NDLI: Assessing the impact of COVID-19 interventions on influenza-like illness in Beijing and Hong Kong: an observational and modeling study

Content Provider	Springer Nature : BioMed Central
Author	Zhang, Xingxing Du, Jing Li, Gang Chen, Teng Yang, Jin Yang, Jiao Zhang, Ting Wang, Qing Yang, Liuyang Lai, Shengjie Feng, Luzhao Yang, Weizhong
Abstract	Background The impact of coronavirus diseases 2019 (COVID-19) related non-pharmaceutical interventions (NPIs) on influenza activity in the presence of other known seasonal driving factors is unclear, especially at the municipal scale. This study aimed to assess the impact of NPIs on outpatient influenza-like illness (ILI) consultations in Beijing and the Hong Kong Special Administrative Region (SAR) of China. Methods We descriptively analyzed the temporal characteristics of the weekly ILI counts, nine NPI indicators, mean temperature, relative humidity, and absolute humidity from 2011 to 2021. Generalized additive models (GAM) using data in 2011–2019 were established to predict the weekly ILI counts under a counterfactual scenario of no COVID-19 interventions in Beijing and the Hong Kong SAR in 2020–2021, respectively. GAM models were further built to evaluate the potential impact of each individual or combined NPIs on weekly ILI counts in the presence of other seasonal driving factors in the above settings in 2020–2021. Results The weekly ILI counts in Beijing and the Hong Kong SAR fluctuated across years and months in 2011–2019, with an obvious winter-spring seasonality in Beijing. During the 2020–2021 season, the observed weekly ILI counts in both Beijing and the Hong Kong SAR were much lower than those of the past 9 flu seasons, with a 47.5% [95% confidence interval (CI): 42.3%, 52.2%) and 60.0% (95% CI: 58.6%, 61.1%) reduction, respectively. The observed numbers for these two cities also accounted for only 40.2% (95% CI: 35.4%, 45.3%) and 58.0% (95% CI: 54.1%, 61.5%) of the GAM model estimates in the absence of COVID-19 NPIs, respectively. Our study revealed that, “Cancelling public events” and “Restrictions on internal travel” measures played an important role in the reduction of ILI in Beijing, while the “restrictions on international travel” was statistically most associated with ILI reductions in the Hong Kong SAR. Conclusions Our study suggests that COVID-19 NPIs had been reducing outpatient ILI consultations in the presence of other seasonal driving factors in Beijing and the Hong Kong SAR from 2020 to 2021. In cities with varying local circumstances, some NPIs with appropriate stringency may be tailored to reduce the burden of ILI caused by severe influenza strains or other respiratory infections in future. Graphical Abstract
Related Links	https://idpjournal.biomedcentral.com/counter/pdf/10.1186/s40249-023-01061-8.pdf
Ending Page	15
Page Count	15
Starting Page	1
File Format	HTM / HTML
ISSN	20499957
DOI	10.1186/s40249-023-01061-8
Journal	Infectious Diseases of Poverty
Issue Number	1
Volume Number	12
Language	English
Publisher	BioMed Central
Publisher Date	2023-02-16
Access Restriction	Open
Subject Keyword	Infectious Diseases Tropical Medicine Public Health Influenza-like illness Non-pharmaceutical intervention COVID-19 SARS-CoV-2 Influenza China
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Public Health, Environmental and Occupational Health
Journal Impact Factor	4.8/2023
5-Year Journal Impact Factor	5/2023

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