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Infectious illness prevention and control is an important part of public health management. The early monitoring and numerical modelling of incidence data can help with the efficient prevention and control of infectious disease prevalence. The reproduction number R, as an essential index to understand the dynamics of COVID-19, can be predicted by using confirmed new incidence cases and serial interval data in the datasets provided by UK government. In this paper, an extended model is proposed to account for variable reporting rates instead of 1 for the estimation of the R number. The impact of using various modelling parameters is also evaluated, which provides insight into how to select a set of suitable parameters in modelling. The variation of the estimation of the R number by incorporating variable reporting rates can be observed and assessed. [ABSTRACT FROM AUTHOR]

Introduction: A range of nonpharmaceutical public health interventions has been introduced in many countries following the rapid spread of Covid‐19 since 2020, including recommendations or mandates for the use of face masks or coverings in the community. While the effectiveness of face masks in reducing Covid‐19 transmission has been extensively discussed, scant attention has been paid to the lived experience of those wearing face masks. Method: Drawing on 40 narrative interviews with a purposive sample of people in the United Kingdom, with a particular focus on marginalised and minoritized groups, our paper explores experiences of face mask use during the pandemic. Results: We find that face masks have a range of societal, health and safety impacts, and prompted positive and negative emotional responses for users. We map our findings onto Lorenc and Oliver's framework for intervention risks. We suggest that qualitative data offer particular insights into the experiences of public health interventions, allowing the potential downsides and risks of interventions to be more fully considered and informing public health policies that might avoid inadvertent harm, particularly towards marginalised groups. Patient or Public Contribution: The study primarily involved members of the public in the conduct of the research, namely through participation in interviews (email and telephone). The conception for the study involved extensive discussions on social media with a range of people, and we received input and ideas from presentations we delivered on the preliminary analysis. [ABSTRACT FROM AUTHOR]

This paper aims to illustrate the tension between public health and civil liberties through the case study of the UK government's emergency response to the Covid-19 pandemic. In the area of public health, this tension is predominantly approached by reference to two theories: liberalism and communitarianism. This paper studies these positions and how they are manifested in evidence-based policymaking by combining a study of public health policy with a study of public health ethics. The studies help demonstrate the UK government's framing of health policy relating to Covid-19 in terms of liberalism and communitarianism. The paper concludes that in the initial UK government response to Covid-19, the government discourse evoked communitarian values and framed its policies as being evidence-led and as prioritising public health. However, the policy measures themselves manifested liberal values: they had the underlying concern of not infringing excessively on civil liberties, and individuals were given autonomy of decision making within the measures that were taken. The article concluded that emergency times require a communitarian response based on preventative action. This article is the first to combine public health policy with public health ethics to demonstrate how values form a key part of decision making. [ABSTRACT FROM AUTHOR]

Background: Researchers conducting cohort studies may wish to investigate the effect of episodes of COVID-19 illness on participants. A definitive diagnosis of COVID-19 is not always available, so studies have to rely on proxy indicators. This paper seeks to contribute evidence that may assist the use and interpretation of these COVID-indicators.Methods: We described five potential COVID-indicators: self-reported core symptoms, a symptom algorithm; self-reported suspicion of COVID-19; self-reported external results; and home antibody testing based on a 'lateral flow' antibody (IgG/IgM) test cassette. Included were staff and postgraduate research students at a large London university who volunteered for the study and were living in the UK in June 2020. Excluded were those who did not return a valid antibody test result. We provide descriptive statistics of prevalence and overlap of the five indicators.Results: Core symptoms were the most common COVID-indicator (770/1882 participants positive, 41%), followed by suspicion of COVID-19 (n = 509/1882, 27%), a positive symptom algorithm (n = 298/1882, 16%), study antibody lateral flow positive (n = 124/1882, 7%) and a positive external test result (n = 39/1882, 2%), thus a 20-fold difference between least and most common. Meeting any one indicator increased the likelihood of all others, with concordance between 65 and 94%. Report of a low suspicion of having had COVID-19 predicted a negative antibody test in 98%, but positive suspicion predicted a positive antibody test in only 20%. Those who reported previous external antibody tests were more likely to have received a positive result from the external test (24%) than the study test (15%).Conclusions: Our results support the use of proxy indicators of past COVID-19, with the caveat that none is perfect. Differences from previous antibody studies, most significantly in lower proportions of participants positive for antibodies, may be partly due to a decline in antibody detection over time. Subsequent to our study, vaccination may have further complicated the interpretation of COVID-indicators, only strengthening the need to critically evaluate what criteria should be used to define COVID-19 cases when designing studies and interpreting study results. [ABSTRACT FROM AUTHOR]

