PONE-D-23-35350Changing risk factors for developing SARS-CoV-2 infection from Delta to OmicronPLOS ONE

Dear Dr. Brainard,

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PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: 1. The method section in the Abstract is too short. Please add more information on the data and the statistical analyses. The estimates should be reported in the result section. The conclusions should be the implications and interpretation of the results.

2. I suggest replacing the term “likelihood of testing positive” with the risk/likelihood of infection.

3. As the study period across phases where different variants are circulating, a variable related to these distinct phases should be included in the meta-regression model instead of the period number, such that the interpretation of the estimates can be compared among different variants' predominant phases.

4. Given that the meta-regression was often used in the context of substantial between-study variations, the metric I2 should be reported for each pooled estimate.

5. Please be consistent about the term “Covid-19” (e.g., instead of “covid”) throughout the text.

6. Why are the results for multigeneration households reversed compared to household sizes? Please state the difference between multigeneration household and normal household.

7. Please change Table 1 to a figure similar to figure 1-4 but combining all the pooled estimates shown in Table 1.

8. It is unclear why the authors only show the detailed estimates during the periods for 4 strata in table1. I suggest generating the same figure for all other strata as well and moving all these figures to the Appendix.

9. The strata “Adults, living in a household with someone aged 16 or under” and “Aged under 70 years, living in a household with someone aged 70 or over ” are different from the figure2 legend.

10. Please use add the full form of “effective R”.

Reviewer #2: The authors analyzed SARS-CoV-2 infection risk in the general population using the UK Office of National Statistics Infection Survey. They used meta-regression of likelihood estimates during the pandemic to reveal that certain risk factors fluctuated, particularly with the emergence of Omicron BA.2 dominance. They report variables such as mask-wearing habits, foreign travel, household size, working status, and contact with children or persons over 70 showed variable relationships with infection risk. The concluded the relevance of these factors may be linked to reinfection risk, variant infectiousness, and the status of social distancing regulations, emphasizing the dynamic nature of infection risks during different phases of the pandemic. Overall, the findings may seem interesting, but some questions can be raised as of their value now that the pandemic has largely subsided.

Major comments:

It is unclear to me why the authors did not include some of the statistically significant predictor variables that they reported in Table 1 (such as Traveling abroad, Rurality, and Employment status) in their subsequent analysis.

Minor comments:

Page 3: “We report a study to determine whether risk factors for infection after the emergence of the

omicron variant.”. Please rephrase for clarity.

Please replace “covid” with “COVID-19” across the manuscript when discussing and referring to COVID-19.

Table 1: Please highlight statistically significant values using the asterisk sign and define the p-value cutoff in the table's footnote.

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Reviewer #1: No

Reviewer #2: No

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Changing risk factors for developing SARS-CoV-2 infection from Delta to Omicron

PONE-D-23-35350R1

Dear Dr. Brainard,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Marwan Osman

Academic Editor

PLOS ONE

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: (No Response)

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: (No Response)

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: (No Response)

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors addressed all comments reasonably and made corresponding revisions in the manuscript.

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

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