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随着 COVID-19 公共卫生措施的实施,流感和呼吸道病毒的流行率下降:加拿大艾伯塔省。

Decline of Influenza and Respiratory Viruses With COVID-19 Public Health Measures: Alberta, Canada.

机构信息

Division of Preventive Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; School of Public Health, University of Alberta, Edmonton, Alberta, Canada.

Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

出版信息

Mayo Clin Proc. 2021 Dec;96(12):3042-3052. doi: 10.1016/j.mayocp.2021.09.004. Epub 2021 Sep 20.

Abstract

OBJECTIVE

To determine the incidence of influenza and noninfluenza respiratory viruses (NIRVs) pre-/post-implementation of public health measures aimed to decrease coronavirus disease 2019 (COVID-19) transmission using population-based surveillance data. We hypothesized that such measures could reduce the burden of respiratory viruses (RVs) transmitting via the same routes.

PATIENTS AND METHODS

An interrupted time-series analysis of RV surveillance data in Alberta, Canada, from May 2017 to July 2020 was conducted. The burden of influenza and NIRVs before and after intervention initiation at week 11 was compared. The analysis was adjusted for seasonality, overdispersion, and autocorrelation.

RESULTS

During the study period, an average of 708 and 4056 weekly respiratory multiplex molecular panels were conducted pre-/post-intervention, respectively. We found significant reductions in test positivity rates in the postintervention period for influenza (-94.3%; 95% CI, -93.8 to 97.4%; P<.001) and all NIRVs (-76.5%; 95% CI, -77.3 to -75.8%; P<.001) in the crude model, and -86.2% (95% CI, -91.5 to -77.4%: P<.001) and -75% (95% CI, -79.7 to -69.3%; P<.001), respectively, in the adjusted models. Subanalyses for individual viruses showed significant decreases in respiratory syncytial virus, human metapneumovirus, enterovirus/rhinovirus, and parainfluenza. For non-severe acute respiratory coronavirus 2 human coronaviruses, the decline was not statistically significant after adjustment (-22.3%; 95% CI, -49.3 to +19%, P=.246).

CONCLUSION

The implementation of COVID-19 public health measures likely resulted in reduced transmission of common RVs. Although drastic lockdowns are unlikely to be required given widespread COVID-19 vaccination, targeted implementation of such measures can lower RV disease burden. Studies to evaluate relative contributions of individual interventions are warranted.

摘要

目的

利用基于人群的监测数据,确定在实施旨在降低 2019 年冠状病毒病(COVID-19)传播的公共卫生措施前后,流感和非流感呼吸道病毒(NIRV)的发生率。我们假设这些措施可以减少通过相同途径传播的呼吸道病毒(RV)的负担。

患者和方法

对 2017 年 5 月至 2020 年 7 月期间加拿大艾伯塔省的 RV 监测数据进行了一项干预前后的时间序列分析。比较了干预开始前 11 周和干预开始后两周的流感和 NIRV 负担。该分析调整了季节性、过分散和自相关性。

结果

在研究期间,平均每周进行 708 次和 4056 次呼吸道多重分子检测。我们发现,在干预后时期,流感(-94.3%;95%置信区间,-93.8 至 97.4%;P<.001)和所有 NIRV(-76.5%;95%置信区间,-77.3 至-75.8%;P<.001)的检测阳性率均有显著降低,在未调整模型中分别为-86.2%(95%置信区间,-91.5 至-77.4%:P<.001)和-75%(95%置信区间,-79.7 至-69.3%;P<.001),在调整后的模型中分别为-86.2%(95%置信区间,-91.5 至-77.4%:P<.001)和-75%(95%置信区间,-79.7 至-69.3%:P<.001)。针对个别病毒的亚组分析显示,呼吸道合胞病毒、人偏肺病毒、肠病毒/鼻病毒和副流感病毒的数量显著减少。对于非严重急性呼吸道冠状病毒 2 型人类冠状病毒,调整后下降无统计学意义(-22.3%;95%置信区间,-49.3 至+19%,P=.246)。

结论

实施 COVID-19 公共卫生措施可能导致常见 RV 传播减少。尽管鉴于 COVID-19 疫苗的广泛接种,不太可能需要实施严格的封锁,但有针对性地实施这些措施可以降低 RV 疾病负担。需要评估个别干预措施相对贡献的研究。

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