Urban design studio education aims to prepare future urban designers to more effectively understand how cities work and critically engage with the role of design intervention in the built environment. A design studio is an appropriate setting where this can take place. This paper details the design and delivery of a postgraduate urban design studio subject in the MA Urban Design programme at Cardiff University during the COVID-19 pandemic in the UK. We particularly investigate the capacities and challenges of blended learning and teaching, with a primary focus on the experience and perception of students in the context of design studio pedagogy. To this end, we discuss the findings from an online survey of postgraduate urban design students and reflect on their experience and perception of the related learning and teaching activities, assessment, feedback, field study visits, workshops, and digital platforms during the subject delivery period in the 2021–2022 academic year. The outcomes of this paper can inform future practices of blended learning and teaching incorporating a mix of face-to-face and online modes of delivery in relation to design studio education, particularly in the context of unprecedented global health challenges such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: The sudden introduction of social distancing measures in response to the COVID-19 pandemic resulted in significant lifestyle changes for the UK population. People living with physical disabilities were deemed to be at greater risk of complications following COVID-19 infection and were subjected to stricter social distancing guidelines. But gaps remain in our understanding of how the COVID-19 pandemic and associated restrictions affected the ability to access support, health and wellbeing of people with physical disabilities. Such understanding is vital to ensure equitable future pandemic preparedness for people living with physical disabilities. Methods: We conducted qualitative semi-structured interviews with 31 people living in the UK between May 2020 and January 2022. All participants self-identified as having a physical disability that affected their mobility, sight, or hearing. We analysed the data using reflexive thematic analysis. Results: Six themes were identified that described the impact of the pandemic on ability to access support, health and wellbeing: (i) adaptations to healthcare provision led to difficulties in managing health and wellbeing; (ii) exacerbations of inequalities in access to public space due to social distancing guidelines; (iii) experiences of hostility from able-bodied people; (iv) loss of social lives and encounters; (v) difficulties maintaining distance from others and subsequent fear of infection and (vi) strategies to support wellbeing and coping when confined to the home. Conclusion: The COVID-19 pandemic exacerbated existing health and social inequalities experienced by disabled people. The disproportionate impact of the pandemic on service provision and social connections resulted in challenging circumstances for disabled people who faced unmet medical needs, deteriorating health, and at times, hostile public spaces. Disabled people's experiences need to be incorporated into future pandemic or health-related emergency planning to ensure equality of access to services and public spaces to ensure their health and wellbeing is supported and maintained. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a significant impact on countries worldwide, including the United Kingdom (UK). The UK has faced numerous challenges, but its response, including the rapid vaccination campaign, has been noteworthy. While progress has been made, the study of the pandemic is important to enable us to properly prepare for future epidemics. Collaboration, vigilance, and continued adherence to public health measures will be crucial in navigating the path to recovery and building resilience for the future. In this article, we propose an overview of the COVID-19 situation in the UK using both mathematical (a nonlinear differential equation model) and statistical (time series modeling on a moving window) models on the transmission dynamics of the COVID-19 virus from the beginning of the pandemic up until July 2022. This is achieved by integrating a hybrid model and daily empirical case and death data from the UK. We partition this dataset into before and after vaccination started in the UK to understand the influence of vaccination on disease dynamics. We used the mathematical model to present some mathematical analyses and the calculation of the basic reproduction number ( R 0 ). Following the sensitivity analysis index, we deduce that an increase in the rate of vaccination will decrease R 0 . Also, the model was fitted to the data from the UK to validate the mathematical model with real data, and we used the data to calculate time-varying R 0 . The homotopy perturbation method (HPM) was used for the numerical simulation to demonstrate the dynamics of the disease with varying parameters and the importance of vaccination. Furthermore, we used statistical modeling to validate our model by performing principal component analysis (PCA) to predict the evolution of the spread of the COVID-19 outbreak in the UK on some statistical predictor indicators from time series modeling on a 14-day moving window for detecting which of these indicators capture the dynamics of the disease spread across the epidemic curve. The results of the PCA, the index of dispersion, the fitted mathematical model, and the mathematical model simulation are all in agreement with the dynamics of the disease in the UK before and after vaccination started. Conclusively, our approach has been able to capture the dynamics of the pandemic at different phases of the disease outbreak, and the result presented will be useful to understand the evolution of the disease in the UK and future and emerging epidemics. [ABSTRACT FROM AUTHOR]

