By March 2020 (early COVID-19 pandemic restrictions), changes for crude IRRs varied by pneumonia diagnosis and district (Appendix Table 3). For all districts combined, IRR was reduced for all patients with all clinical pneumonia (21%, 95% CI 18%-23%), PEP (20%, 95% CI 12%-27%), severe pneumonia (23%, 95% CI 20%-25%), very severe pneumonia (26%, 95% CI 22%-29%), hypoxic pneumonia (34%, 95% CI 29%-39%), and PPP (38%, 95% CI 31%-44%). Individual districts mainly showed reductions, except for CHD, which showed increases in IRRs in cases of all clinical, severe, and very severe pneumonia. By March 2021, which included a period of COVID-19 restrictions, additional reductions were observed in line with reduced case numbers, and PEP was reduced by 36% (95% CI 29%-42%) (Appendix Table 3). We found some variability by age group; slightly larger reductions were observed for the 24-59-month age group compared with the younger age group (Appendix Table 4). Annual incidence rates were highest in 2016 in SKD, SBD, and BZD, but CHD showed high incidence rates until 2019 (Appendix Table 5). What does this mean in simplified terms