Understanding and responding to COVID-19 in Wales: protocol for a privacy-protecting data platform for enhanced epidemiology and evaluation of interventions

Abstract

IntroductionThe emergence of the novel respiratory SARS-CoV-2 and subsequent COVID-19 pandemic have required rapid assimilation of population-level data to understand and control the spread of infection in the general and vulnerable populations. Rapid analyses are needed to inform policy development and target interventions to at-risk groups to prevent serious health outcomes. We aim to provide an accessible research platform to determine demographic, socioeconomic and clinical risk factors for infection, morbidity and mortality of COVID-19, to measure the impact of COVID-19 on healthcare utilisation and long-term health, and to enable the evaluation of natural experiments of policy interventions.Methods and analysisTwo privacy-protecting population-level cohorts have been created and derived from multisourced demographic and healthcare data. The C20 cohort consists of 3.2 million people in Wales on the 1 January 2020 with follow-up until 31 May 2020. The complete cohort dataset will be updated monthly with some individual datasets available daily. The C16 cohort consists of 3 million people in Wales on the 1 January 2016 with follow-up to 31 December 2019. C16 is designed as a counterfactual cohort to provide contextual comparative population data on disease, health service utilisation and mortality. Study outcomes will: (a) characterise the epidemiology of COVID-19, (b) assess socioeconomic and demographic influences on infection and outcomes, (c) measure the impact of COVID-19 on short -term and longer-term population outcomes and (d) undertake studies on the transmission and spatial spread of infection.Ethics and disseminationThe Secure Anonymised Information Linkage-independent Information Governance Review Panel has approved this study. The study findings will be presented to policy groups, public meetings, national and international conferences, and published in peer-reviewed journals.

Evaluating the effect of COVID-19 on dispensing patterns: a national cohort analysis

“…3,139,662 patients with a total of 353,516,236 dispensing records entered in the WDDS were linked in two COVID-19 e-cohorts (13). This comprised 87.7% of Welsh residents between 2016 and 2019 (C16) who had at least one dispensing record in WDDS and could be successfully linked.…”

“…Medications for Welsh residents that are dispensed against non-barcoded prescriptions or dispensed outside Wales are not included in this dataset. These data are made available to SAIL on a monthly basis with approximately a 6-week lag to allow for official reporting and quality assurance processes (13).…”

“…Dispensing data from 1 st of January 2016 to 31 st of December 2019 (counterfactual pre-COVID-19, “C16 cohort”) were compared to data from 1st January 2020 to the 31 st of September 2020 (COVID-19 year, “C20 cohort”). For all people who were alive and resident in Wales with a record in the two purpose-built residency spine datasets (13), drug dispensing history was retrieved from patient-level linked dispensing record using anonymized linkage fields, and the date of dispensing of the drugs.…”

Staff-Pupil SARS-CoV-2 Infection Pathways in Schools: A Population Level Linked Data Approach

“…Data are anonymised at an individual and household level (12,13). Our primary health data cohort was the Welsh COVID-19 e-cohort (14) which consists of all people alive and known to the NHS in Wales on or after the 1st January 2020. To this core we linked the School Workforce Annual Census (SWAC) which details all individuals who work in a publicly funded school (15) covering 1498 out of 1502 schools in Wales; and the Pupil Level Annual School Census (PLASC)(16) which includes annual returns on 1480 out of 1502 schools.…”

Evaluating the effect of COVID-19 on dispensing patterns: a national cohort analysis

“…Medications for Welsh residents that are dispensed against non-barcoded prescriptions or dispensed outside Wales are not included in this dataset. These data are made available to SAIL on a monthly basis with approximately a 6-week lag to allow for o cial reporting and quality assurance processes (13).…”