Implementation Of Public Health Measures Research Articles

The secondary outcome of public health measures amidst the COVID-19 pandemic in the spread of other respiratory infectious diseases in Thailand

The coronavirus disease 2019 (COVID-19) has promoted stringent public health measures such as hand hygiene, face mask wearing, and physical distancing to contain the spread of the viral infection. In this retrospective study, the secondary outcomes of those public health measures on containing other respiratory infections among the Thai population were investigated. Hospitalization data spanning from 2016 to 2021 of six respiratory infectious diseases, namely influenza, measles, pertussis, pneumonia, scarlet fever, and tuberculosis (TB), were examined. First, the expected respiratory infectious cases where no public health measures are in place are estimated using the seasonal autoregressive integrated moving average (SARIMA) model. Then the expected number of cases and the observed cases were compared. The results showed a significant drop in the incidence of respiratory infectious diseases by an average of 61%. The reduction in hospitalization is significant for influenza, measles, pertussis, pneumonia, and scarlet fever (p < 0.05), while insignificant for TB (p = 0.54). The notable decrease in the incidence of cases is ascribed to the implementation of public health measures that minimized the opportunity for spread of disease. This decline in cases following relaxation of pandemic countermeasure is contingent on its scope and nature, and it is proof that selective physical distancing, hand hygiene, and use of face masks in public places is a viable route for mitigating respiratory morbidities.

Aneurysmal Subarachnoid Hemorrhage during the Shutdown for COVID-19.

The aim was to evaluate hospitalization rates for aneurysmal subarachnoid hemorrhage (SAH) within an interdisciplinary multicenter neurovascular network (NVN) during the shutdown for the COVID-19 pandemic along with its modifiable risk factors. In this multicenter study, admission rates for SAH were compared for the period of the shutdown for the COVID-19 pandemic in Germany (calendar weeks (cw) 12 to 16, 2020), the periods before (cw 6–11) and after the shutdown (cw 17–21 and 22–26, 2020), as well as with the corresponding cw in the years 2015–2019. Data on all-cause and pre-hospital mortality within the area of the NVN were retrieved from the Department of Health, and the responsible emergency medical services. Data on known triggers for systemic inflammation, e.g., respiratory viruses and air pollution, were analyzed. Hospitalizations for SAH decreased during the shutdown period to one-tenth within the multicenter NVN. There was a substantial decrease in acute respiratory illness rates, and of air pollution during the shutdown period. The implementation of public health measures, e.g., contact restrictions and increased personal hygiene during the shutdown, might positively influence modifiable risk factors, e.g., systemic inflammation, leading to a decrease in the incidence of SAH.

Human biomonitoring of persistent and non-persistent pollutants in a representative sample of the general population from Cape Verde: Results from the PERVEMAC-II study

International Public Health authorities recommend biomonitoring studies to assess the exposure to chemicals in the general population. The aim of the present study was to analyze the blood concentrations of a total 360 pollutants, including 230 pesticides in current or recent use, 59 persistent organochlorine pollutants (POPs), 11 anticoagulant rodenticides and 60 pharmaceutical active compounds (PhACs), in a cohort of 403 subjects from Cape Verde. The study was performed in the frame of the Pesticide Residues in Vegetables of the Macaronesia project (PERVEMAC-II). A total of 60 out of 360 toxic compounds (16.7%) were detected, at least, in one participant. The three most frequently detected substances were p,p’-DDE (100%), phenanthrene (94.0%) and hexachlobenzene (35.9%). 2-Phenylphenol and imidacloprid were detected in 29.0 and 14.4% of the population. The three substances with the highest serum concentrations were PhACs: naproxen (249.1 ng/mL), metronidazole (115.6 ng/mL) and acetaminophen (25.2 ng/mL). Median blood concentration of p,p’-DDE, HCB and phenanthrene were 1.87, 0.08 and 0.36 ng/mL. Blood concentrations of POPs were influenced by age, although both gender and body mass index may exert an influence in the presence of these substances. Lifestyle has an effect on the concentration of these substances, especially in terms of dietary habits. Both the frequency of detection and the concentration of the studied substances are similar to those of other biomonitored populations. This is the first biomonitoring study carried out in Cape Verde. Our results may be useful for the implementation of public health measures by the competent authorities.

An Epidemiological Study to Investigate Links between Atmospheric Pollution from Farming and SARS-CoV-2 Mortality.

