Abstract
BackgroundDuring the first wave of COVID-19 it was hypothesized that COVID-19 is subject to multi-wave seasonality, similar to Influenza-Like Illnesses since time immemorial. One year into the pandemic, we aimed to test the seasonality hypothesis for COVID-19. MethodsWe calculated the average annual time-series for Influenza-Like Illnesses based on incidence data from 2016 till 2019 in the Netherlands, and compared these with two COVID-19 time-series during 2020/2021 for the Netherlands. We plotted the time-series on a standardized logarithmic infection scale. Finally, we calculated correlation coefficients and used univariate regression analysis to estimate the strength of the association between the time-series of COVID-19 and Influenza-Like Illnesses. ResultsThe time-series for COVID-19 and Influenza-Like Illnesses were strongly and highly significantly correlated. The COVID-19 peaks were all during flu season, and lows were all in the opposing period. Finally, COVID-19 meets the multi-wave characteristics of earlier flu-like pandemics, namely a short first wave at the tail-end of a flu season, and a longer and more intense second wave during the subsequent flu season. ConclusionsWe conclude that seasonal patterns of COVID-19 incidence and Influenza-Like Illnesses incidence are highly similar, in a country in the temperate climate zone, such as the Netherlands. Further, the COVID-19 pandemic satisfies the criteria of earlier respiratory pandemics, namely a first wave that is short-lived at the tail-end of flu season, and a second wave that is longer and more severe.This seems to imply that the same factors that are driving the seasonality of Influenza-Like Illnesses are causing COVID-19 seasonality as well, such as solar radiation (UV), temperature, relative humidity, and subsequently seasonal allergens and allergies.
Highlights
Time-series analysis shows that COVID-19 and historic of Influenza-Like illnesses have highly similar
During the first wave of COVID-19 it was hypothesized that COVID-19 is subject to multi-wave seasonality [1, 2], comparable to other respiratory viral infections and pandemics since time immemorial [3, 4]
On our logarithmic infection scale (Fig. 2), the estimated COVID-19 incidence tops around 6, and the nadir bottoms out around 3. On this scale, it becomes visible that COVID-19 incidence starts to rise slightly earlier than what is usual for Influenza-Like Illnesses (ILI)
Summary
During the first wave of COVID-19 it was hypothesized that COVID-19 is subject to multi-wave seasonality [1, 2], comparable to other respiratory viral infections and pandemics since time immemorial [3, 4]. Already during the first COVID-19 cycle the data suggested seasonality, comparable to the seasonality of Influenza-Like Illnesses (ILI), the time-series were typically too short for definitive conclusions [8]. We are one year into the COVID-19 pandemic, and we can witness in the temperate climate zone in the Northern Hemisphere, a second wave that appears to rise and peak during the boundaries of a typical flu season, as the first cycle before. We aim to test our hypothesis that COVID-19 has a similar seasonal pattern as ILI in a country in the temperate climate zone as the Netherlands. We performed time-series analysis to compare the COVID-19 cycles with the multi-wave seasonality patterns of flu-like illnesses. During the first wave of COVID-19 it was hypothesized that COVID-19 is subject to multi-wave seasonality, similar to Influenza-Like Illnesses since time immemorial. One year into the pandemic, we aimed to test the seasonality hypothesis for COVID-19
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