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ORIGINAL RESEARCH article

Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1437485

Lifting COVID-19-associated non-pharmaceutical interventions: potential impact on notifications of infectious diseases transmitted from person to person in 2022 in Bavaria, Germany

Provisionally accepted
Judith Hausmann Judith Hausmann 1,2,3*Achim Dörre Achim Dörre 4Katharina Katz Katharina Katz 3Sarah van de Berg Sarah van de Berg 3
  • 1 Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Munich, Germany
  • 2 Pettenkofer School of Public Health, Munich, Germany
  • 3 Bavarian Health and Food Safety Authority (LGL), Munich, Germany
  • 4 Department of Infectious Disease Epidemiology, Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute, Berlin, Germany

The final, formatted version of the article will be published soon.

    Background The COVID-19 pandemic and associated non-pharmaceutical interventions (NPIs) have led to substantial decreases in case numbers of infectious diseases in several countries worldwide. As NPIs were gradually lifted, intense or out-of-season outbreaks of respiratory and gastrointestinal diseases were reported, raising the hypothesis of a potential catch-up effect of infections. By analysing surveillance data from the federal reporting system for notifiable infectious diseases, we aimed to assess the potential impact of lifting COVID-19 associated NPIs on notifications of selected infectious diseases in Bavaria, 2022. Methods We compared influenza, chickenpox, norovirus gastroenteritis, rotavirus gastroenteritis weekly case numbers in a pre-pandemic period (2016–2019) and 2022 using two time series analyses approaches: i) a predictive model forecasting weekly case numbers for the pandemic years 2020–2022, based on 2016–2019 data, ii) interrupted time series model, based on 2016–2022 data, including a term per pandemic period. Results In 2022, incidence rates were higher compared to pre-pandemic period for influenza (IRR=3.47, 95%CI: 1.49–7.94) and rotavirus gastroenteritis (IRR=1.36, 95%CI: 0.95–1.93), though not significant for rotavirus gastroenteritis. Conversely, case numbers remained significantly below pre-pandemic levels for chickenpox (IRR=0.52, 95%CI: 0.41–0.65) and norovirus gastroenteritis (IRR=0.59, 95%CI: 0.42–0.82). Seasonality changed notably for influenza, showing in an earlier influenza wave compared to pre-pandemic periods. Conclusion: The lifting of NPIs was associated with heterogenic epidemiological patterns depending on the selected disease. The full impact of NPIs and their discontinuation may only become clear with continued monitoring and assessment of potential additional contributing factors.

    Keywords: Infectious diseases, surveillance, pandemic, Non-pharmaceutical interventions, influenza, Chickenpox, Norovirus gastroenteritis, Rotavirus gastroenteritis

    Received: 23 May 2024; Accepted: 16 Jul 2024.

    Copyright: © 2024 Hausmann, Dörre, Katz and van de Berg. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Judith Hausmann, Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Munich, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.