COVID-19: how our research is supporting the global effort
Our cross-disciplinary team is currently involved in many different aspects of COVID-19 related research. We are engaging in research to understand the impact of the pandemic on population health and inequalities in collaboration with key partners, including Public Health Scotland. We are also providing advice and expert commentary to leaders, practitioners and the media.
These webpages provide a summary of our activities relating to COVID-19, including research projects, publications, resources and podcasts.
- Ethnic and socioeconomic differences in SARS-CoV-2 infection: prospective cohort study using UK Biobank (published in BMC Medicine). This study found that black and south Asian ethnic groups have a higher risk of testing positive with SARS-CoV-2, the virus which causes COVID-19. These groups were also at a higher risk of testing positive while attending hospital, suggesting they were also at greater risk of severe disease from the virus. This higher risk was not accounted for by differences in socioeconomic conditions, self-reported health or behavioural risk factors.
- Mitigating the wider health effects of Covid-19 pandemic response (published in the BMJ). Health inequalities are likely to widen without action to support those most vulnerable to the effects of social distancing measures. These effects have numerous mechanisms, including economic, social, health related behaviours, and disruption to services and education.
- Vitamin D concentrations and COVID-19 infection in UK Biobank (published in Diabetes & Metabolic Syndrome: Clinical Research & Reviews). The findings do not support a potential link between vitamin D concentrations and risk of COVID-19 infection, nor that vitamin D concentration may explain ethnic differences in COVID-19 infection.
- Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data (published in Wellcome Open Research). The analysis adds to evidence that BAME people are at increased risk of death from COVID-19 even after adjusting for geographical region, but was limited by the lack of data on deaths outside of NHS settings and ethnicity denominator data being based on the 2011 census. Despite these limitations, there is an urgent need to take action to reduce the risk of death for BAME groups and better understand why some ethnic groups experience greater risk.
- BMI and future risk for COVID-19 infection and death across sex, age and ethnicity: Preliminary findings from UK Biobank (published in Diabetes and Metabolic Syndrome: Clinical Research & Reviews). BMI was associated strongly with positive test, and risk of death related to COVID-19. Obesity was more strongly linked to COVID-19-related deaths in younger people and non-white ethnicities.
- Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: longitudinal analyses of the UK Household Longitudinal Study (published in Journal of Epidemiology and Community Health). During the UK coronavirus 'lockdown', smoking declined, but adverse alcohol use generally increased. The study also found that psychological distress markedly increased during the first month of lockdown, with women and younger people particularly adversely affected.
- Official report from Social & System Recovery - Environment and Spaces Group published by Public Health Scotland explores the change in use of green and open space following the COVID-19 lockdown.
- Scaling COVID-19 against inequalities: should the policy response consistently match the mortality challenge? (published in Epidemiology & Community Health). The study found that mortality risk from COVID-19 is substantial and if unmitigated could lead to a decline of 5.96 years of life expectancy.
- Occupation and risk of severe COVID-19: prospective cohort study of 120,075 UK Biobank participants (published in Occupational and Environmental Medicine). Healthcare workers are seven times as likely to have severe COVID-19 infection as those with other types of ‘non-essential’ jobs. The study found those with jobs in the social care and transport sectors are twice as likely to have severe COVID-19, emphasising the need to ensure that key workers are adequately protected against the infection.
- Modifiable and non-modifiable risk factors for COVID-19, and comparison to risk factors for influenza and pneumonia: results from a UK Biobank prospective cohort study (published in BMJ Open). Findings suggest that modification of lifestyle may help to reduce the risk of COVID-19 and could be a useful adjunct to other interventions, such as social distancing and shielding of high risk.
- Correspondence to the EJPC in response to position paper by Ambrosetti M et al. 2020: Cardiovascular rehabilitation and COVID-19: The need to maintain access to evidence-based services from the safety of home (published in European Journal of Preventive Cardiology).
- Impact of COVID-19 restrictions on pre-school children’s eating, activity and sleep behaviours: a qualitative study (pre-print). Children’s activity, screen time, eating, and sleep routines had some level of disruption during COVID-19 restrictions. Parents reported children ate more snacks during lockdown, but also spent more time preparing meals and eating as a family. Most parents reported a reduction in their children’s physical activity and an increase in screen time, which some linked to difficulties in getting their child to sleep.
- Exploring the effectiveness of a COVID-19 contact tracing app using an agent-based model (published in Scientific Reports). Findings suggest that COVID-19 smartphone apps can contribute to epidemic mitigation at any adoption level, but their efficacy strongly depends on the availability of testing and testing policy. The model also suggests that digital contact tracing is more effective when the virus circulates the most, i.e. when lockdown restrictions are relaxed.
- The inverse care law in critical care during the COVID-19 pandemic (commentary published in The Lancet Regional Health-Europe).
- Effectiveness of First Dose of COVID-19 Vaccines Against Hospital Admissions in Scotland: National Prospective Cohort Study of 5.4 Million People (Preprints with The Lancet). Findings suggest that vaccination has been linked to a substantial reduction in the risk of COVID-19 admissions to Scotland’s hospitals.
- The wider implications of the COVID-19 pandemic: Assessing the impact of accident and emergency use for frequent attenders (published in International Emergency Nursing). Findings suggest that attendances for frequent attenders to the Emergency Department appear to have decreased during the pandemic.
- Predictors of COVID-19 vaccine hesitancy in the UK Household Longitudinal Study (published in Brain, Behavior, and Immunity). This study found willingness to be vaccinated was generally high across the UK population but vaccine hesitancy exists in population subgroups. Black and Pakistani/Bangladeshi ethnic groups had higher vaccine hesitancy, as did people with lower education levels.
- Ethnicity, household composition and COVID-19 mortality: a national linked data study (published in the Journal of the Royal Society of Medicine). Findings suggest that elderly adults living with younger people are at increased risk of COVID-19 mortality, and this is a contributing factor to the excess risk experienced by older South Asian women compared to White women. Relevant public health interventions should be directed at communities where such multi-generational households are highly prevalent.
