can result in a pandemic if a large portion of the population is susceptible and the virus is easily spread.
- Full Text
- View/download PDF
46. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study
- Author
-
Hayward, Andrew C., Fragaszy, Ellen B., Bermingham, Alison, Wang, Lili, Copas, Andrew, Edmunds, W. John, Ferguson, Neil, Goonetilleke, Nilu, Harvey, Gabrielle, Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nguyen-Van-Tam, J.S, Nazareth, Irwin, Pebody, Richard, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Johnson, Anne M., Zambon, Maria, Hayward, Andrew C., Fragaszy, Ellen B., Bermingham, Alison, Wang, Lili, Copas, Andrew, Edmunds, W. John, Ferguson, Neil, Goonetilleke, Nilu, Harvey, Gabrielle, Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nguyen-Van-Tam, J.S, Nazareth, Irwin, Pebody, Richard, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Johnson, Anne M., and Zambon, Maria
- Abstract
BACKGROUND: Assessment of the effect of influenza on populations, including risk of infection, illness if infected, illness severity, and consultation rates, is essential to inform future control and prevention. We aimed to compare the community burden and severity of seasonal and pandemic influenza across different age groups and study years and gain insight into the extent to which traditional surveillance underestimates this burden. METHODS: Using preseason and postseason serology, weekly illness reporting, and RT-PCR identification of influenza from nasal swabs, we tracked the course of seasonal and pandemic influenza over five successive cohorts (England 2006-11; 5448 person-seasons' follow-up). We compared burden and severity of seasonal and pandemic strains. We weighted analyses to the age and regional structure of England to give nationally representative estimates. We compared symptom profiles over the first week of illness for different strains of PCR-confirmed influenza and non-influenza viruses using ordinal logistic regression with symptom severity grade as the outcome variable. FINDINGS: Based on four-fold titre rises in strain-specific serology, on average influenza infected 18% (95% CI 16-22) of unvaccinated people each winter. Of those infected there were 69 respiratory illnesses per 100 person-influenza-seasons compared with 44 per 100 in those not infected with influenza. The age-adjusted attributable rate of illness if infected was 23 illnesses per 100 person-seasons (13-34), suggesting most influenza infections are asymptomatic. 25% (18-35) of all people with serologically confirmed infections had PCR-confirmed disease. 17% (10-26) of people with PCR-confirmed influenza had medically attended illness. These figures did not differ significantly when comparing pandemic with seasonal influenza. Of PCR-confirmed cases, people infected with the 2009 pandemic strain had markedly less severe symptoms than those infected with seasonal H3N2. INTERPRETATI
- Full Text
- View/download PDF
47. Cohort profile: the Flu Watch Study
- Author
-
Fragaszy, Ellen B., Warren-Gash, Charlotte, Wang, Lili, Copas, Andrew, Dukes, Oliver, Edmunds, W. John, Goonetilleke, Nile, Harvey, Gabrielle, Johnson, Anne M., Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nazareth, Irwin, Nguyen-Van-Tam, Jonathan, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Zambon, Maria, Hayward, Andrew C., Fragaszy, Ellen B., Warren-Gash, Charlotte, Wang, Lili, Copas, Andrew, Dukes, Oliver, Edmunds, W. John, Goonetilleke, Nile, Harvey, Gabrielle, Johnson, Anne M., Kovar, Jana, Lim, Megan S.C., McMichael, Andrew, Millett, Elizabeth R.C., Nazareth, Irwin, Nguyen-Van-Tam, Jonathan, Tabassum, Faiza, Watson, John M., Wurie, Fatima, Zambon, Maria, and Hayward, Andrew C.