Students' learning experiences and perceptions are markedly influenced by the use of digital technology during the COVID-19 pandemic. Exploring students' perception of blended online learning, amid the adaptations of the higher education sector in the wake of uncertainty, has become more critical than ever. This paper reflects on the experience of learning and teaching the Research Methods and Techniques subject in the postgraduate programme of MA Urban Design at Cardiff University during COVID-19 in the UK. To do so, we designed and carried out an online survey to explore students' perception of online teaching and learning activities, feedback and assessment, and digital platforms based on their experience during the subject delivery period in the 2020–2021 academic year. One of the significant findings of this paper was that students agreed with the impact of eye contact on their virtual learning experience but as long as this was aligned with their rights to see others, including their peers and instructors, rather than reciprocal rights to be seen. In addition, students felt that facilitating synchronous communication through effective interaction among diverse peers has been quite challenging in small-group online reading seminars. The majority of respondents also reported that attending live online lectures was more helpful than watching pre-recorded lectures. Online formative feedback and synchronous interim reviews also allowed students to reflect on their progress and develop their projects further before their summative assessment. The outcomes of this paper can effectively assist educators who consider delivering programmes, adopting a blended online learning environment design model, in the post COVID-19 era. The findings of this study can also provide guidance for further developments and improvements in using digital technology and blended online learning in urban design education and pedagogy. [ABSTRACT FROM AUTHOR]

Summary: Objectives: The aim of this study was to conduct a preliminary assessment of the prevalence of fatigue and level of physical activity, as well as the relationship between fatigue and physical activity among Poles living in Poland and the United Kingdom (UK) in the further year in the COVID-19 pandemic. Methods: A web-based online survey was conducted among Poles living permanently in Poland and the UK in January 2023. Responses were obtained from 200 respondents aged 18–69 years. The level of fatigue was assessed by the Modified Fatigue Impact Scale (MFIS). The level of physical activity was measured by the International Physical Activity Questionnaire (IPAQ). Results: The median for the total fatigue score was equal to 17 points out of a possible 105. 13.5% of the subjects had a low level of physical activity, the average MET for high-intensity activity was 1294.55 METs, for moderate activity 714.44 METs, and for walking 631 METs. As age and number of COVID-19 cases increased, scores on the MFIS questionnaire scale also increased. With an increase in the number of COVID-19 cases, high-intensity MET scores decreased. Conclusions: The level of fatigue, in contrast to the level of physical activity, was low in the study population. There were few statistically significant differences in fatigue between people living in Poland and the UK. Further experimental studies on the physiological mechanism of differences in fatigue and physical activity are needed. [ABSTRACT FROM AUTHOR]