Disrupted prevention: condom and contraception access and use among young adults during the initial months of the COVID-19 pandemic. An online survey (published in BMJ Sexual and Reproductive Health). This study found that emerging barriers to STI and pregnancy prevention within the context of COVID-19 have the potential to undermine positive sexual and reproductive health practices, and widen inequalities, among young people.
- Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities (Published in Epidemiology and Community Health). The COVID-19 pandemic has highlighted existing health inequalities among ethnic minority groups and exacerbated them. This study found that the unequal impacts of the pandemic can be mitigated, through more comprehensive and evidence informed action at each of the following pathways: differential exposure, differential vulnerability to infection/disease, differential disease consequences, differential social consequences, differential effectiveness of control measures and differential adverse consequences of control measures.
- Interim findings from first-dose mass COVID-19 vaccination roll-out and COVID-19 hospital admissions in Scotland: a national prospective cohort study (published in The Lancet). Mass roll-out of the first doses of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines was associated with substantial reductions in the risk of hospital admission due to COVID-19 in Scotland.
- Psychological distress among people with probable COVID-19 infection: analysis of the UK Household Longitudinal Study (published in BJPsych Open). Findings suggest that COVID-19 infection could lead to an increase in clinically significant psychological distress that persists months after infection and is additional to the mental health impact of societal changes during the pandemic.
- Tracking the mental health of home-carers during the first COVID-19 national lockdown: evidence from a nationally representative UK survey (published in Psychological Medicine). The study found that the mental health of home-carers deteriorated more during lockdown than non-carers. Policies that reinstate support for them and their care-recipients will benefit the health of both vulnerable groups.
- The impact of COVID-19 on different population subgroups: ethnic, gender and age-related disadvantage (published in Journal of the Royal College of Physicians of Edinburgh). The study found that ethnic minorities, men and older people have disproportionately suffered from COVID-19, including their risk of mortality.
- Remote history of VTE is associated with severe COVID-19 in middle and older age: UK Biobank cohort study (published in Journal of Thrombosis and Haemostatis). Venous thromboembolism (VTE) is a common, life-threatening complication of COVID-19 infection. The findings support inclusion of remote history of VTE in COVID-19 risk-prediction scores, and consideration of sex-specific risk scores.
- Risk of mortality among inpatients with COVID-19 and type 2 diabetes: National data from Kuwait (published in Endocrinology, Diabetes and Metabolism). Type 2 diabetes is a strong risk factor for COVID-19 death in the Middle East. Given the high prevalence of type 2 diabetes in the Middle East, as well as many Western countries, the public health implications are considerable.
- Towards a behavioural model of Covid-19 spread (peer-reviewed conference paper). The paper introduces a behavioural model through which households decrease their social interaction as a response to the COVID-19 pandemic, a first step towards the development of more policy-relevant agent-based models of pandemics. It proposes that models like this can provide a platform for designing and evaluating more effective public health restrictions and messaging during a pandemic.
- Methodology of Natsal-COVID Wave 1: a large, quasi-representative survey with qualitative follow-up measuring the impact of COVID-19 on sexual and reproductive health in Britain (published in Wellcome Open Research). Natsal-COVID Wave 1 rapidly collected quasi-representative population data to enable evaluation of the early population-level impact of COVID-19 and lockdown measures on SRH in Britain and inform policy.
- Ethnic and social inequalities in COVID-19 outcomes in Scotland: protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II) (published in BMJ Open). The protocol outlines the review’s objective to describe the epidemiology of COVID-19 by social factors.
- COVID-19 pandemic and its impact on social relationships and health (published in Journal of Epidemiology and Community Health). This essay examines key aspects of social relationships that were disrupted by the COVID-19 pandemic. It focuses explicitly on relational mechanisms of health and brings together theory and emerging evidence on the effects of the COVID-19 pandemic to make recommendations for future public health policy and recovery.
- The impact of school closure on adolescents’ wellbeing and steps towards a new normal: the need for an assessment tool update? (published in Adolescents). The commentary discusses the effects that school closures to decrease the spread of the COVID-19 have had on the wellbeing of children and adolescents.
- Pre-pandemic mental health and disruptions to healthcare, economic and housing outcomes during the COVID-19 pandemic: evidence from 12 UK longitudinal studies (published in The British Journal of Psychiatry). The study found that people who had higher pre-pandemic levels of depression or anxiety have been more severely affected by disruption to jobs and healthcare during the pandemic.
- COVID-19 hospital admissions and deaths post BNT162b2 and ChAdOx1 vaccinations: National prospective cohort study of 2.57 million people in Scotland (published in The Lancet Respiratory Health). COVID-19 hospitalisations and deaths were uncommon 14 days or more after the first vaccine dose in this national analysis in the context of a high background incidence of SARS-CoV-2 infection and with extensive social distancing measures in place.
- Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection (published in Nature Medicine). This study found an increased risk of neurological complications in those who received COVID-19 vaccines, but the risk of these complications is greater following a positive COVID test.
- Impact of COVID-19 restrictions on preschool children's eating, activity and sleep behaviours: a qualitative study (published in BMJ Open). Parents reported that lockdown negatively impacted on preschool children’s eating, activity and sleep routines. While some positive changes were identified, many participants described lack of routines, habits and boundaries which may have been detrimental for child health and development.
- Predicted COVID-19 positive cases, hospitalisations and deaths associated with the Delta variant of concern, June-July 2021 (published in The Lancet Digital Health). Caution was recommended when proceeding to lift lockdown restrictions until a higher proportion of the population was double vaccinated. This was due to the increase in forecasted numbers of daily hospitalisations as a result of COVID-19.
- Risk of COVID-19 hospital admission among children aged 5-17 years with asthma in Scotland: a national incident cohort study (published in The Lancet Respiratory Medicine). School-aged children with asthma with previous recent hospital admission or two or more courses of oral corticosteroids are at markedly increased risk of COVID-19 hospital admission and should be considered a priority for vaccinations. This would translate into 9124 children across Scotland and an estimated 109,448 children across the UK.
- Tackling population health challenges as we build back from the pandemic (published in The BMJ). This paper argues that a radical shift in the government’s approach to population health is needed, integrating equity and health in all policies, and shifting to a wellbeing economy.
