The Eat-Out-to-Help-Out incentive: A trigger for gastrointestinal infections in England, 2020?

Our study assessed the link between gastrointestinal (GI) infections in England and the Eat Out to Help Out scheme (EOHO), a government subsidy created to encourage people to eat out during COVID-19 pandemic (03-30 August 2020). We studied national laboratory data between January 2015 and December 2020. We used time series change point analysis to see if there were shifts in reported cases of specific GI infections (<i>Campylobacter</i> spp., <i>Escherichia coli</i> O157, and non-typhoidal <i>Salmonella</i> spp.) associated with the timing of the scheme. Our analysis uniquely applied the Pruned Exact Linear Time method, with generalized linear models to a national dataset of GI infections. This revealed increases in cases closely aligned to the timing of the easing of COVID-19 restrictions, prior to the introduction of the EOHO scheme. Our study showed the scheme had no measurable impact, as there was no significant change on reported cases. Substantial reductions in cases after the first lockdown, followed by an increase as restrictions were phased out, show the wider impact of COVID-19 control measures, for example, public information campaigns aimed at improving hand-hygiene. These findings highlight the complicated interactions between COVID-19 control measures, the public's behaviour, and the spread of GI infections.