Exposure to atmospheric particulate matter and nitrogen dioxide has been linked to SARS-CoV-2 infection and death. We hypothesized that long-term exposure to farming-related air pollutants might predispose to an increased risk of COVID-19-related death. To test this hypothesis, we performed an ecological study of five Italian Regions (Piedmont, Lombardy, Veneto, Emilia-Romagna and Sicily), linking all-cause mortality by province (administrative entities within regions) to data on atmospheric concentrations of particulate matter (PM2.5 and PM10) and ammonia (NH3), which are mainly produced by agricultural activities. The study outcome was change in all-cause mortality during March–April 2020 compared with March–April 2015–2019 (period). We estimated all-cause mortality rate ratios (MRRs) by multivariate negative binomial regression models adjusting for air temperature, humidity, international import-export, gross domestic product and population density. We documented a 6.9% excess in MRR (proxy for COVID-19 mortality) for each tonne/km2 increase in NH3 emissions, explained by the interaction of the period variable with NH3 exposure, considering all pollutants together. Despite the limitations of the ecological design of the study, following the precautionary principle, we recommend the implementation of public health measures to limit environmental NH3 exposure, particularly while the COVID-19 pandemic continues. Future studies are needed to investigate any causal link between COVID-19 and farming-related pollution.

IDF21-0611 The COVID-19 pandemic and Type 1 Diabetes (T1D): effect of the second wave on newly diagnosed children with T1D

Background: The COVID-19 pandemic had affected the access to the healthcare services around the world. During the first wave of the COVID-19 pandemic that occurred in Kuwait on Feb 24th, 2020, the official health authorities implemented public health measures such as curfews, total lockdowns, and diabetes clinics' unavailability, along with limited access to healthcare services. The second wave of the pandemic was declared on March 7, 2021; virtual visits, diabetes clinics‘ availability, and easier access to the hospitals might change the Diabetes Ketoacidosis (DKA) at presentation and the requirement of ICU admission in children with Type 1 Diabetes (T1D) onset in the second wave.

Analysis of Risk of Death due to COVID-19 in Cameroon

Background Cameroon is battling against the novel coronavirus (COVID-19) pandemic. Although several control measures have been implemented, the epidemic continues to progress. This paper analyses the evolution of the pandemic in Cameroon and attempts to provide insight on the evolution of COVID-19 within the country’s population. Methods A susceptible-infected-recovered-dead (SIRD)-like model coupled with a discrete time-dependent Markov chain was applied to predict COVID-19 distribution and assess the risk of death. Two main assumptions were examined in a 10-state and 3-state Markov chain: i) a recovered person can get infected again; ii) the person will remain recovered. The COVID-19 data collected in Cameroon during the period of March 6 to July 30, 2020 were used in the analysis. Results COVID-19 epidemic showed several peaks. The reproductive number was 3.08 between May 18 and May 31; 2.75 between June 1 and June 25, and 2.84 between June 16 and June 24. The number of infected individuals ranged from 17632 to 26424 (June 1 to June 15), and 28100 to 36628 (June 16 to June 24). The month of January 2021 was estimated as the last epidemic peak. Under the assumption that a recovered person will get infected again with probability 0.15, 50000 iterations of the Markov chain (10 and 3- state) demonstrated that the death state was the most probable state. The estimated lethality rate was 0.44, 95%CI=0.10%-0.79%. Mean lethality rate assuming ii) was 0.10. Computation of transition probabilities from reported data revealed a significant increase in the number of active cases throughout July and August, 2020, with a mean lethality rate of 3% by September 2020. Conclusion Multiple approaches to data analysis is a fundamental step for managing and controlling COVID-19 in Cameroon. The rate of transmission of COVID-19 is growing fast because of insufficient implementation of public health measures. While the epidemic is spreading, assessment of major factors that contribute to COVID-19-associated mortality may provide the country’s public health system with strategies to reduce the burden of the disease. The model outputs present the threatening nature of the disease and its consequences. Considering the model outputs and taking concrete actions may enhance the implementation of current public health intervention strategies in Cameroon. Strict application of preventive measures, such as wearing masks and social distancing, could be reinforced before and after the opening of learning institutions (schools and universities) in the 2020/2021 calendar year and next.

The Environment Encouraging COVID-19 Response at Public Health Centers and Future Challenges in Japan.