- Predicted COVID-19 positive cases, hospitalisations, and deaths associated with the Delta variant of concern, June–July, 2021 (published in the Lancet Digital Health). The authors recommended caution when proceeding to lift lockdown restrictions until a higher proportion of the population was double vaccinated. This was due to the increase in forecasted numbers of daily hospitalisations as a result of COVID-19.
- Two-dose ChAdox1 nCoV-19 vaccine protection against COVID-19 hospital admissions and deaths over time: a retrospective, population-based cohort study in Scotland and Brazil (published in The Lancet). The study found that the protection offered by the Oxford-Astra Zeneca Covid-19 vaccine declines after three months of receiving two doses. The findings suggest that booster programmes are needed to help maintain protection from severe disease in those vaccinated with Oxford-Astra Zeneca.
- Initial impacts of the COVID-19 pandemic on sexual and reproductive health service use and unmet need in Britain: findings from a quasi-representative survey (Natsal-COVID) (published in The Lancet Public Health). The study found that many people accessed sexual and reproductive health care during the initial lockdown, however, young people and those reporting sexual risk behaviours reported difficulties in accessing services.
- Cohort Profile: The COVID-19 in Pregnancy in Scotland (COPS) dynamic cohort of pregnant women to assess effects of viral and vaccine exposures on pregnancy (published in the International Journal of Epidemiology). COVID-19 in Pregnancy in Scotland (COPS) is a new national prospective dynamic cohort that was created to describe the epidemiology of COVID-19 in pregnancy and the effect of SARS-CoV-2 infection on pregnancy outcomes and to investigate the safety and effectiveness of COVID-19 vaccines among pregnant women.
- SARS-CoV-2 infection and COVID-19 vaccination rates in pregnant women in Scotland (published in Nature Medicine). Vaccine coverage was substantially lower in pregnant women than in the general female population of reproductive age: 32.3% of women giving birth in October 2021 had two doses of vaccine compared to 77.4% in women aged 18-44 years.
- The impact of changes in COVID-19 lockdown restrictions on alcohol consumption and drinking occasion characteristics in Scotland and England in 2020: an interrupted time-series analysis (published in Addiction). Lockdown measures throughout 2020 have been linked to people in Scotland and England drinking more at home. In Scotland, there was an increase in solitary drinking, although this could be explained by a higher proportion of people living alone in Scotland than in England.
- Intimate physical contact between people from different households during the COVID-19 pandemic: a mixed methods study from a large, quasi-representative survey (Natsal-COVID) (published in the BMJ). Given 90% of people did not report intimate physical contact outside the household, this contact may not be a large additional contributor to SARS-CoV-2 transmission, although heterogeneity exists within the population.
- Vaccine effectiveness of heterologous CoronaVac plus BNT162b2 in Brazil (published in Nature Medicine). Compared with younger age groups, individuals 80 years of age or older had lower protection after the second dose but similar protection after the booster. The findings support a BNT162b2 booster vaccine dose after two doses of CoronaVac, particularly for the elderly.
- COVID-19 vaccine uptake, effectiveness, and waning in 82,959 health care workers: A national prospective cohort study in Wales (published in Vaccine). With some variation in rate of uptake, those who were vaccinated had a reduced risk of PCR-confirmed SARS-CoV-2 infection, compared to those unvaccinated. Second dose has provided stronger protection for longer than first dose but this study is consistent with waning from seven weeks onwards.
- The COVID-19 pandemic in children and young people during 2020-2021: A complex discussion on vaccination (editorial published in the Journal of Global Health).
- The COVID-19 pandemic in children and young people during 2020-2021: Learning about clinical presentation, patterns of spread, viral load, diagnosis and treatment (editorial published in the Journal of Global Health).
- First dose ChAdOx1 and BNT162b2 COVID-19 vaccinations and cerebral venous sinus thrombosis: A pooled self-controlled case series study of 11.6 million individuals in England, Scotland, and Wales (published in PLoS Medicine). A small elevated risk of cerebral venous sinus thrombosis (CVST) events was observed following vaccination with ChAdOx1, but not BNT162b2.
- A qualitative exploration of weight management during COVID-19 (published in Clinical Obesity). The study found perception of risk, environmental and social changes, and personal well-being all influenced participants' weight losses.
- Variations in COVID-19 vaccination uptake among people in receipt of psychotropic drugs: cross-sectional analysis of a national population-based prospective cohort (published in The British Journal of Psychiatry). This study found significantly lower odds of vaccination in people who were receiving treatment with anxiolytic and antipsychotic medications. There is an urgent need for evidence-based, tailored vaccine support for people with mental health conditions.
- Initial Impacts of COVID-19 on Sex Life and Relationship Quality in Steady Relationships in Britain: Findings from a Large, Quasi-representative Survey (Natsal-COVID) (published in The Journal of Sex Research). Overall, 10.6% of participants reported sexual difficulties that started/worsened during lockdown, and 6.9% reported deterioration to a ”lower quality” relationship. Intimate relationship quality is yet another way in which COVID-19 has led to divergence in experience.
- Comparing population-level mental health of UK workers before and during the COVID-19 pandemic: a longitudinal study using Understanding Society (published in Journal of Epidemiology & Community Health). Psychological distress increases during the pandemic were concentrated among ‘professional and technical’ and ‘hospitality’ industries and ‘small employers/self-employed’ and ‘sales and customers service’ workers.
- The UK Coronavirus Job Retention Scheme and diet, physical activity, and sleep during the COVID-19 pandemic: evidence from eight longitudinal population surveys (published in BMC Medicine). Those furloughed exhibited similar health behaviours to those who remained in employment during the initial stages of the pandemic.
- Access to and quality of sexual and reproductive health services in Britain during the early stages of the COVID-19 pandemic: a qualitative interview study of patient experiences (published in BMJ Sexual & Reproductive Health). The COVID-19 pandemic impacted access and quality of sexual and reproductive health services. Participants’ accounts revealed self-censorship of need, difficulty navigating shifting service configurations and perceived quality reductions.
