Abstract

Background Respiratory infection is the 4th most common reason for absence from work in Finland. There is limited knowledge of how social distancing affects the spread of respiratory infections during respiratory epidemics. We assessed the effect of nationwide infection control strategies against coronavirus disease in 2020 on various respiratory infections (International Statistical Classification of Diseases and Related Health Problems code J06) in occupational outpatient clinics. Methods We used occupational healthcare data of respiratory infection J06 diagnoses from 2017 to 2020 obtained from the largest health service provider in Finland. The data was divided into three 252 day-long pieces and was weekday-matched and smoothed by 7-day-moving average. The difference in the J06 diagnosis rate between the follow-up years was measured using Pearson correlation. Possible confounding by sex, age, and region was investigated in a stratified analysis. Confounding by respiratory syncytial virus was analysed using nationwide data of confirmed cases obtained from the national registry. Results In the second quarter of 2020, the trend in the daily number of J06 diagnoses was significantly different from the follow-up years 2019 and 2018. The number of J06 diagnoses peaked between March and April 2020 with roughly 2-fold higher count compared to normal. The timing of these peaks matched with the government issued infection control strategies and lockdowns. Based on stratified analysis, the increase in the number of J06 diagnoses was not confounded by region, age, or sex. Moreover, the rapid increase in the number of J06 diagnoses was not governed by the respiratory syncytial virus. Conclusion Nationwide infection control strategies were effective to slow down the spread of common respiratory infectious diseases in the occupational population.

Highlights

  • The World Health Organisation (WHO) declared the COVID-19 outbreak as a global emergency and recommended governments to take measures to slow the worldwide spread of this coronavirus

  • We studied the effects of the lockdown on the incidence of respiratory infections and further on the seasonal influenza and respiratory syncytial virus (RSV) epidemics among outpatients in occupational health care in Finland

  • The rapid increase was followed by a rapid decline shortly after the first major infection control strategy was issued by the Finnish government on 13 March 2020 (Figure 1(a))

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Summary

Introduction

The World Health Organisation (WHO) declared the COVID-19 outbreak as a global emergency and recommended governments to take measures to slow the worldwide spread of this coronavirus. On 12 March 2020, the government of Finland followed the recommendation of the WHO and the European Centre for Disease Prevention and Control (ECDC) to slow the spread of the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) [1,2]. The government of Finland ordered nationwide infection control strategies by recommending remote working whenever possible on March 12, limiting social gatherings to less than ten people, closing universities, high schools, and upper elementary schools, and encouraging parents to take care of their children at home on March 18, and quarantining the capital region of Uusimaa on March 28. The number of J06 diagnoses peaked between March and April 2020 with roughly 2-fold higher count compared to normal The timing of these peaks matched with the government issued infection control strategies and lockdowns. Conclusion: Nationwide infection control strategies were effective to slow down the spread of common respiratory infectious diseases in the occupational population

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