Predicted norovirus resurgence in 2021–2022 due to the relaxation of nonpharmaceutical interventions associated with COVID-19 restrictions in England: a mathematical modeling study

Abstract

Background To reduce the coronavirus disease burden in England, along with many other countries, the government implemented a package of non-pharmaceutical interventions (NPIs) that have also impacted other transmissible infectious diseases such as norovirus. It is unclear what future norovirus disease incidence is likely to look like upon lifting these restrictions. Methods Here we use a mathematical model of norovirus fitted to community incidence data in England to project forward expected incidence based on contact surveys that have been collected throughout 2020–2021. Results We report that susceptibility to norovirus infection has likely increased between March 2020 and mid-2021. Depending upon assumptions of future contact patterns incidence of norovirus that is similar to pre-pandemic levels or an increase beyond what has been previously reported is likely to occur once restrictions are lifted. Should adult contact patterns return to 80% of pre-pandemic levels, the incidence of norovirus will be similar to previous years. If contact patterns return to pre-pandemic levels, there is a potential for the expected annual incidence to be up to 2-fold larger than in a typical year. The age-specific incidence is similar across all ages. Conclusions Continued national surveillance for endemic diseases such as norovirus will be essential after NPIs are lifted to allow healthcare services to adequately prepare for a potential increase in cases and hospital pressures beyond what is typically experienced.

Noro‐ and rotavirus detections in children during COVID‐19 pandemic—A nationwide register study in Finland

“…Our results show that the social restrictions reduced the visits due to gastroenteritis and both norovirus and rotavirus detections in Finnish children. Our results are in line with the previous reports from Germany, England and China, 1–4 which showed that the norovirus and rotavirus detections decreased rapidly after the restrictions were implemented. Interestingly, we report a much later increase in the incidence of norovirus than the previous report from Hong Kong, 5 although Finland relaxed the restrictions much earlier.…”

“…As the restrictions have been relaxed, there has been concern that the norovirus and rotavirus cases would start to increase rapidly. The year 2021 was also predicted to have a high incidence of cases of norovirus and rotavirus as modelling studies suggested a possible two‐fold increase in the detections compared with the pre‐pandemic era 3,4 . Interestingly, a study from Hong Kong reported that despite continuous restrictions, the norovirus and rotavirus cases returned near to pre‐pandemic levels 5 .…”

“…The year 2021 was also predicted to have a high incidence of cases of norovirus and rotavirus as modelling studies suggested a possible two‐fold increase in the detections compared with the pre‐pandemic era. 3 , 4 Interestingly, a study from Hong Kong reported that despite continuous restrictions, the norovirus and rotavirus cases returned near to pre‐pandemic levels. 5 As Finland minimised the restrictions set towards children already in the fall of 2020 and continued a similar strategy throughout the year 2021, we decided to analyse the primary care visit rate due to gastroenteritis in children aged 0–14 years.…”

Norovirus: Facts and Reflections from Past, Present, and Future

“…Resurgence of norovirus incidence after relaxation of non-pharmaceutical interventions related to SARS-CoV2 pandemic has been predicted [161]. Continued surveillance should be encouraged to allow adequate preparation for a potential increase in healthcare pressures beyond previous levels.…”

A process mining- deep learning approach to predict survival in a cohort of hospitalized COVID‐19 patients

“…Throughout the COVID-19 pandemic, machine learning and artificial intelligence (AI) methods have been used to understand and predict virus spread, the potential impact of vaccines, morbidity, mortality, and resource allocation [ 1 ]. Modeling of COVID-19 morbidity and mortality has yielded insights into disease progression [ 2 , 3 ], which have been informative for health systems to anticipate resource needs and effective interventions [ 4 ]. However, with the emergence of COVID-19 variants and rapid advances in COVID-19 treatment, prevention, and vaccination, 1-time modeling is likely ineffective for understanding how to provide optimal care from the patient, health system, and public health perspectives [ 4 ].…”