- Psychological distress before and during the COVID-19 pandemic among adults in the United Kingdom based on coordinated analyses of 11 longitudinal studies (published in JAMA Network Open). This study found that mental health has deteriorated from before the start of the COVID-19 pandemic, and this deterioration was sustained across the first year of the pandemic. Deterioration in mental health varied by age, sex, and education, and did not recover when social restrictions were eased.
- Chronic pain and COVID-19 hospitalisations and mortality: a UK Biobank cohort study (published in Pain). Chronic pain is associated with higher risk of hospitalisation for COVID-19 but the association with mortality is unclear.
- Estimating the effects of lockdown timing on COVID-19 cases and deaths in England: A counterfactual modelling study (published in PLOS One). The study supports the claim that the relatively late introduction of social distancing and lockdown measures likely increased the scale, severity and duration of the first wave of COVID-19 in England.
- Impact on emergency and elective hospital-based care in Scotland over the first 12 months of the pandemic: interrupted time series analysis of national lockdowns (published in the Journal of the Royal Society of Medicine). The study found substantial disruption to urgent and planned inpatient healthcare provision in hospitals across NHS Scotland.
- Public mental health during the COVID-19 pandemic: impact on children's rights (published in The International Journal of Human Rights). Using the Scottish context as an exemplar, this review highlights the value of a rights-based framework for providing a holistic view that can inform preventative approaches to support better mental health among children in the future.
- The LoCo (Lockdown Cohort)-effect: why the LoCo may have better life prospects than previous and subsequent birth cohorts (published in the European Journal of Public Health). The LoCo-effect outlines the counterintuitive possibility that, despite the potential detrimental impacts of the COVID-19 pandemic, babies conceived at the start of the pandemic and the following months may have, on average, better life prospects than earlier and even later birth cohorts.
- Estimating the social and spatial impacts of Covid mitigation strategies in United Kingdom regions: synthetic data and dashboards (published in the Cambridge Journal of Regions, Economy and Society). This study demonstrates the feasibility and importance of estimating local-area impacts of pandemic restrictions. It also demonstrates the potential for synthetic data methods to help fill in the gaps, where existing data provision is concerned.
- The prospective relationship between loneliness, life satisfaction and psychological distress before and during the COVID-19 pandemic in the UK (published in Journal of Public Health). Loneliness, life satisfaction and psychological distress deteriorated minimally between April and November 2020, compared to pre-pandemic levels, while the rate of change in each outcome influenced the rates of change in the other two.
- Association between home working and mental health by key worker status during the Covid-19 pandemic. Evidence from four British longitudinal studies (published in Industrial Health). Key workers working from home showed the greatest decline in mental health outcomes relative to other groups. Pre-pandemic homeworking did not significantly change the nature of such a relationship and loneliness slightly attenuated some of the effects.
- What were patients' experiences of trying to access sexual and reproductive health services during the early months of the COVID-19 pandemic? (blog published in BMJ Sexual & Reproductive Health).
- Long Covid burden and risk factors in 10 UK longitudinal studies and electronic health records (published in Nature Communications). Increasing age, female sex, white ethnicity, poor pre-pandemic general and mental health, overweight/obesity, and asthma were associated with prolonged symptoms. Findings for other factors, such as cardio-metabolic parameters, were inconclusive.
- Racism as the fundamental cause of ethnic inequities in COVID-19 vaccine hesitancy: A theoretical framework and empirical exploration using the UK Household Longitudinal Study (published in SSM-Population Health). Institutional-level factors (socioeconomic position, area-level deprivation, overcrowding) explained the largest part (42%) of the inequity in vaccine hesitancy for Pakistani or Bangladeshi people, and community-level factors (ethnic density, community cohesion, political efficacy, racism in the area) were the most important factors for Indian and Black groups, explaining 35% and 15% of the inequity, respectively.
- Occupational differences in SARS-CoV-2 infection: analysis of the UK ONS COVID-19 infection survey (published in Epidemiology and Community Health). The findings suggest that elevated risks among healthcare workers have diminished over time but education workers have had persistently higher risks. Long-term mitigation measures in certain workplaces may be warranted.
- Migrants’ primary care utilisation before and during the COVID-19 pandemic in England: An interrupted time series analysis (published in The Lancet Regional Health - Europe). Migrants were less likely to use primary care than non-migrants before the pandemic and the first year of the pandemic exacerbated this difference.
- Mental and social wellbeing and the UK coronavirus job retention scheme: Evidence from nine longitudinal studies (published in Social Science & Medicine). During the early stages of the pandemic, those furloughed had increased risk for poor mental and social wellbeing, but furloughed workers fared better than those who became unemployed.
- Vaccine effectiveness of two-dose BNT162b2 against symptomatic and severe COVID-19 among adolescents in Brazil and Scotland over time: a test-negative case-control study (published in The Lancet Infectious Diseases). Waning vaccine protection of BNT162b2 against symptomatic COVID-19 infection was found among adolescents in Brazil and Scotland from 27 days after the second dose. However, protection against severe COVID-19 outcomes remained high at 98 days or more after the second dose in the omicron-dominant period.
- Second-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland (published in Nature Communications). Two conditions showed a borderline increased risk after the second dose of an Oxford-AstraZeneca vaccine. These are ‘idiopathic thrombocytopenic purpura’ (ITP) and ‘cerebral venous sinus thrombosis’ (CVST). No link was found between the conditions studied and a second dose of the Pfizer-BioNTech vaccine.
- Face mask use during the COVID-19 pandemic: how risk perception, experience with COVID-19, and attitude towards government interact with country-wide policy stringency (published in BMC Public Health). Policy stringency is strongly positively associated with face mask use. There was a positive association between self-related risk perception and mask use, but no relationship of mask use with experience with COVID-19 and attitudes towards government.
- The UK Coronavirus Job Retention Scheme and smoking, alcohol consumption and vaping during the COVID-19 pandemic: evidence from eight longitudinal population surveys (published in BMC Medicine). No clear evidence was found of furlough or unemployment having adverse impacts on smoking, vaping or drinking behaviours during the early stages of the COVID-19 pandemic in the UK.
- An agent-based model of social care provision during the early stages of the Covid-19 pandemic (published in Scientific Reports).
