Deprivation, essential and non-essential activities and SARS-CoV-2 infection following the lifting of national public health restrictions in England and Wales

Abstract

Background Individuals living in deprived areas in England and Wales undertook essential activities more frequently and experienced higher rates of SARS-CoV-2 infection than less deprived communities during periods of restrictions aimed at controlling the Alpha (B.1.1.7) variant. We aimed to understand whether these deprivation-related differences changed once restrictions were lifted. Methods Among 11,231 adult Virus Watch Community Cohort Study participants multivariable logistic regressions were used to estimate the relationships between deprivation and self-reported activities and deprivation and infection (self-reported lateral flow or PCR tests and linkage to National Testing data and Second Generation Surveillance System (SGSS)) between August – December 2021, following the lifting of national public health restrictions. Results Those living in areas of greatest deprivation were more likely to undertake essential activities (leaving home for work (aOR 1.56 (1.33 – 1.83)), using public transport (aOR 1.33 (1.13 – 1.57)) but less likely to undertake non-essential activities (indoor hospitality (aOR 0.82 (0.70 – 0.96)), outdoor hospitality (aOR 0.56 (0.48 – 0.66)), indoor leisure (aOR 0.63 (0.54 – 0.74)), outdoor leisure (aOR 0.64 (0.46 – 0.88)), or visit a hairdresser (aOR 0.72 (0.61 – 0.85))). No statistical association was observed between deprivation and infection (P=0.5745), with those living in areas of greatest deprivation no more likely to become infected with SARS-CoV-2 (aOR 1.25 (0.87 – 1.79). Conclusion The lack of association between deprivation and infection is likely due to the increased engagement in non-essential activities among the least deprived balancing the increased work-related exposure among the most deprived. The differences in activities highlight stark disparities in an individuals’ ability to choose how to limit infection exposure.

Contact behaviour before, during and after the COVID-19 pandemic in the Netherlands: evidence from contact surveys in 2016-2017 and 2020-2023

“…This difference was smaller or even reversed in the periods with lockdown measures (survey rounds 1 and 4), which was also observed in a contact study in Hungary [35]. An explanation is that participants with a lower education level more often have work in essential sectors that preclude working from home [16]. This is confirmed by the results on the survey question whether participants worked from home last week stratified by education level (Suppl.…”

“…Persons with comorbidities may have reduced their contacts more than persons without comorbidities [8,13,14], given their higher probability of severe outcomes [15]. Also the socio-economic status of a person may have influenced contact behaviour, as persons with a low socio-economic status often have professions that preclude working from home [16].…”