- Abstract
Influenza is a common, highly contagious respiratory virus which infects all age groups, causing a range of outcomes from asymptomatic infection and mild respiratory disease to severe respiratory disease and death.1 If infected, the adaptive immune system produces a humoral (antibody) and cell-mediated (T cell) immune response to fight the infection.2 Influenza viruses continually evolve through antigenic drift, resulting in slightly different ‘seasonal’ influenza strains circulating each year. Population-level antibody immunity to these seasonal viruses builds up over time, so in any given season only a proportion of the population is susceptible to the circulating strains. Occasionally, influenza A viruses evolve rapidly through antigenic shift by swapping genes with influenza viruses usually circulating in animals. This process creates an immunologically distinct virus to which the population may have little to no antibody immunity. The virus can result in a pandemic if a large portion of the population is susceptible and the virus is easily spread.
- Full Text
- View/download PDF
48. The changing contributory role to infections of work, public transport, shopping, hospitality and leisure activities throughout the SARS-CoV-2 pandemic in England and Wales.
- Author
-
Hoskins S, Beale S, Nguyen VG, Byrne T, Yavlinsky A, Kovar J, Fong EWL, Geismar C, Navaratnam AMD, van Tongeren M, Johnson AM, Aldridge RW, and Hayward A
- Abstract
Background: Understanding how non-household activities contributed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections under different levels of national health restrictions is vital., Methods: Among adult Virus Watch participants in England and Wales, we used multivariable logistic regressions and adjusted-weighted population attributable fractions (aPAF) assessing the contribution of work, public transport, shopping, and hospitality and leisure activities to infections., Results: Under restrictions, among 17,256 participants (502 infections), work [adjusted odds ratio (aOR) 2.01 (1.65-2.44), (aPAF) 30% (22-38%)] and transport [(aOR 1.15 (0.94-1.40), aPAF 5% (-3-12%)], were risk factors for SARS-CoV-2 but shopping, hospitality and leisure were not. Following the lifting of restrictions, among 11,413 participants (493 infections), work [(aOR 1.35 (1.11-1.64), aPAF 17% (6-26%)] and transport [(aOR 1.27 (1.04-1.57), aPAF 12% (2-22%)] contributed most, with indoor hospitality [(aOR 1.21 (0.98-1.48), aPAF 7% (-1-15%)] and leisure [(aOR 1.24 (1.02-1.51), aPAF 10% (1-18%)] increasing. During the Omicron variant, with individuals more socially engaged, among 11,964 participants (2335 infections), work [(aOR 1.28 (1.16-1.41), aPAF (11% (7-15%)] and transport [(aOR 1.16 (1.04-1.28), aPAF 6% (2-9%)] remained important but indoor hospitality [(aOR 1.43 (1.26-1.62), aPAF 20% (13-26%)] and leisure [(aOR 1.35 (1.22-1.48), aPAF 10% (7-14%)] dominated., Conclusions: Work and public transport were important to transmissions throughout the pandemic with hospitality and leisure's contribution increasing as restrictions were lifted, highlighting the importance of restricting leisure and hospitality alongside advising working from home, when facing a highly infectious and virulent respiratory infection., Competing Interests: Competing interests: ACH serves on the UK New and Emerging Respiratory Virus Threats Advisory Group. AMJ and ACH are members of the COVID-19 transmission sub-group of the Scientific Advisory Group for Emergencies (SAGE). AMJ is Chair of the UK Strategic Coordination of Health of the Public Research board and is a member of COVID National Core studies oversight group., (Copyright: © 2023 Hoskins S et al.)
- Published
- 2023
- Full Text
- View/download PDF
49. Settings for non-household transmission of SARS-CoV-2 during the second lockdown in England and Wales - analysis of the Virus Watch household community cohort study.
