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Contact patterns changed in response to national COVID-19 guidance

Press release issued: 9 February 2021

The number of daily contacts changed over the course of 2020, following the first lockdown, corresponding to alterations in the COVID-19 guidance, suggests a study among staff and students at the University of Bristol. The research led by scientists at the University of Bristol is published on the pre-print server medRxiv.org.

CONQUEST (COroNavirus QUESTionnaire) is an online survey of contacts, behaviour, and potential SARS-Cov-2 symptoms for University of Bristol staff and students. The questionnaire was set-up to measure changing behaviour and contact patterns during this unprecedented time, in order to predict how COVID-19 will spread in universities settings.

The online survey, which went live on 23 June 2020, investigated whether there were differences in contact patterns for University staff and students during four different COVID-19 guidance periods: the period following the first lockdown (23 June – 3 July 2020); the relaxed guidance period (4 July – 13 September 2020); "rule-of-six" period (14 August – 4 November 2020); and the second lockdown (5 November - 24 November 2020). There was a reduction in the number of contacts during the second lockdown, returning them to the levels in the period after the first UK lockdown.

The study included 4,199 responses from staff and 1,906 from students. For staff, median contacts remained low throughout the analysis period but were higher in the relaxed guidance and the "rule-of-six" periods than the period following the first lockdown and the second lockdown period when guidance was stricter. Mean contacts were higher during the weeks in these two middle periods, usually varying between four to six contacts per day but were around three contacts per day in the weeks during the post-lockdown and second lockdown periods. The differences between the median and means were due to some individuals reporting many contacts.

For students, there were few responses until October 2020 when a University-wide mass communications campaign was launched to recruit participants to the survey. After 5 November 2020, when student response was high with 1,452 participants, each week the median was two contacts per day and the mean was around six or seven contacts, until the second lockdown when it dropped to around three contacts per day.

Additionally, the research has shown that on average there was high adherence to the guidance throughout the survey period for both staff and students, with few people meeting in groups larger than six, despite many students living in large households.

Dr Adam Trickey, Senior Research Associate in the Bristol Medical School: Population Health Sciences, said: "Our analysis highlights the importance of measuring contact patterns in real-time. We have more responses from staff than from students, yet students are critical to understanding how SARS-CoV-2 will spread in a university setting. We are calling for more University of Bristol students to participate in the online survey."

He continued: "Compared to daily contact numbers reported in other UK studies before the COVID-19 outbreak, our study found University of Bristol staff and student contacts were lower throughout the survey period, particularly during the second lockdown, which possibly indicates that COVID-19 guidance measures successfully worked to reduce numbers of contacts."

The study is important for several reasons. Firstly, it comes at a unique time when a third national lockdown has been implemented to reduce contacts between individuals. However, the number of reported daily cases of COVID-19 is still high. Bristol went into the second lockdown covered by this study in the lowest tier of COVID-19 restrictions and came out in - as with much of the country - in the highest tier.

Secondly, the setting is important due to its uniqueness, as universities were allowed to carry on teaching throughout the lockdown, meaning that large gatherings of people were still allowed – also notable due to the high prevalence of COVID-19 among students and their potential for high numbers of contacts due to their large household sizes.

As well as its uniqueness, the setting is also important as university staff are representative in age structure of many working age populations. It is important to be able to understand the effect of the COVID-19 guidance changes, particularly lockdowns, on people’s behaviour, as another lockdown might be needed in the COVID-19 pandemic or for any future pandemics that could occur.

The CONQUEST survey continues to capture responses and behaviours and further research will be done to look at variation in behaviours over time and factors to explain this.

Call for more Bristol students to participate in an online survey of contact patterns

If you are a University of Bristol student or member of staff you can still take part in this ongoing questionnaire that will enable researchers to collect data as the pandemic progresses and help researchers monitor changes as testing is rolled out and during the current lockdown.

Link to the questionnaire (for University of Bristol staff and students only): https://is.gd/uob_covid19

The study, funded by the Elizabeth Blackwell Institute and supported by the NIHR Health Protection Research Unit in Behavioural Science and Evaluation, is one of a number being conducted by UNCOVER Bristol's COVID Emergency Research Group. Other questionnaires are focusing on under-represented groups, including children and older adults.

