Abstract
Background: Respiratory viral diseases have considerably declined since the COVID-19 outbreak, perhaps through influence by nonpharmaceutical interventions. We conducted a cross-sectional study using the CDC database to compare the pre- vs. post-pandemic flu activity (incidence) between the US states. Our secondary objectives were to estimate the association between flu activity and flu vaccination rates and compare the national trends of flu and RSV activities since the pandemic outbreak. Methods: We estimated the difference between pre-pandemic (April 2019–March 2020) and post-pandemic (April 2020–March 2021) flu activity between individual states using the Wilcoxon signed-rank test. The association between flu activity and immunization rates was also measured. Finally, parallel time trend graphs for flu and RSV activities were illustrated with a time series modeler. Results: The median (IQR) pre-pandemic flu activity was 4.10 (1.38), higher than the post-pandemic activity (1.38 (0.71)) (p-value < 0.001). There was no difference between pre-pandemic (45.50% (39.10%)) and post-pandemic (45.0% (19.84%)) flu vaccine acceptance (p-value > 0.05). Flu activity and vaccination rates were not associated (p-value > 0.05). Flu activity has declined since the COVID-19 outbreak, while RSV made a strong comeback in June 2021. Conclusion: Flu activity has significantly diminished throughout the pandemic while a sudden upsurge in RSV is a public health concern indicative of possible resurgence of other viruses. Flu vaccine acceptance neither changed during the pandemic nor influenced the diminished Flu activity.
Highlights
In March 2020, COVID-19 was declared a pandemic by the World Health Organization [1].Since most countries have implemented preventive guidelines, including quarantine, social distancing, hand washing, and face mask usage in public places [2,3]
COVID-19 outbreak, while RSV made a strong comeback in June 2021
Most countries have implemented preventive guidelines, including quarantine, social distancing, hand washing, and face mask usage in public places [2,3]. These measures were primarily implemented to prevent the spread of COVID-19, incidences of other respiratory viruses were influenced by these nonpharmaceutical interventions [4,5]
Summary
Most countries have implemented preventive guidelines, including quarantine, social distancing, hand washing, and face mask usage in public places [2,3]. These measures were primarily implemented to prevent the spread of COVID-19, incidences of other respiratory viruses were influenced by these nonpharmaceutical interventions [4,5]. RSV has been the predominant cause of bronchiolitis and pneumonia in infants and affects the elderly population aged 65 years and over [8]. To the best of our knowledge, the flu vaccine acceptance trend at the time of the pandemic has not been well-reported in the USA
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