- Author
-
Hoskins S, Beale S, Nguyen V, Fragaszy E, Navaratnam AMD, Smith C, French C, Kovar J, Byrne T, Fong WLE, Geismar C, Patel P, Yavlinksy A, Johnson AM, Aldridge RW, and Hayward A
- Abstract
Background : "Lockdowns" to control serious respiratory virus pandemics were widely used during the coronavirus disease 2019 (COVID-19) pandemic. However, there is limited information to understand the settings in which most transmission occurs during lockdowns, to support refinement of similar policies for future pandemics. Methods : Among Virus Watch household cohort participants we identified those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outside the household. Using survey activity data, we undertook multivariable logistic regressions assessing the contribution of activities on non-household infection risk. We calculated adjusted population attributable fractions (APAF) to estimate which activity accounted for the greatest proportion of non-household infections during the pandemic's second wave. Results : Among 10,858 adults, 18% of cases were likely due to household transmission. Among 10,475 participants (household-acquired cases excluded), including 874 non-household-acquired infections, infection was associated with: leaving home for work or education (AOR 1.20 (1.02 - 1.42), APAF 6.9%); public transport (more than once per week AOR 1.82 (1.49 - 2.23), public transport APAF 12.42%); and shopping (more than once per week AOR 1.69 (1.29 - 2.21), shopping APAF 34.56%). Other non-household activities were rare and not significantly associated with infection. Conclusions: During lockdown, going to work and using public or shared transport independently increased infection risk, however only a minority did these activities. Most participants visited shops, accounting for one-third of non-household transmission. Transmission in restricted hospitality and leisure settings was minimal suggesting these restrictions were effective. If future respiratory infection pandemics emerge these findings highlight the value of working from home, using forms of transport that minimise exposure to others, minimising exposure to shops and restricting non-essential activities., Competing Interests: Competing interests: ACH serves on the UK New and Emerging Respiratory Virus Threats Advisory Group. AMJ and ACH are members of the COVID-19 transmission sub-group of the Scientific Advisory Group for Emergencies (SAGE). AMJ is Chair of the UK Strategic Coordination of Health of the Public Research board and is a member of COVID National Core studies oversight group., (Copyright: © 2022 Hoskins S et al.)
- Published
- 2022
- Full Text
- View/download PDF
50. Workplace contact patterns in England during the COVID-19 pandemic: Analysis of the Virus Watch prospective cohort study.
- Author
-
Beale S, Hoskins S, Byrne T, Fong WLE, Fragaszy E, Geismar C, Kovar J, Navaratnam AMD, Nguyen V, Patel P, Yavlinsky A, Johnson AM, Van Tongeren M, Aldridge RW, and Hayward A
- Abstract
Background: Workplaces are an important potential source of SARS-CoV-2 exposure; however, investigation into workplace contact patterns is lacking. This study aimed to investigate how workplace attendance and features of contact varied between occupations across the COVID-19 pandemic in England., Methods: Data were obtained from electronic contact diaries (November 2020-November 2021) submitted by employed/self-employed prospective cohort study participants ( n =4,616). We used mixed models to investigate the effects of occupation and time for: workplace attendance, number of people sharing workspace, time spent sharing workspace, number of close contacts, and usage of face coverings., Findings: Workplace attendance and contact patterns varied across occupations and time. The predicted probability of intense space sharing during the day was highest for healthcare (78% [95% CI: 75-81%]) and education workers (64% [59%-69%]), who also had the highest probabilities for larger numbers of close contacts (36% [32%-40%] and 38% [33%-43%] respectively). Education workers also demonstrated relatively low predicted probability (51% [44%-57%]) of wearing a face covering during close contact. Across all occupational groups, workspace sharing and close contact increased and usage of face coverings decreased during phases of less stringent restrictions., Interpretation: Major variations in workplace contact patterns and mask use likely contribute to differential COVID-19 risk. Patterns of variation by occupation and restriction phase may inform interventions for future waves of COVID-19 or other respiratory epidemics. Across occupations, increasing workplace contact and reduced face covering usage is concerning given ongoing high levels of community transmission and emergence of variants., Funding: Medical Research Council; HM Government; Wellcome Trust., Competing Interests: AH serves on the UK New and Emerging Respiratory Virus Threats Advisory Group. AJ and AH are members of the COVID-19 transmission sub-group of the Scientific Advisory Group for Emergencies (SAGE). AJ is Chair of the UK Strategic Coordination of Health of the Public Research board and is a member of COVID National Core studies oversight group., (© 2022 The Authors.)
- Published
- 2022
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.