- Pregnancy outcomes following SARS-CoV-2 infection in Delta and Omicron dominant periods in Scotland: a population-based cohort study (published in The Lancet Respiratory Medicine). Pregnant women infected with SARS-CoV-2 were substantially less likely to have a preterm birth or maternal critical care admission during the omicron-dominant period than during the delta-dominant period.
- Severe COVID-19 outcomes post full vaccination of primary schedule and boosters: A meta-analysis of national prospective cohort studies of 30 million individuals in England, Northern Ireland, Scotland and Wales (published in The Lancet). Older people, those with multimorbidity, and those with specific underlying health conditions remain at increased risk of COVID-19 hospitalisation and death after the initial vaccine booster and should, therefore, be prioritised for additional boosters, and the increasing array of COVID-19 therapeutics.
- Inequalities in healthcare disruptions during the COVID-19 pandemic: evidence from 12 UK population-based longitudinal studies (published in BMJ Open). Prevalence of healthcare disruption varied substantially across studies. Females, older people and ethnic minorities were more likely to report healthcare disruptions.
- Psychological distress, depression, anxiety, and life satisfaction following COVID-19 infection: evidence from 11 UK longitudinal population studies (published in The Lancet Psychiatry). Self-reporting COVID-19 was longitudinally associated with deterioration in mental health and life satisfaction.
- A population-based matched cohort study of early pregnancy outcomes following COVID-19 vaccination and SARS-CoV-2 infection (published in Nature Communications). There was no association between COVID-19 vaccination or infection and miscarriage or ectopic pregnancy.
- Self-isolation and testing during the COVID-19 pandemic: An agent-based model (published in Artificial Life). An agent-based model is presented that includes a behavioural module determining agent testing and isolation propensity in order to understand the role of various behavioural parameters in the spread of COVID-19.
- Risk of COVID-19 hospitalizations among school-aged children in Scotland: A national incident cohort study (published in Journal of Global Health). There is an increased risk of COVID-19 hospital admissions among school-aged children with specific underlying long-term health conditions compared with children without these conditions.
- Exploring Inequalities in COVID-19 in Scotland. Vittal Katikireddi (lead), Kirsten Hainey, Paul Henery.
During the Covid-19 pandemic, research in England has identified certain groups in the population, who have been more adversely affected by Covid-19, both in the risk of infection and the risk of severe illness and death. Individuals in minority ethnic groups and those living in more deprived areas have been identified as at higher risk of Covid-19. The evidence of such patterns in Scotland is limited, but more research is required. Our research aims to explore the risk of Covid-19 in these groups in the Scottish population. The findings of our research will be used to inform healthcare planning and policy in Scotland.
- Impact of school closures on socioeconomic inequalities in children's wellbeing and development, led by Peter Craig.
Over 100 countries, including the UK, have closed schools as part of their social distancing measures during the coronavirus pandemic. A possibly severe unintended consequence of school closures is a widening of educational inequalities, with implications for health inequalities down the line. Research in countries with a long summer break suggests that differential attainment losses account for a substantial fraction of total educational inequalities. Although UK schools have a relatively short summer holiday, the COVID-19 related closures will lead to (at least) a 3-4 month break from classroom teaching for most children, and the possibility of further disruption after that.
A range of surveys in the UK have reported widely varying levels of support for home schooling between pupils at private and publicly-funded schools, and between schools within the public sector.
The suspension of much education testing and survey fieldwork will make impacts difficult to measure directly, but it may be possible to get useful insights into possible consequences from existing data. Our study includes (1) a rapid scoping review of the international evidence of differential attainment loss; (2) analysis of cognitive and social development measures for 5, 7, 11 and 13 year olds in the Millennium Cohort Study to identify whether disparities (e.g. by parental income or education) widen between the last month prior to the summer break and the first month after, and whether the pattern changes as children get older.
Impacts of restricted pre-school childcare availability, led by Michael Green.
This project aims to anticipate impacts of restricted access to pre-school childcare on various outcomes including child well-being, school readiness, and BMI. Using data from the Millennium Cohort study taken at ages 9 months and 3 years, we will assess how impacts may vary with different durations of restricted access. Importantly, we aim to estimate the impact of restricted childcare availability on inequalities in outcomes by baseline parental education, and lone parenting status.
Impact of reducing direct social contact on loneliness and depression among older people, led by Michael Green.
Using data from the 8th wave of the English Longitudinal Study of Aging, this project will (1) estimate impacts of reducing direct, in-person social contact on loneliness and depression among older people, (2) estimate impacts of increasing remote (e.g. phone, internet) social contact on loneliness and depression among older people, and (3) estimate impacts of above on inequalities in loneliness and depression by education, partner status and wealth.
- An equity focused rapid review of the epidemiology of COVID-19, Vittal Katikireddi (lead), Hilary Thomson, Valerie Wells, Evangelia Demou.
This is a collaborative project to conduct a rapid systematic review to assess the available epidemiological evidence on social factors that predict developing developing SARS-CoV2 and the prognosis of COVID-19 disease in those affected. The review will search for evidence from published and unpublished sources, including archives of pre-prints. We will select evidence on the exposures within the PROGRESS-Plus framework, this includes, residency status (migrant workers and homeless), race/ethnicity, occupation, religion, education, socio-economic status, pregnancy and substance misuse.
Protocol is available on this website, this includes details of inclusion criteria, searches etc.
- How has COVID-19, and the restrictions on movement in the UK, affected use of green space? Hannah Burnett (lead), Rich Mitchell, Jonathan Olsen.
This project aims to explore if, and how, the UK population changed their green space use following restrictions on movement on 23rd March 2020 due to the COVID-19 pandemic. Data from 2,252 respondents were collected by an online survey administered by YouGov (from 30th April-1st May 2020). We asked participants about: 1) the frequency of green space visitations before and since restrictions; 2) whether visits increased or decreased following restrictions; 3) how their experiences of green space have changed (for example, increased physical activity, or loss of social interaction); and 4) reasons why they may not visited green space since restrictions. Demographic characteristics were also obtained (including sex, age, social grade, health conditions and ethnicity).
- How has Covid-19 social distancing amplified the mental health vulnerabilities of gay, bisexual and other men who have sex with men (GBM). Lisa McDaid.
