The effectiveness of the three-tier system of local restrictions for control of COVID-19

Hunter, Paul R ORCID:, Brainard, Julii and Grant, Alastair ORCID: (2020) The effectiveness of the three-tier system of local restrictions for control of COVID-19.

Full text not available from this repository. (Request a copy)


Despite it being over 10 months since COVID-19 was first reported to the world and it having caused over 1.3 million deaths it is still uncertain how the virus can be controlled whilst minimising the negative impacts on society and the economy. On the 14th October, England introduced a three-tier system of regional restrictions in an attempt to control the epidemic. This lasted until the 5th November when a new national lockdown was imposed. Tier 1 was the least and Tier 3 the most restrictive tiers. We used publicly available data of daily cases by local authority (local government areas) and estimated the reproductive rate (R value) of the epidemic over the previous 14 days at various time points after the imposition of the tier system or where local authorities were moved into higher tiers at time points after reallocation. At day 0 there vas very little difference in the R value between authorities in the different groups but by day 14 the R value in Tier 3 authorities had fallen to about 0.9, in Tier 2 to about 1.0 and in Tier 1 the R value was about 1.5. The restrictions in Tier 1 had little impact on transmission and allowed exponential growth in the large majority of authorities. By contrast the epidemic was declining in most Tier 3 authorities. In Tier 2, exponential growth was being seen in about half of authorities but declining in half. We concluded that the existing three tier system would have been sufficient to control the epidemic if all authorities had been moved out of Tier 1 into tier 2 and there had been more rapid identification and transfer of those authorities where the epidemic was increasing out of Tier 2 into Tier 3. A more restrictive tier than Tier 3 may be needed but only by a small number of authorities.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Faculty of Science > School of Environmental Sciences
UEA Research Groups: Faculty of Social Sciences > Research Centres > Water Security Research Centre
Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Faculty of Science > Research Centres > Centre for Ecology, Evolution and Conservation
Faculty of Science > Research Groups > Centre for Ocean and Atmospheric Sciences
Faculty of Science > Research Groups > Environmental Biology
Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User: LivePure Connector
Date Deposited: 01 Mar 2022 17:30
Last Modified: 19 Oct 2023 03:50
DOI: 10.1101/2020.11.22.20236422

Actions (login required)

View Item View Item