Impact of non-pharmaceutical interventions targeted at COVID-19 pandemic on influenza burden – a systematic review - 19/01/21

Doi : 10.1016/j.jinf.2020.11.039

Lara Marleen Fricke ^a,^b,^⁎ , Stephan Glöckner ^a,^c , Maren Dreier ^b , Berit Lange ^a,^c
^a Helmholtz Centre for Infection Research (HZI), Inhoffenstraße 7, 38124 Braunschweig, Germany
^b Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
^c German Center for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany

^⁎Corresponding author.

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Highlights

•	Evidence synthesis suggests that NPIs targeted at SARS-CoV-2-transmission reduce influenza burden as well.
•	Surveillance systems are often not sufficiently described using adequate quality indicators, thus leading to uncertainties and a risk of misclassification.
•	Low threshold NPIs such as enforcing current hygiene rules as additional components of local seasonal influenza strategies have the potential to relevantly decrease influenza disease burden and excess mortality.

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Abstract

Objectives

To better understand the impact of comprehensive COVID-19 targeted non-pharmaceutical interventions (NPIs) on influenza burden worldwide.

Methods

We conducted a systematic literature search in selected databases (PubMed, WHO COVID-19), preprint servers (medRxiv, bioRxiv) and websites of European Public Health institutes. Documents that compared influenza estimates in the 2019/2020 season with previous seasons were included. Information synthesis was qualitative due to a high heterogeneity in the number and periods of comparative seasons, outcome measures and statistical methods.

Results

We included 23 records reporting from 15 countries/regions as well as 8 reports from European Public Health agencies. Estimates in the 2019/2020 season based on influenza virus tests (4 out of 7 countries/regions), defined influenza cases (8 out of 9), influenza positivity rate (7 out of 8), and severe complications (1 out of 2) were lower than in former seasons. Results from syndromic indicators, such as influenza-like-illness (ILI), were less clear or even raised (4 out of 7) after the influenza season indicating a misclassification with COVID-19 cases.

Conclusions

Evidence synthesis suggests that NPIs targeted at SARS-CoV-2-transmission reduce influenza burden as well. Low threshold NPIs need to be more strongly emphasized in influenza prevention strategies.

Le texte complet de cet article est disponible en PDF.