Aim To examine trends in public awareness and knowledge of drinking guidelines in the UK since their revision in 2016, which had moved from a daily to a weekly guideline, made the guideline the same for men and women, and reduced the guideline for men by around one-third. Method Data were from a representative, repeat cross-sectional survey. We analysed changes in awareness and knowledge of drinking guidelines among 8168 adult drinkers between 2016 and 2022 and associations with sociodemographic characteristics, smoking status and level of alcohol consumption. Results The proportion of drinkers aware of guidelines declined from 86.0% (95%CI 84.0–88.0%) in 2016 to 81.7% (79.5–84.0%) in 2019, then increased during the COVID-19 pandemic, peaking at 91.6% (90.1–93.1%) in 2020. The proportion who correctly identified the guideline as a maximum of exactly 14 units/week remained at around a quarter from 2016 (25.0%, 22.4–27.5%) to 2018 (25.8%, 23.2–28.3%), whereas the proportion who gave a figure of 14 units or fewer rose from 52.1 (49.2–55.0%) to 57.4% (54.6–60.3%). However, by 2022, guideline knowledge had worsened significantly, with these figures falling to 19.7 (17.4–21.9%) and 46.5% (43.6–49.4%), respectively. Changes over time were similar across subgroups. Odds of guideline awareness and knowledge were higher among drinkers who were aged ≥35, female, more educated and from more advantaged social grades. Conclusions The majority of adult drinkers in the UK are aware of low-risk drinking guidelines. However, 6 years since their announcement, knowledge of the revised drinking guidelines remains poor. Less than a quarter know the recommended weekly limit and only around half think it is 14 units or less. Inequalities have persisted over time, such that disadvantaged groups remain less likely to know the guidelines. [ABSTRACT FROM AUTHOR]

Background Public Health registrars (SpRs) were an important component of the workforce that contributed to the COVID-19 response. This study explores their contribution and the impact the early stages of the pandemic had on their learning and training. Methods Data were collected from SpRs in the London and Kent, Surrey, Sussex training programme between July and September 2020 through a mixture of questionnaires and semi-structured interviews. A thematic analysis of interview transcripts was undertaken to identify themes. Results 35/128 SpRs responded to the survey and 11 were interviewed. SpRs were placed across a range of organizations and made a significant contribution to the COVID-19 response. Overall, SpRs learned important skills but working on the response may for some have impacted negatively on training. A number of facilitators and barriers to learning were identified. Conclusion The study findings highlight the opportunities for learning created by the pandemic. However, changing projects and the desire of SpRs to contribute to the response meant the impacts on training were mixed. Future deployment of SpRs should consider the balance of responsibility and pace when delegating work, as well as the need to supervise effectively and support remote working to maintain good mental wellbeing. [ABSTRACT FROM AUTHOR]

This study examined the emergence and implementation of community touchpoints established in the UK during the COVID‐19 pandemic for victims/survivors of domestic abuse (DA). Community touchpoints are designated places, both online and in accessible settings such as pharmacies and banks, where victims/survivors can seek confidential advice and be directed to expert DA services. The research adopted a case study approach and explored a range of perspectives through expert interviews, document analysis, consultation with survivors and stakeholders and a survey of DA co‐ordinators. Four national community touchpoint schemes were identified and, of these, three were implemented rapidly and were available in 2020–2021 when the UK experienced lockdowns. Partnerships between Government/voluntary organisations and commercial businesses‐assisted design and implementation. Some stakeholders considered that the schemes lacked responsivity to the local context and noted challenges in providing a confidential service in rural areas. Whilst pharmacies, banks and online spaces were identified as non‐stigmatised and trusted places to seek advice, community touchpoints were judged less accessible for some groups including those experiencing digital poverty and victims whose movements were heavily scrutinised. Most of the touchpoint schemes targeted adults only. There were also concerns about whether frontline staff in commercial businesses received sufficient training. Whilst robust evidence of outcomes was limited, there were indications that the schemes had achieved good reach with some early evidence of take‐up. Testimonials indicated that victims/survivors were using the touchpoints in flexible ways which met their needs. Moreover, the wide reach and visibility of these initiatives delivered in non‐stigmatised settings may have served to raise public awareness of DA, reducing the silence that has traditionally surrounded it. Further research into the use and impact of these initiatives is required and there may be future potential to extend community touchpoints to include children and young people experiencing DA. [ABSTRACT FROM AUTHOR]