The coronavirus disease 2019 (COVID-19) pandemic has triggered the implementation of public health measures globally. The health department of local governments has played a critical role in confronting COVID-19. In Japan, public health centers (PHCs) are focal points for COVID-19 response. Understanding the response to COVID-19 in local areas is critical to ensure adequate preparation for future emergencies. Therefore, the purpose of this study is to clarify how the COVID-19 operations by PHCs in Japan were managed and facilitated at the beginning of the infection spread, and their future challenges. We designed a case study that included two PHCs with a population of approximately 400,000 in Japan. Semi-structured focus group interviews with public health nurses from these two PHCs were conducted in September and October 2020. The data were analyzed using chronological time-series analysis. The switch to crisis response was encouraged by the business continuity plan. Their operations for the prevention of COVID-19 in the community were facilitated by the existing network. Further, strengthening the knowledge and skill regarding infectious disease control and management skills during infectious disease-related health emergencies were recommended. It is important to ensure that the environment facilitates emergency response and that people-and-community-centered health promotion activities are conducted, during an emergency situation, with more innovative action and leadership.

Interpretation of Discrepancies between Cities in the Transmission of COVID-19: Evidence from China in the First Weeks of the Pandemic

ObjectivesThis study aims to examine and explain the differences at city level in cumulative COVID-19 cases and time from first to last infection during the first 6 weeks of the epidemic in China. MethodsA quantitative study is conducted in China based on the multisource spatial data of 315 Chinese cities. Firstly, the spatial discrepancy of COVID-19 transmission was examined based on spatial autocorrelation analysis and hot pot analysis. Next, a comprehensive indicator framework was established by including a wide range of factors such as human mobility, geographical features, public health measures, and residents’ awareness. Finally, multivariate regression models using these variables were constructed to identify the determinants of COVID-19 transmission. ResultsSignificant spatial discrepancy of transmission was proved, and 10 determinants were identified. ConclusionsThe transmission consequence (measured by the number of cumulative cases) was mostly correlated with the migration scale from Wuhan, followed by socioeconomic factors. Transmission duration (measured as the time from the first to last case within the city) was mostly determined by total migration scale and lockdown speed, which suggests that timely implementation of public health measures facilitated fast control of transmission. Residents’ attention to COVID-19 was proved to be not only helpful for reducing confirmed cases, but also in favor of rapid transmission control. Altitude produced slight but significant effect on transmission duration. These conclusions are expected to provide decision support for the local governments of China and other jurisdictions.

The Role of Children and Young People in the Transmission of SARS-CoV-2.

The Role of Children and Young People in the Transmission of SARS-CoV-2.

The impact of COVID-19 and associated measures on health, police, and non-government organisation service utilisation related to violence against women and children

BackgroundGlobally, concerns have been raised that the priority implementation of public health measures in response to COVID-19 may have unintended negative impacts on a variety of other health and wellbeing factors, including violence. This study examined the impact of COVID-19 response measures on changes in violence against women and children (VAWC) service utilisation across European countries.MethodsA rapid assessment design was used to compile data including a survey distributed across WHO Europe Healthy Cities Networks and Violence Injury Prevention Focal Points in WHO European Region member states, and a scoping review of media reports, journal articles, and reports. Searches were conducted in English and Russian and covered the period between 1 January 2020 and 17 September 2020. Data extracted included: country; violence type; service sector; and change in service utilisation during COVID-19. All data pertained to the period during which COVID-19 related public health measures were implemented compared to a period before restrictions were in place.ResultsOverall, findings suggested that there was a median reported increase in VAWC service utilisation of approximately 20% during the COVID-19 pandemic. Crucially, however, change in service utilisation differed across sectors. After categorising each estimate as reflecting an increase or decrease in VAWC service utilisation, there was a significant association between sector and change in service utilisation; the majority of NGO estimates (95.1%) showed an increase in utilisation, compared to 58.2% of law enforcement estimates and 42.9% of health and social care estimates.ConclusionsThe variation across sectors in changes in VAWC service utilisation has important implications for policymakers in the event of ongoing and future restrictions related to COVID-19, and more generally during other times of prolonged presence in the home. The increased global attention on VAWC during the pandemic should be used to drive forward the agenda on prevention, increase access to services, and implement better data collection mechanisms to ensure the momentum and increased focus on VAWC during the pandemic is not wasted.

Dengue Virus Cases Surge Amidst COVID-19 in Pakistan: Challenges, Efforts and Recommendations.

