Background Key workers played a pivotal role during the national lockdown in the UK’s response to the COVID-19 pandemic. Although protective measures have been taken, the impact of the pandemic on key workers is yet to be fully elucidated.
Methods Participants were from four longitudinal age-homogeneous British cohorts (born in 2001, 1990, 1970 and 1958). A web-based survey provided outcome data during the first UK national lockdown (May 2020) on COVID-19 infection status, changes in financial situation, trust in government, conflict with people around, household composition, psychological distress, alcohol consumption, smoking and sleep duration. Generalised linear models with logit link assessed the association between being a key worker and the above outcomes. Adjustment was made for cohort design, non-response, sex, ethnicity, adult socioeconomic position (SEP), childhood SEP, the presence of a chronic illness and receipt of a shielding letter. Meta-analyses were performed across the cohorts.
Findings 13 736 participants were included. During lockdown, being a key worker was associated with increased chances of being infected with COVID-19 (OR 1.43, 95% CI 1.22 to 1.68) and experiencing conflict with people around (OR 1.19, 95% CI 1.03 to 1.37). However, key workers were less likely to be worse off financially (OR 0.32, 95% CI 0.24 to 0.65), to consume more alcohol (OR 0.88, 95% CI 0.79 to 0.98) or to smoke more (OR 0.60, 95% CI 0.44 to 0.80) during lockdown. Interestingly, being a key worker was not associated with psychological distress (OR 0.95, 95% CI 0.85 to 1.05).
Interpretation Being a key worker during the first UK COVID-19 lockdown was a double-edged sword, with both benefits and downsides. The UK government had the basic duty to protect its key workers from SARS-CoV-2 infection, but it may have failed to do so, and there is an urgent need to rectify this in light of the ongoing third wave.
- health impact assessment
- public health
Data availability statement
Data are available upon reasonable request. Data from the cohorts are available from the UK data archive: https://www.data-archive.ac.uk.
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Contributors C-CT analysed the data and wrote the manuscript. C-CT, JCM, AH, NC, GC, DB, PP and GC were involved in the study design and implementation. AW, AH, NC, GC, DB and PP actively participated in data acquisition. GC contributed to the data analysis, interpretation of the results and manuscript drafting. All authors were involved in critically revising the manuscript and approved the final version. GC is the guarantor of this work.
Funding The study was funded by the Economic and Social Research Council under the Centre for Longitudinal Studies, Resource Centre 2015-20 (grant number ES/M001660/1), and by the Medical Research Council (grant MC_UU_00019/1). GC is supported by the British Heart Foundation (MyoFit46 Special Programme Grant SP/20/2/34841), the National Institute for Health Research Rare Diseases Translational Research Collaboration (NIHR RD-TRC) and by the NIHR UCL Hospitals Biomedical Research Centre. JCM is directly and indirectly supported by the UCL Hospitals NIHR BRC and Biomedical Research Unit at Barts Hospital, respectively. DB is supported by the Economic and Social Research Council (grant number ES/M001660/1) and by The Academy of Medical Sciences/Wellcome Trust ('Springboard Health of the Public in 2040' award: HOP001/1025). AH receives support from the British Heart Foundation, the Economic and Social Research Council (ESRC), the Horizon 2020 Framework Programme of the European Union, the National Institute on Ageing, the NIHR University College London Hospitals Biomedical Research Centre, the UK Medical Research Council and works in a unit that receives support from the UK Medical Research Council. GC has the support of the European Research Council under the European Union’s Horizon 2020 research and innovation programme (grant agreement no. 819752 DEVORHBIOSHIP–ERC-2018-COG).
Disclaimer None of the funders was involved in the study design, the collection, the analysis, the interpretation of the data and in the decision to submit the article for publication.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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