In Scotland, GBM experience higher levels of suicide, anxiety and depression, problematic alcohol and drug misuse, acute and chronic physical conditions, stigma, discrimination and social isolation, HIV and other STIs than heterosexual populations. Covid-19 social distancing will exacerbate these issues and remove sources of support including work, gay bars and sociosexual mixing. This project will detail the impact of social distancing on GBM’s mental health, wider health and alcohol/drug use. Working with NHS and 3rd sector partners, it will identify services to reduce this impact and produce resources for Scottish service providers. www.smmash2020.org
- National Study of Health and Relationships during Covid-19 (Natsal-Covid Study). Kirstin Mitchell (lead), Raquel Bosó Pérez, Karen Maxwell, Susan Patterson, Ruth Lewis.
This national online survey of 6,000 participants aged 18 to 59 seeks to understand changes in sexual behaviour in Britain during the Covid-19 pandemic and assess the impact on sexual and reproductive health. The project includes follow-up interviews with around 40 survey participants to explore sexual partnerships across households, unmet health needs and relationship difficulties. The project is co-led by Kirstin Mitchell and comprises the researchers from University of Glasgow, UCL and LSHTM responsible for the National Surveys of Sexual Attitudes and Lifestyles (Natsal). The findings will seek to capture the excess sexual and reproductive health morbidity arising from the Covid-19 and social restrictions, and will contribute to SRH service and policy planning, modelling of STI transmission, and understanding of anomalies in routine SRH data over the course of the pandemic.
The Natsal COVID study team, co-led by University of Glasgow, presented preliminary findings from wave one of their national survey on the impact of COVID on sexual and reproductive health in Britain. Over 500 sexual and reproductive health professionals registered for the event, including from across Europe. The presentations highlighted strong age-related inequalities, with adverse outcomes more commonly experienced by younger people. The findings also underlined that although SRH services moved rapidly to reconfigure services, there were delays to access and unmet need affecting contraceptive use, cervical screening and STI diagnosis. The team are now writing up the papers for publication. You can watch a webinar discussing preliminary findings on the Natsal study website.
- Can the app contain the spread? An agent-based model of the progression of COVID-19 and the effectiveness of smartphone-based contact tracing. Jonatan Almagor, Stefano Picascia.
An effective contact tracing system is essential to contain the spread of COVID-19 following the relaxation of lock-down measures implemented in several countries. By means of an agent-based model, we simulate the introduction of a contact-tracing smartphone app, adopted by individuals on a voluntary basis, and assess its effectiveness in containing the spread of the infection. Using demographic census data of the city of Glasgow we generate a synthetic population connected by a social network, and simulate the spread of the virus. Our aim is to explore the impact of several interacting factors on COVID-19 transmission: (1) Proportion of app users (2) testing capacity (3) testing policy and (4) compliance with self-isolation of app users. Using Netlogo simulation environment, we've developed an agent-based simulation model (ABM) of COVID-19 spread and its mitigation strategies. The code of the ABM is stored in GitHub repository and can be freely downloaded: https://github.com/harrykipper/covid. A paper describing the model, the results and possible policy implications is published in Scientific reports.
- Assessing policy to address the medium-run impact of COVID-19 on income and health inequality with models informed by the history of disease outbreaks. Rebecca Mancy (Co-I. PI is Konstantinos Angelopoulos)
This project will model the evolution of inequalities in income, wealth and health following COVID-19, as informed by historical disease outbreaks, and use the models developed to assess mitigation policies. We will develop models of income, wealth and health inequality in the UK. Our models will be used to examine the effects of tax and benefits policies, as well as public health interventions, therefore informing a better policy response to the inequality impacts of COVID-19. This grant is funded by ESRC as part of UK Research and Innovation’s rapid response to COVID-19. Briefing: Post-pandemic mortality dynamics - historical city-level evidence was published in September 2020.
- Investigating incidence, severity and risk factors for COVID-19 in BAME and Migrant groups to inform public health action. Vittal Katikireddi (Co-I. PI Rob Aldridge, UCL)
This project aims to better understand the impact of COVID-19 on minority ethnic and migrant groups and how to tackle it in community settings. The study will build on ‘Virus Watch’, which was previously funded by UKRI and NIHR to study 25,000 individuals across the country in a nationally representative household cohort to monitor spread of the novel coronavirus across England. This funding will enable the recruitment of approximately 12,000 more people from minority ethnic and migrant groups. Their symptoms will be followed over time and subsets of participants will receive antigen and antibody tests and they will study factors such as household transmission, occupation, co-morbidities, healthcare usage, and mental health and economic impacts. Separately, the project also utilise the Million Migrant Cohort study of healthcare and mortality outcomes in non-EU migrants and refugees to England since 2015. In collaboration with Public Health England, the team will link this with data on COVID-19 diagnosis and hospitalisation to determine how often these groups are diagnosed, hospitalised and die with COVID-19 and how this is affected by their socioeconomic situation and pre-existing health conditions. Read the news story on UKRI website: Multimillion investment in six new research projects to investigate COVID-19 and ethnicity.
- GCRF ARISE hub consortium and COVID-19. ARISE Hub team including Linsay Gray, Alastair Leyland, Eliud Kibuchi and Ross Forsyth.
Through the GCRF ARISE hub consortium, we are involved in the conduct of COVID-19 case studies in informal settlements in Bangladesh, India, Kenya and SierraLeone.
The purposes of these community-based participatory research (CBPR) studies are 1) to identify and explore accountability and governance deficits exposed by COVID-19, as well as any new opportunities to address these, in order to inform strategic responses by organisations to address these, within and across local, municipal, national and global spaces; 2) to understand how intersecting social inequalities may shape vulnerabilities and resilience to COVID-19 over time in order to inform efforts to work in an empowering way with the most marginalised; 3) to identify the health and well-being challenges that emerge over time during the pandemic to inform immediate actions in the short term and collective prioritisation for action in the medium term through CBPR cycles.
The COVID-19 case study aims to generate learning across different contexts (spatially) and through the different evolving stages of the pandemic responses (temporally), including documenting the (potential) emergence of new governance actors, modalities or interactions, accountability processes, and shifting health and well-being priorities.