Improving young people's (YP) mental health and well‐being is a global public health priority. Despite continued commitment within the UK policy agenda to improve the mental health and well‐being of YP, the incidence of mental health issues continues to rise. This has been further compounded by the outbreak of COVID‐19 which has disproportionately affected YP in the most socioeconomically disadvantaged areas. Understanding YP's perspectives on what supports their mental health is important to develop policies that meet their needs. We conducted focus groups (n = 18 with 42 YP aged 13–21) in three geographical areas with high levels of deprivation in England, UK. Recruited through six local youth organisations, each group of YP took part in three interlinked focus groups designed to explore their perceptions of what impacts their health in their local area, and their understandings of health inequalities through participatory methods. Throughout their discussions, YP foregrounded the significance of mental health and mental health support structures. YP perceived challenges to accessing mental health provision and an unmet need for support within their local communities. Alongside this, YP consistently highlighted the importance of youth groups for promoting good mental health and mitigating challenges to poor mental health. However, ongoing cuts to the voluntary sector and universal services continue to impact areas and individuals in the greatest need. In the face of deficits in formal mental health support, our findings highlight the pressing need for increased investment in services focused on prevention (such as youth groups) in areas of high deprivation. [ABSTRACT FROM AUTHOR]

Background: A high COVID-19 vaccine uptake is essential to achieve herd immunity to combat the current strain of COVID-19 and potential future variants. This review aimed to identify factors associated with public intention to receive COVID-19 vaccines until February 2021 to provide accessible data to policymakers to inform framing and targeting of messages designed to optimise vaccine uptake.Methods: Medline, Embase, CINAHL, PsycINFO, PsycARTICLES, Sociological Abstracts and Applied Social Sciences Index and Abstracts were searched for cross-sectional studies reporting data regarding COVID-19 vaccine intentions, published between 01/01/2020 and 12/02/2021. Title/abstract and full-text screening were performed independently by two authors. The Appraisal Tool for Cross-sectional Studies (AXIS) was used to assess bias and quality. Both random-effects meta-analysis and narrative synthesis were used to describe vaccine intentions and associated factors. A subgroup analysis assessing the impact of sex, sampling method and time of survey on COVID-19 vaccine intention was performed.Results: Searches identified 4739 studies, and 23 cross-sectional studies were deemed eligible for the review; 22 used online surveys and one used a mixed-methods study design. Eighteen surveys were conducted in the first half of 2020 and five were conducted in the latter half of 2020. Fifteen countries were represented, with the most common being the United States (n = 4) and the United Kingdom (n = 4) sampling 41,403 participants across all surveys. Most studies employed convenience sampling and 11 non-responder rates raised concerns over non-response bias. From the 18 studies included in the meta-analysis, the pooled proportion of survey participants willing to receive the COVID-19 vaccine was 73.3% (n = 18, 95% Confidence Interval 64.2 to 81.5%, I2 = 99.7%). Factors associated with a higher COVID-19 vaccine acceptance included greater perceived risk of COVID-19, lower level of perceived vaccine harm, higher educational attainment and household income, older age, being of White ethnicity and male sex.Conclusions: There was a high willingness to receive the COVID-19 vaccine which was influenced by sociodemographic factors and risk perceptions. The findings suggest future research should explore reasoning behind vaccine intentions for different sociodemographic groups to allow targeted communication strategies to be formulated by public health agencies.Registration: PROSPERO Registration Number: CRD42021239134. [ABSTRACT FROM AUTHOR]

