Changes in notifiable infectious disease incidence in China during the COVID-19 pandemic

Abstract

Nationwide nonpharmaceutical interventions (NPIs) have been effective at mitigating the spread of the novel coronavirus disease (COVID-19), but their broad impact on other diseases remains under-investigated. Here we report an ecological analysis comparing the incidence of 31 major notifiable infectious diseases in China in 2020 to the average level during 2014-2019, controlling for temporal phases defined by NPI intensity levels. Respiratory diseases and gastrointestinal or enteroviral diseases declined more than sexually transmitted or bloodborne diseases and vector-borne or zoonotic diseases. Early pandemic phases with more stringent NPIs were associated with greater reductions in disease incidence. Non-respiratory diseases, such as hand, foot and mouth disease, rebounded substantially towards the end of the year 2020 as the NPIs were relaxed. Statistical modeling analyses confirm that strong NPIs were associated with a broad mitigation effect on communicable diseases, but resurgence of non-respiratory diseases should be expected when the NPIs, especially restrictions of human movement and gathering, become less stringent.

Trends in non-COVID-19 hospitalizations prior to and during the COVID-19 pandemic period, United States, 2017 – 2021

“…These results substantiate prior studies of influenza, RSV and other upper and lower respiratory infections during the winter 2020/2021 season [10,23]. NPIs are believed to have reduced influenza transmission during the 2020/2021 influenza season while also contributing to the decline in mumps and other respiratory infections in some countries [12,23–25]. While the decline in influenza could be partially attributed to a decrease in the number of specimens sent for respiratory panel testing, as evidenced by an 61% decrease in US specimens sent for testing in 2020, studies have shown that the positivity rate among specimens sent had also declined, approximately 98%, during winter 2020/2021 [11].…”

“…influenza, acute lower respiratory infections) and otitis media (the main contributor to the “middle ear diagnosis” subchapter) clustered in our analysis given their shared dramatic decrease in IRR during April and May 2020 and their uncharacteristically low relative incidence during fall/winter 2020/2021. These results substantiate prior studies of influenza, RSV and other upper and lower respiratory infections during the winter 2020/2021 season [10,23]. NPIs are believed to have reduced influenza transmission during the 2020/2021 influenza season while also contributing to the decline in mumps and other respiratory infections in some countries [12,23–25].…”

Impact of COVID-19 Outbreak on the Gynecological Outpatients HPV Infection Rate in Wuhan, China: A Retrospective Observational Study

“…This suggests that the decrease in the HPV infection rate may come from the reduction of new HPV infections. A recent Chinese nationwide research showed that the incidence of STIs was significantly reduced during COVID-19 pandemic ( 16 ). The decrease of the five most prevalent STIs was positively linked with COVID-19 pandemic and strict quarantine measures ( 17 ).…”

COVID-19 impact on routine immunisations for vaccine-preventable diseases: Projecting the effect of different routes to recovery

“…Variation is also likely across countries as NPIs used have varied substantially in both timing and stringency [39] . Furthermore, despite short-term reductions in transmission, recent studies have highlighted the risks of resurgence and outbreaks following the relaxation of NPIs [40] , [41] , [42] . Further work and data are required to assess the full effects of these interventions.…”