Pakistan is currently facing two outbreaks, dengue and COVID-19; both have strained its healthcare system resulting in multiple concerns including the co-diagnosis of two. Due to poor healthcare capacity, low vaccination rate, increasing COVID-19 variants, socioeconomic disparities, and misinformation, it is inevitable that implications will prove to be damaging to both healthcare workers and civilians. Among these challenges, it is important to note the need for stronger epidemiological surveillance for both COVID-19 and dengue and the implementation of public health measures without endangering sources of livelihood. To sustain this, cooperation between WHO and Pakistan’s government must continue through smart lockdowns, dengue awareness campaigns, and double laboratory procedures.

Has the COVID-19 pandemic wiped out the seasonality of outpatient antibiotic use and influenza activity? A time-series analysis from 2014 to 2021

ObjectiveTo assess the influence of the emergence of severe acute respiratory syndrome coronavirus 2 and the implementation of public health measures on the seasonality of outpatient antibiotic use and their possible association with the incidence of influenza. MethodsWe performed a time-series ecological study in 1516 primary care centres of Andalusia, Spain, comparing the coronavirus disease 2019 period (April 2020 to March 2021) with the 6 previous years. We assessed the number of packs and defined daily doses per 1000 inhabitants of antibacterials and key antibiotics commonly used for acute respiratory tract infections and the number of influenza-positive cases per 100 000 inhabitants. We calculated the correlation between variables and analyzed the seasonal patterns and differences in quarterly antibiotic use. ResultsFor all quarters, a significant correlation was observed between influenza activity and antibiotic use (Spearman's r = 0.94; p < 0.001). Before the pandemic period, both variables presented similar seasonal patterns. After the start of the pandemic, influenza activity was suppressed and the pattern of antibiotic use flattened into a straight line (R2 = 0.96; p = 0.022) with a quarterly change of 3.9% (p = 0.007). Total antibiotic use and antibiotics used for treating acute respiratory tract infections showed significant reductions in all quarters compared to the previous year (p < 0.01). DiscussionThe coronavirus disease 2019 pandemic has strongly influenced the seasonality of antibiotic use in primary care. The decline in respiratory viruses, among which the influenza virus is a major player that may act as a proxy for general prevalence, is proposed as a reason for the flattening of the seasonal fluctuations of outpatient antibiotic use in our region.

Effects of public health measures during the SARS-CoV-2 pandemic on the winter respiratory syncytial virus epidemic: An interrupted time series analysis.

Public health measures (PHM) designed to contain the spread of COVID-19 pandemic have influenced the epidemiological characteristics of other viral infections. Its impact on acute RSV bronchiolitis in infants of ≤24months old has not been systematically studied in our setting. To describe the monthly pattern of visits to the Paediatric Emergency Department (PED) of patients 0 to 14years of age, the rate of patients diagnosed with RSV acute bronchiolitis per thousand inhabitants of 0 to 24months, and the rate of them requiring hospital admission during the winter 2020-2021, in the context of local and national COVID-19 restrictions and compare them to the four previous seasons. Interrupted time series analysis of patients assisted in the PED and diagnosed with or admitted for RSV acute bronchiolitis in a tertiary University Hospital from January 2016 to February 2020 (pre-intervention period) and from March 2020 to June 2021 (post-intervention period). Preventive PHM implemented by the Spanish government weighted by the Containment and Health Index of the Oxford COVID-19 Government Response Tracker. The intervention was followed by an immediate reduction of the rate of visits to the PED of -19.5 (95% confidence interval [CI] -24.0, -14.9) per thousand, and the rate of diagnoses and admissions for RSV acute bronchiolitis of -44.3 (95% CI -73.8, -14.8) and -1.4 (95% CI -2.7, -0.1) per thousand, respectively, with a delayed rebound. After the implementation of PHM to prevent the spread of SARS-CoV-2 infection, an immediate and important decline in the visits to the PED was observed, with an upward change thereafter. There was also an initial reduction in the diagnoses of and admissions by RSV acute bronchiolitis. An upward trend was observed six to nine months after the usual time of the winter RSV epidemic, coinciding with the relaxation of the preventive PHM.

Salmonellosis in Australia in 2020: possible impacts of COVID-19 related public health measures.