Background: Whilst children and young people have not often been at forefront of the immediate Covid-19 pandemic health response there has been concern about the indirect consequences of Covid-19 on children's physical and mental health and what the effect of the pandemic will be throughout their lifetimes. Early adolescence is a time of transition and reorientation. This study considers the impact of the first UK Covid-19 lockdown on early adolescents. Methods: The study topic was identified through a consultation process which aimed to provide appropriate evidence to local decision makers in Bradford, UK and plan for future interventions. A group of children and their parents from the longitudinal Born in Bradford (BiB) cohort study were randomly selected and then purposively sampled by ethnicity, age, sex and deprivation. The BiB cohort is made up of 13,776 children and their families and were recruited at Bradford Royal Infirmary between 2007 and 2011. 41 interviews (with 20 families: 20 parents and 21 children) were carried out between August and September 2020. Interview data was analysed using reflexive thematic analysis. Results: The transitional age of the children interviewed had an important influence on their experience Covid-19 and the first UK lockdown. Their age combined with lockdown and school closures meant that they missed out on key learning and social opportunities at a crucial time in their lives. Covid-19 and lockdown also disrupted their daily mental wellbeing and led to increased anxiety, lethargy and low moods, during a period of personal change and social transition. Conclusion: For children at the start of their adolescence undergoing change and formation, the experiences and feelings Covid-19 has set in motion will likely have an impact on their mental and cognitive functioning as they develop further. It is important to acknowledge these early adolescent experiences and continue to monitor and provide targeted support to this group of young people. [ABSTRACT FROM AUTHOR]

Background: Confidence in the central UK Government has declined since the beginning of the COVID-19 pandemic, and while this may be linked to specific government actions to curb the spread of the virus, understanding is still incomplete. Examining public opinion is important, as research suggests that low confidence in government increases the extent of non-compliance with infection-dampening rules (for instance, social distancing); however, the detailed reasons for this association are still unclear. Methods: To understand public opinion on the central UK government during the first phase of the COVID-19 pandemic, we used structural topic modeling, a text mining technique, to extract themes from over 4000 free-text survey responses, collected between 14 October and 26 November 2020. Results: We identified eleven topics, among which were topics related to perceived government corruption and cronyism, complaints about inconsistency in rules and messaging, lack of clear planning, and lack of openness and transparency. Participants reported that elements of the government's approach had made it difficult to comply with guidelines (e.g., changing rules) or were having impacts on mental wellbeing (e.g., inability to plan for the future). Conclusions: Results suggested that consistent, transparent communication and messaging from the government is critical to improving compliance with measures to contain the virus, as well as protecting mental health during health emergencies. [ABSTRACT FROM AUTHOR]

Background Knife-related violence is of growing concern in the UK. This study aims to investigate the impact of the COVID-19 pandemic on the frequency of penetrating injuries at a UK major trauma centre. Methods This was a retrospective study comparing the number of patients attending the emergency department of King's College Hospital (KCH) with a penetrating injury (gunshot or stab wound) during the 'pandemic year' (1 March 2020–28 February 2021) compared with the equivalent time period in the previous year. Penetrating injuries as a result of self-harm were excluded. The primary outcome was to assess whether there were any changes to the frequency of presentations during three periods of national lockdowns. Results Lockdown 1 showed a 48.45% reduction in presentations in the 'pandemic year' compared to the previous year, lockdown 2 showed a 31.25% reduction; however, lockdown 3 showed an 8.89% increase in the number of presentations. Conclusion Our findings suggest that despite the initial reduction in the number of presentations of penetrating injury during lockdown 1, this returned to normal levels by lockdown 3. Further research is required to understand the effects of government-imposed restrictions on interpersonal violence and identify appropriate methods of outreach prevention during a pandemic. [ABSTRACT FROM AUTHOR]

