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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.
Highlights
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
By comparing incidences in 2020 to the average historical levels during 2014–2019 within each phase defined by the timeline of NPIs, we found that the spread of most acute infectious diseases, especially respiratory and gastrointestinal/enteric diseases, was largely interrupted during February–August of 2020 when the most stringent NPIs were in effect
Respiratory diseases were more sensitive to the NPIs than other disease categories
Summary
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. Pandemic phases with more stringent NPIs were associated with greater reductions in disease incidence. Respiratory pathogens were likely affected the most by the nonpharmaceutical interventions, pathogens with other transmission modes, e.g., gastrointestinal, sexually transmitted, or even vectorborne diseases, could have been affected as the unprecedented changes in human movement and behavioral patterns might have changed exposure levels. We aim to quantify the changes in the incidences of notifiable infectious diseases with different transmission modes before, during, and after the first wave of COVID-19 in the mainland of China and to assess how these changes relate to the public health interventions, using the national surveillance data from 2014 to 2020
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