A lot of discussion about separating those at risk to protect them from becoming infected w. SARS-CoV-2. ‘Let’s protect the elderly & vulnerable from Covid19 & the rest of us get on with our lives’. New paper shows how challenging this would be (PREPRINT not peer reviewed) 1/10

Compared Covid-19 outcomes among shielded and non-shielded populations in one part of Scotland. Led by @BhauteshJani with @Jill_p_pell @FrancesMair & colleagues 2/10 https://www.medrxiv.org/content/10.1101/2020.09.17.20196436v1

Cohort study of 1.3 million residents in Greater Glasgow & Clyde (UK’s largest health authority area). Sample: those registered with GPs in @NHSGGC. Of these, 32,533 (2.47%) in the official ‘shielding’ category but a further 347,374 (26.41%) were classified at moderate risk 3/10

The team linked primary care records up to *May 2020* with other relevant datasets including prescribing, hospitalisation and death certificates. Outcomes were: infection; hospitalisation; ICU admission; #Covid19 related mortality 4/10

Lots more information on methods in the paper and confounders (things that might explain or influence outcomes) were adjusted for in the analysis 5/10

FINDINGS: Testing was more common in the shielded category (not a surprise given hospital patients tested at the time) and the moderate risk category compared to low risk (rest of the population registered with GPs) 6/10

Compared to low risk, the shielded group had a higher risk of infection and death associated with Covid19. The moderate risk group had intermediate (medium) risk of infection & death compared to the general population, but similar death rate to those classified as shielding 7/10

The moderate risk group made up a higher proportion of deaths. The biggest factor was age, with those over aged 70 being 8 times more at risk of infection and 74 times more likely to die from Covid19 related factors than the low risk (rest of the population) group 8/10

TAKE HOME MESSAGES: If we want to separate and protect higher risk groups from hospital admission and Covid19 related deaths, this is not just those who were recommended to shield during the early stages of the pandemic. It is actually over one in four of us. 9/10

I’d be delighted if someone could tell me how we cut off 1 in 4 people from the rest of society? Also how we cut off the people who care for and live with this 25%+, which is likely to be many more people. Look forward to the plan for that, from those who promote it? 10/10