Breakpoint modelling of temporal associations between non-pharmaceutical interventions and symptomatic COVID-19 incidence in the Republic of Ireland

To constrain propagation and mitigate the burden of COVID-19, most countries initiated and continue to implement several non-pharmaceutical interventions (NPIs), including national and regional lockdowns. In the Republic of Ireland, the first national lockdown was decreed on 23.sup.rd of March 2020,...

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Bibliographic Details
Published in:PloS one 2021-07, Vol.16 (7), p.e0255254
Main Authors: Boudou, Martin, ÓhAiseadha, Coilin, Garvey, Patricia, O'Dwyer, Jean, Hynds, Paul
Format: Article
Language:English
Subjects:
Breakpoints
Coronaviruses
COVID-19
Deprivation
Disease transmission
Earth science
Epidemiology
Ethics
Evaluation
Funding
Health services
Health surveillance
Infections
Laboratories
Medicine and Health Sciences
Modelling
Mortality
Pandemics
People and places
Pharmaceuticals
Phases
Population
Population studies
Populations
Public health
Rural areas
Severe acute respiratory syndrome coronavirus 2
Social Sciences
Socioeconomic factors
Subgroups
Surveillance
Sustainable development
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Summary:To constrain propagation and mitigate the burden of COVID-19, most countries initiated and continue to implement several non-pharmaceutical interventions (NPIs), including national and regional lockdowns. In the Republic of Ireland, the first national lockdown was decreed on 23.sup.rd of March 2020, followed by a succession of restriction increases and decreases (phases) over the following year. To date, the effects of these interventions remain unclear, and particularly within differing population subsets. The current study sought to assess the impact of individual NPI phases on COVID-19 transmission patterns within delineated population subgroups in the Republic of Ireland. Confirmed, anonymised COVID-19 cases occurring between the 29.sup.th of February 2020 and 30.sup.th November 2020 (n = 72,654) were obtained. Segmented modelling via breakpoint regression with multiple turning points was employed to identify structural breaks across sub-populations, including primary/secondary infections, age deciles, urban/commuter/rural areas, patients with underlying health conditions, and socio-demographic profiles. These were subsequently compared with initiation dates of eight overarching NPI phases. Study findings suggest that many NPIs have been successful in decreasing COVID-19 incidence rates, however the strictest Phase 5 NPI was not. Moreover, NPIs were not equally successful across all sub-populations, with differing response times noted. Future strategies and interventions may need to be increasingly bespoke, based on sub-population profiles and required responses.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0255254