We examine how the earnings, time use, and subjective wellbeing of different social groups changed at different stages/waves of the pandemic in the United Kingdom (UK). We analyze longitudinal data from the latest UK Household Longitudinal Survey (UKHLS) COVID study and the earlier waves of the UKHLS to investigate within-individual changes in labor income, paid work time, housework time, childcare time, and distress level during the three lockdown periods and the easing period between them (from April 2020 to late March 2021). We find that as the pandemic developed, COVID-19 and its related lockdown measures in the UK had unequal and varying impacts on people's income, time use, and subjective well-being based on their gender, ethnicity, and educational level. In conclusion, the extent of the impacts of COVID-19 and COVID-induced measures as well as the speed at which these impacts developed, varied across social groups with different types of vulnerabilities. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and the mitigation measures by governments have upended the economic and social lives of many, leading to widespread psychological distress. We explore heterogeneity in trajectories of psychological distress during the pandemic in the United Kingdom and relate this heterogeneity to socio-demographic and health factors. We analyze nine waves of longitudinal, nationally representative survey data from the UK Household Longitudinal Study ( N = 15 , 914 ), covering the period from early 2020 to mid-2021. First, latent class mixture modelling is used to identify trajectories of psychological distress. Second, associations of the trajectories with covariates are tested with multinomial logistic regressions. We find four different trajectories of distress: continuously low, temporarily elevated, repeatedly elevated, and continuously elevated distress. Nearly two fifths of the population experienced severely elevated risks of distress during the pandemic. Long-term distress was highest among younger people, women, people living without a partner, those who had no work or lost income, and those with previous health conditions or COVID-19 symptoms. Given the threat of persistent stress on health, policy measures should be sensitized to the unintended yet far-reaching consequences of non-pharmaceutical interventions. [ABSTRACT FROM AUTHOR]

It's official: The UK is in a recession. The economy has suffered its biggest slump on record with a drop in gross domestic product (GDP) of 20.4%. 1 This is going to have a significant impact on our health and well-being. It risks creating a spiralling decay as we know good health is not only a consequence, but also a condition for sustained and sustainable economic development. 2 In this way, the health of a nation creates a virtuous circle of improved health and improved economic prosperity. How we measure prosperity is therefore important and needs to be considered. [ABSTRACT FROM AUTHOR]

Objectives: Policy responses to the COVID-19 pandemic in 2020 led to behaviour changes in the UK's population, including a sudden shift towards working from home. These changes may have affected overall exposure to fine particulate matter (PM2.5), an air pollutant and source of health harm. We report the results of a simulation model of a representative sample of the UK's population, including workers and non-workers, to estimate PM2.5 exposure before and during the pandemic. Methods: PM2.5 exposure was simulated in April and August 2017–2020 for 10,000 individuals across the UK drawn from the 2011 nationwide census. These data were combined with data from the UK's ambient PM2.5 monitoring network, time use data and data on relevant personal behaviour before and during the first stage of the pandemic (such as changes in smoking and cooking). Results: The simulated exposures were significantly different between each year. Changes in ambient PM2.5 resulted in regional and temporal variation. People living in homes where someone smoked experienced higher exposure than those in smoke-free homes, with an increase of 4 µg/m3 in PM2.5 exposure in 2020. Conclusions: Changes in PM2.5 exposure were minimal for most individuals despite the simulated increases in cooking activity. Those living in smoking homes (estimated to be around 11% of the UK population) experienced increased exposure to PM2.5 during COVID lockdown measures and this is likely to have increased mortality and morbidity among this group. Government policy should address the risk of increased exposure to second-hand smoke in the event of future COVID-19-related restrictions. [ABSTRACT FROM AUTHOR]