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People advised to protect themselves in the first wave of the pandemic were five times more likely to die after a confirmed Covid infection than those considered to be at low risk of contracting the disease, according to research in Scotland.
The study, led by the University of Glasgow, found that efforts to protect the most vulnerable did not prevent substantial levels of infection in groups most at risk, with many patients inevitably succumbing to the virus.
The findings raise questions about the effectiveness of shielding during the first wave of the pandemic and show that other measures, from reducing transmission in the community to Covid-safe support at home, are crucial for those at risk. more vulnerable to disease.
“The only way to protect these people is to prevent them from getting infected in the first place, as they are a high risk group,” said Professor Jill Pell, director of the Institute of Health and Welfare. from the University of Glasgow. “You can’t just blame people at high risk for protecting themselves because, as we’ve shown, they can’t protect themselves 100%. “
Pell and his colleagues analyzed data from more than 1.3 million people registered with general practitioners in the NHS Greater Glasgow and Clyde between March and May 2020. The majority, 934,239, were considered to be at low risk of Covid, while that 353,085 were at medium risk due to conditions such as diabetes and high blood pressure. Another 27,747 were asked to protect themselves because of serious health problems that put them at the highest risk.
People asked to protect themselves were eight times more likely to have a confirmed Covid infection than those at low risk. And while testing rates were 10 times higher in the protected group than in the low-risk group, many of the first wave tests were not ordered until people had symptoms. People at average risk had four times more confirmed infections than people at low risk.
When researchers looked at people who died from Covid, they found 140 deaths (0.51%) among those protected, 803 deaths (0.23%) in the medium risk group, and 84 deaths (0.01%) in people at low risk of the disease.
One of the questions the study sought to answer is whether the shielding helps prevent the NHS from being overwhelmed. The results suggest not, as only a fraction of the population is vulnerable enough to protect themselves and many more people at average risk are hospitalized with Covid. “You would have to deploy armor to about a third of the population to have a real impact on the NHS burden and that is not doable,” Pell said.
The main driver of shielding is to protect vulnerable patients, but researchers believe it is not as effective as hoped. “We don’t know what would have happened to these people if they hadn’t been advised to protect themselves, but the bottom line is that it certainly didn’t stop them from having negative results,” Pell said.
“These people have medical issues and I don’t think you can reasonably expect someone to stay in their house and never leave it for months, because whether they like it or not, they have to go to hospital appointments, under domestic pressure to do other things, and they live with other people in the house, “she added.” Although it is easy to say do not share kitchen facilities, do not share living space, very few people in the population have two kitchens, two living rooms and two bathrooms Insulating inside the house is almost impossible.
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