- How has COVID-19 and associated mitigation measures impacted on the mental health of carers? Led by Elise Whitley.
It is estimated that approximately 9 million adults in the UK are carers with around half caring for someone in the same household. In the context of COVID-19, informal live-in carers have been especially important as formal and informal external care and services have been withdrawn. Prior to the pandemic, the mental health of carers was known to be worse than that of the general population and it is therefore important to understand the additional impact of COVID-19 and associated mitigation measures.
We will use data from the Understanding Society main and COVID-specific surveys to explore changes in mental health of those caring for others in the home. We will consider the relationship of carer to care-recipient and the nature of the recipient's condition, as well as the impact of factors such as the withdrawal of external support, changes to carer workload and role, and the shielding status of both carer and care-recipient.
The COVID-19 pandemic has caused extensive disruption and challenges within the lives of young people. However, while there is good evidence to draw upon for advice and support, it is not always easily accessible for those who need it.
Over the next 18 months, the team will be working on an exciting new project to support young people’s mental health. The project will work to make sense of what research says about how the mental health of young people aged 11 – 16 years has been affected by the pandemic.
- Understanding the impacts of income and welfare policy responses to COVID-19 on inequalities in mental health: a microsimulation model. Professor Vittal Katikireddi (lead).
During the COVID-19 pandemic, the UK government and devolved administrations are implementing policies to try and maintain employment and income. Despite this, many people have lost their jobs and more are likely to do so. Further policy changes will be needed as the pandemic continues. It is vital that these are informed by evidence about the impact they could have on people’s mental health, as unemployment and poverty are strongly associated with poorer health.
This project will look at who is impacted the most by the job losses and declines in income, what the likely mental health consequences are of an economic crisis, and what the implications are of different economic and welfare policies. The project team will develop a mathematical model which will simulate the potential impact of economic changes on the mental health of people in Britain. Economic models will be used to estimate how the downturn will impact jobs and income, and information collected from the same people over many years will be used to study the relationship between jobs, income and mental health. The model will demonstrate how mental health might change under different economic policies (such as furlough or changes in welfare benefits), and the impact on mental health inequalities. The project, funded by the Health Foundation, will help inform the COVID-19 response by demonstrating the scale of the potential mental health crisis and how unemployment and income falls contribute, comparing the mental health impacts of different policies, and demonstrating how simulation models can be used to study the broader causes of poor health and inequalities.
- ICAROS: Impacts of COVID-19 and Associated Responses On people who use or have used Substances. Dr Mark Mccann (lead).
This project explores the extent of service and social disruption due to COVID-19 among people who use substances or treatment services. Interim findings from this study were presented at the Scottish Parliament Cross Party Group on drugs and alcohol in December 2020 and four rapid reports have been produced for Alcohol and Drug Partnership.
- Impacts of COVID-19 mitigation measures on pregnancy and birth outcomes in Scotland: a natural experiment study using administrative data. Anna Pearce, Moritz Oberndorfer, Paul Henery, Alastair Leyland, Ruth Dundas (and colleagues from elsewhere in UofG and Public Health Scotland).
During the COVID-19 pandemic, mitigation measures such as social distancing and isolation, along with atypical maternal primary care service delivery have had a profound impact on the health and wellbeing of expectant and new mothers and their babies. However, much of our existing knowledge is anecdotal and causal analyses are needed. Furthermore, the impact of COVID-19 mitigation measures on inequalities at this crucial point of the life-course is not established. Using natural experiment methods we will a) investigate whether the prevalence of pregnancy, birth and infancy outcomes changed over the course of the pandemic, b) consider whether the impacts varied by phase of lockdown and stage of pregnancy c) examine whether any impacts varied by socio-economic circumstances.
Linked hospital and birth registration records have been requested for all children (and mothers) born 2010-21 in Scotland (n~650,000). Outcomes will include health-related behaviours (e.g. smoking, infant feeding), birth characteristics (e.g. birth weight, Apgar score) and service characteristics (e.g. delivery mode). Interrupted time series analysis will be used to examine whether outcomes changed in relation to the timing of COVID-19 mitigation measures. We will also examine duration and timing of exposure to lockdown measures, comparing, for example, mothers who were pregnant and gave birth before the pandemic (pre-March 2020), gave birth in the initial lockdown, or who were pregnant during lockdown but gave birth when measures were starting to ease. Effect modification approaches will be used to examine whether inequalities widened (or narrowed) over the pandemic. More details of our study plans can be found at: https://inrichnetwork.org/wp-content/uploads/2020/02/Paul-Henery-poster.pdf
- Stories of Abortion During Covid study. Co-I Carrie Purcell.
Carrie Purcell was co-investigator on the Stories of Abortion During Covid study (2020-21), which was jointly funded by Wellcome Trust (as a sub-project of the Sexuality and Abortion Stigma Study [sassproject.org.uk]) and the Open University. Led by Dr Victoria Newton and Prof Lesley Hoggart at the OU, this qualitative study explored changes in abortion provision introduced in response to the pandemic, including telemedicine consultations and home use of medications for early abortion. 23 women from across the UK who had recently undergone abortion took part in interviews about their experiences, and findings are currently being written up for publication.
- SCOT:REACH-HF. Rod Taylor (PI), (Project Manager).
Heart failure is a serious condition that affects nearly one million people in the UK, and its prevalence is increasing. Existing research shows that cardiac rehabilitation (e.g. specially tailored exercise programmes) is highly effective, cost-effective and integral to comprehensive care of people with heart failure. Despite national guidelines recommending that everyone with heart failure should receive rehab, currently only a small proportion are offered or participate in this rehab. Most of what is offered is hospital-based, which has been found to be a barrier to participation. The Covid-19 pandemic has significantly limited what rehab can be offered to anyone with cardiovascular disease. At present, home-based programme remains the only feasible option for many cardiac rehab services, as well as for more clinically vulnerable patients. We have co-developed a home-based CR intervention based on health behaviour change theory: Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF). A multi-centre RCT found the addition of REACH-HF to usual medical care had a positive impact on participants living with heart failure. SCOT:REACH-HF seeks to understand what shapes the implementation of the REACH-HF programme in a real-world setting. With six NHS ‘beacon sites’ across Scotland (running in parallel to other beacon sites in England and Northern Ireland), we aim to inform the future implementation of this home-based programme for people with heart failure and their caregivers in Scotland.