Paper

'University students and staff able to maintain low daily contact numbers during various COVID-19 guideline periods' by Adam Trickey et al in medRxiv

Please note this is a preprint, so it is a preliminary piece of research that has not yet been through peer review and has not been published in a scientific journal – so this is early data

Further information

About the CONQUEST questionnaire
CONQUEST (COroNavirus QUESTionnaire) is an ongoing questionnaire on contacts, behaviour, and potential SARS-Cov-2 symptoms for staff and students at the University of Bristol. This questionnaire has been live since the 23 June 2020. Participants complete an initial questionnaire which includes questions on background demographics and then are given the option to fill out a shorter version of the questionnaire on contacts, symptoms, and whether they have had COVID-19, repeating every eight days.

The questionnaire captured demographic information, information about participant’s contacts on the previous day, information about symptoms during the previous week, whether participants had been self-isolating during the previous week, and COVID-19 status if known. 

Demographic information on participants was captured when they filled out the initial questionnaire. This included data on age, gender, ethnicity, whether they were part of a high-risk group, whether they were a student, staff or both, whether they were an undergraduate or postgraduate, their study year, their University department, their residence, and the age of their housemates.

Participants were asked about three types of contacts they had had on the previous day:

  1. Individual contacts - those who they spoke to in person one-on-one, including those in your household and support bubble.
  2. Other contacts - if they spoke in person to many people one-on-one in the same setting (but they did not have the opportunity to speak to each other), for example, as part of working in a customer service role in a shop.
  3. Group contacts - large groups of individuals in the same setting (e.g. sports teams, tutorials, lectures, religious services, large gatherings with friends and family).

About the Elizabeth Blackwell Institute
Nurturing research. Improving health.

The Elizabeth Blackwell Institute drives innovation in research to improve health for all. It nurtures interdisciplinary research to address the complex health challenges facing us today.

The institute focuses on:

•          Supporting the next generation of health researchers
•          Connecting people to develop interdisciplinary research
•          Including everyone in research so the research can benefit all.

About the NIHR Health Protection Research Unit [HPRU] in Behavioural Science and Evaluation
The NIHR HPRU in Behavioural Science and Evaluation at University of Bristol is one of 14 HPRUs across England, part of a £58.7 million investment by the NIHR to protect the health of the nation. The NIHR HPRU in Behavioural Science and Evaluation is a partnership between Public Health England and University of Bristol, in collaboration with MRC Biostatistics Research Unit at the University of Cambridge and University of the West of England. Each NIHR HPRU undertakes high quality research that is used by PHE to keep the public safe from current and emerging public health threats.

About coronavirus (SARS-CoV-2)
The surface of the coronavirus particle has proteins sticking out of it known as Spike proteins which are embedded in a membrane.  They have the appearance of tiny little crowns, giving the virus its name (corona). Inside the membrane is the viral genome wrapped up in other proteins. The genome contains all the genetic instruction to mass produce the virus. Once the virus attaches to the outside of a human cell, its membrane fuses with the human cell membrane and its genetic information passes into the human cell.  Next, the virus instructs the cell to start replicating its genome and produce its proteins. These are then assembled into many new copies of the virus which, upon release, can infect many more cells. The viral proteins play diverse further roles in coronavirus pathology.

Support our COVID-19 research
Bristol’s researchers are part of a global network of scientists responding urgently to the challenge of the coronavirus pandemic.

Find out how you can support their critical work

Bristol UNCOVER Group
In response to the COVID-19 crisis, researchers at the University of Bristol formed the Bristol COVID Emergency Research Group (UNCOVER) to pool resources, capacities and research efforts to combat this infection.

Bristol UNCOVER includes clinicians, immunologists, virologists, synthetic biologists, aerosol scientists, epidemiologists and mathematical modellers and has links to behavioural and social scientists, ethicists and lawyers.

Follow Bristol UNCOVER on Twitter at: twitter.com/BristolUncover

For more information about the University of Bristol’s coronavirus (COVID-19) research priorities visit: http://www.bristol.ac.uk/research/impact/coronavirus/research-priorities/

Bristol UNCOVER is supported by the Elizabeth Blackwell Institute
Find out more about the Institute's COVID-19 research looking into five key areas: virus natural history, therapeutics and diagnostics research; epidemiology; clinical management; vaccines; and ethics and social science.

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