More than seventy per cent of salmonellosis in Australia is thought to be due to contaminated food. Rates of salmonellosis vary across the Australian states and territories, with the highest rates in the Northern Territory. In 2020, to control coronavirus disease 2019 (COVID-19), Australia implemented public health measures including border closures, physical distancing and hygiene advice. This study analyses salmonellosis notification rates in 2020 and considers possible impacts of COVID-19 measures. Monthly and annual salmonellosis notifications per 100,000 population, for each of Australia's eight states and territories for the years 2015 to 2020, were extracted from Australia's publicly accessible National Notifiable Diseases Surveillance System. For each jurisdiction, the salmonellosis rate each month in 2020 was compared with the previous 5-year median rate for that calendar month. The possible impacts of COVID-19 public health measures on salmonellosis notifications in the respective states and territories were examined. The annual Australian salmonellosis notification rate was 27% lower in 2020 than the previous 5-year median. The reduction in salmonellosis rate varied throughout Australia. States and territories with more stringent, more frequent or longer COVID-19 public health measures had generally greater salmonellosis rate reductions. However, Tasmania had a 50% deeper reduction in salmonellosis rate than did the Northern Territory, despite similar restriction levels. Salmonellosis notifications decreased in Australia during the global COVID-19 pandemic. The reduction in notifications corresponded with the implementation of public health measures. Persistence of high rates in the Northern Territory could indicate the overarching importance of demographic and environmental factors.

First molecular-based detection study of Leishmania infantum in the Tapirapé indigenous population in the Brazilian Amazon.

Species of the genus Leishmania parasitize mammals and have life cycles that alternate between vertebrate and invertebrate hosts. Most species develop in a hematophagous arthropod and infect a specific vertebrate host that may belong to diverse orders and families. Visceral leishmaniasis is a chronic zoonosis with a wide geographic distribution, affecting 350 million people globally, mostly in areas with a high risk of infection. In Brazil, this disease not only has a high incidence but is also expanding to new areas, both in urban centers and rural areas, including territories with tribal communities, due to increasing human intervention. The objective of this study was to perform cathepsin L-like gene-based molecular diagnosis of Leishmania infantum in the indigenous Tapirapé ethnic group in the state of Mato Grosso. From the 372 individuals assessed, only 0.8% (3/372) tested positive for L. infantum, all from the same village (Urubu Branco). Despite the small number of infected individuals, this study demonstrates the first human cases of Leishmania infantum infection in this population, suggesting the need for regular monitoring of visceral leishmaniasis in the area and leading to a broad discussion on the planning and implementation of public health measures for the indigenous population, while respecting their distinctive territories and culture.

Exploring the Barriers in Maintaining the Health Guidelines Amid the COVID-19 Pandemic: A Qualitative Study Approach.

Due to the Irretrievable impacts of the COVID-19 pandemic on society, this study aimed to analyze the barriers and reasons for the Iranian people’s implementation of public health measures during the COVID-19 pandemic in 2021. The study explores the barriers and reasons for non-compliance by Iranian people in following and maintaining the health guidelines to combat the spread of the coronavirus in 2021. This research is qualitative and recorded participants’ feedback from the Ardabil province of Iran. The study used a purposeful sampling method and lasted from April to May 2021 to collect the data through semi-structured interviews with 45 participants based on their gender, education, employment status, and marital status. The researchers analyzed the qualitative content until the required data-target through interviews implementation. This study incorporated MAXQDA version 10 to analyze the data and followed Goba and Lincoln’s criteria to ensure quality research results. After analyzing the data, two main categories (internal and external barriers) and seven subcategories were obtained. The internal barriers exhibited further classified subcategories, such as mental, belief, and awareness barriers. The results indicated that external barriers included social, political, managerial, and economic barriers. The study results designated that a set of internal and external factors might cause individuals' non-compliance with health guidelines and standard SOPs in the advent of the pandemic COVID-19. Recognition of such factors, identified following the social, cultural, and political context and individuals' characteristics during the COVID-19 outbreak, can be used effectively to plan educational and management programs. As a result, elimination and eradication of obstacles and the relevant dimensions may facilitate disease control. Moreover, the high prevalence and spread of the disease can be managed by reducing the influence of factors preventing proper health behaviors.

Cost-Effective Method to Perform SARS-CoV-2 Variant Surveillance: Detection of Alpha, Gamma, Lambda, Delta, Epsilon, and Zeta in Argentina.