- Vittal Katikireddi is a member of SAGE subgroup on ethnicity and COVID-19.
- Ruth Dundas is part of The Scottish COVID-19 Response Consortium (SCRC) - a group of epidemiologists, mathematical modellers, data scientists, software developers and other scientists that have come together to develop new models to help inform the control of COVID-19.
- Vittal Katikireddi is co-chair of the Scottish Government’s Expert Reference Group on ethnicity and COVID-19.
- Eric Silverman is a member of Covid-19 Healthcare Coalition which is developing a decision-support dashboard intended to help policy-makers in the US to monitor the progress of the pandemic at the state and county level throughout the country. Eric is also a member of the Department of Health and Social Care College of Experts, reviewing grant proposals for their Covid-19 rapid-response call.
- Rich Mitchell and Jonathan Olsen are on Public Health Scotland's Social and System Recovery: Environments and Spaces Group. Rich is leading their Evidence and Data subgroup. The group is currently exploring the implications of the COVID-19 pandemic for open spaces, parks, streets and public spaces.
- Elise Whitley is a member of Public Health Scotland’s Mental Health Cell and currently contributing to priority setting for future work and advising on likely data sources for monitoring.
- Vittal Katikireddi is co-chair and Rachel Thomson, Theocharis Kromydas and Peter Craig are members of a group convened by Public Health Scotland to advise the Scottish Government and other stakeholders on the impacts of the COVID-19 response on health and health inequalities that arise through economic and related pathways, and on actions that may mitigate negative impacts and enhance positive impacts. The group has published a briefing looking at protecting the health of the working-age population as lockdown reduces.
- Alastair Leyland and Linsay Gray have joined the DHSC/UKRI Global Effort on COVID-19 Health Research College of Experts.
- Vittal Katikireddi has joined the DHSC/UKRI COVID-19 rapid research funding College of Experts.
- Jonathan Olsen is a member of SS&R Transport - Data and Evidence Sub Group hosted by Public Health Scotland.
- The Schools Health and Wellbeing Improvement Research Network (SHINE) have developed resources to help schools, their students and parents with their response to COVID-19. Visit the SHINE website to download these resources.
- Generation Scotland has launched a CovidLife survey to understand the psychological, social and economic impacts of COVID-19. SHINE is working with Generation Scotland to develop a TeenCovidLife survey for 12-17 years olds to see how COVID-19 is affecting their health and wellbeing, social and home life. Read about the findings.
- The Transdisciplinary Research for the Improvement of Youth Mental Public Health (TRIUMPH) Network has created a COVID-19 hub with links to organisations who can offer information, mental health advice and support to children and young people, parents/carers, and others involved in supporting young people at this time. You can also read the latest evidence about the impact of COVID-19 on young people’s mental health. The TRIUMPH Network are also collaborating with Oxford Centre for Emotions and Affective Disorders on the Oxford ARC Study. This UK-wide study investigates resilience and how adolescents and their parents/carers are coping with social isolation during the COVID-19 pandemic, with weekly updates from the study published on the study website.
- Ruth Dundas and Alastair Leyland have written a blog contrasting government responses to the COVID-19 pandemic and inequality in the UK. While taking urgent and radical action according to the precautionary principle is entirely appropriate to address the pandemic, they argue that the inequalities challenge is at least as important and thereby should demand a similar urgency and seriousness of response.
- Umberto Gostoli and Eric Silverman have written a public letter ‘Sound behavioural theories, not data, is what makes computational models useful’ published in Review of Artificial Societies and Social Simulation.
- Carrie Purcell published an opinion piece on the IRESH website on how access to abortion might be supported during Covid-19.
- Whilst undertaking PhD research, Amrit Purba has written two articles published in Nursing Times discussing a number of approaches which could be adopted to reduce the baseline demand on the NHS and flatten the curve: ‘Enhance the NHS nursing workforce’s contribution to tackle COVID-19’ and 'How should the role of the nurse change in response to COVID-19?'
- Rod Taylor and Carrie Purcell have written a correspondence to the European Journal of Preventative Cardiology on the need to maintain access to cardiac rehabilitation during COVID-19.
- Vittal Katikireddi and SHW's Claire Niedzwiedz have published a piece in the Conversation on why black and Asian people are at greater risk of COVID-19.
- Eric Silverman is a member of Covid-19 Healthcare Coalition which is developing a decision-support dashboard intended to help policy-makers in the US to monitor the progress of the pandemic at the state and county level throughout the country.
- Rich Mitchell and Jonathan Olsen have published two reports on the change in use of green and open space following the COVID-19 lockdown. Read Official report from Social & System Recovery - Environment and Spaces Group and COVID-19 Green and Open Space Use in Autumn 2020.
- Marcia Gibson has written a blog for Policy Scotland about whether a basic income could be an effective response to the COVID-19 crisis.
- Alastair Leyland has written a news piece, 'The UK society for social medicine and population health: reflections on COVID-19 in Europe' published in European Journal of Public Health.
- Jamie Lachman has written a correspondence, 'Parenting in a time of COVID-19', published in The Lancet.
- Carrie Purcell, Karen Maxwell, Rachel Wilson-Lowe and Lisa McDaid have responded to a Scottish Government consultation on Future arrangements for early medical abortion at home which sought views on whether temporary arrangements to ensure abortion access during the pandemic should be made permanent.
- COVID-19 engagement tool - this tool aims to start conversations around the wider impact of Covid-19 restrictions on health and society, with a focus on inequalities. The issues covered cut across the Unit’s programmes, and include employment, mental health, the environment and relationships.
- Emily Long and colleagues in the Relationships programme have published a Briefing: COVID-19 and social relationships.
- The Natsal COVID-19 study have published a report: Sexual and reproductive health in Scotland during the 1st year of COVID pandemic
- Rich Mitchell and Jonathan Olsen contributed to a report by Public Health Scotland: Use of private and public greenspace by housing tenure during the COVID-19 pandemic