SARS-CoV-2 variants with concerning characteristics have emerged since the end of 2020. Surveillance of SARS-CoV-2 variants was performed on a total of 4,851 samples from the capital city and 10 provinces of Argentina, during 51 epidemiological weeks (EWs) that covered the end of the first wave and the ongoing second wave of the COVID-19 pandemic in the country (EW 44/2020 to EW 41/2021). The surveillance strategy was mainly based on Sanger sequencing of a Spike coding region that allows the identification of signature mutations associated with variants. In addition, whole-genome sequences were obtained from 637 samples. The main variants found were Gamma and Lambda, and to a lesser extent, Alpha, Zeta, and Epsilon, and more recently, Delta. Whereas, Gamma dominated in different regions of the country, both Gamma and Lambda prevailed in the most populated area, the metropolitan region of Buenos Aires. The lineages that circulated on the first wave were replaced by emergent variants in a term of a few weeks. At the end of the ongoing second wave, Delta began to be detected, replacing Gamma and Lambda. This scenario is consistent with the Latin American variant landscape, so far characterized by a concurrent increase in Delta circulation and a stabilization in the number of cases. The cost-effective surveillance protocol presented here allowed for a rapid response in a resource-limited setting, added information on the expansion of Lambda in South America, and contributed to the implementation of public health measures to control the disease spread in Argentina.

Impact of school closures and re-openings on COVID-19 transmission.

Globally, the education of students at primary and secondary schools has been severely disrupted by the implementation of school closures to reduce the spread of coronavirus disease 2019 (COVID-19). The effectiveness of school closures in reducing transmission of COVID-19 and the impact of re-opening schools are unclear. Research criteria for this rapid review included empirical studies, published or pre-published worldwide before January 25, 2021, that assessed the effectiveness of school closures in reducing the spread of COVID-19 and the impact of school re-openings on COVID-19 transmission. Twenty-four studies on the impact of school closures and re-openings on COVID-19 transmission were identified through the seven databases that were searched. Overall the evidence from these studies was mixed and varied due to several factors such as the time of implementation of public health measures, research design of included studies and variability among the levels of schooling examined. Preliminary findings suggest that school closures have limited impact on reducing COVID-19 transmission, with other non-pharmaceutical interventions considered much more effective. However, due to the limitations of the studies, further research is needed to support the use of this public health measure in response to the COVID-19 pandemic.

Public health implications of SARS-CoV-2 variants of concern: a rapid scoping review

ObjectivesThe four SARS-CoV-2 variants of concern (VOC; Alpha, Beta, Gamma and Delta) identified by May 2021 are highly transmissible, yet little is known about their impact on public health measures....

The indirect impact of COVID-19 pandemic on inpatient admissions in 204 Kenyan hospitals: An interrupted time series analysis.

The first case of severe acute respiratory coronavirus 2 (SARS-CoV-2) was identified in March 2020 in Kenya resulting in the implementation of public health measures (PHM) to prevent large-scale epidemics. We aimed to quantify the impact of COVID-19 confinement measures on access to inpatient services using data from 204 Kenyan hospitals. Data on monthly admissions and deliveries from the District Health Information Software version 2 (DHIS 2) were extracted for the period January 2018 to March 2021 stratified by hospital ownership (public or private) and adjusting for missing data using multiple imputation (MI). We used the COVID-19 event as a natural experiment to examine the impact of COVID-19 and associated PHM on use of health services by hospital ownership. We estimated the impact of COVID-19 using two approaches; Statistical process control (SPC) charts to visualize and detect changes and Interrupted time series (ITS) analysis using negative-binomial segmented regression models to quantify the changes after March 2020. Sensitivity analysis was undertaken to test robustness of estimates using Generalised Estimating Equations (GEE) and impact of national health workers strike on observed trends. SPC charts showed reductions in most inpatient services starting April 2020. ITS modelling showed significant drops in April 2020 in monthly volumes of live-births (11%), over-fives admissions for medical (29%) and surgical care (25%) with the greatest declines in the under-five's admissions (59%) in public hospitals. Similar declines were apparent in private hospitals. Health worker strikes had a significant impact on post-COVID-19 trends for total deliveries, live-births and caesarean section rate in private hospitals. COVID-19 has disrupted utilization of inpatient services in Kenyan hospitals. This might have increased avoidable morbidity and mortality due to non-COVID-19-related illnesses. The declines have been sustained. Recent data suggests a reversal in trends with services appearing to be going back to pre- COVID levels.