Analysis of the Effectiveness of Non-pharmaceutical Interventions on Influenza During the Coronavirus Disease-2019 Pandemic by Time-series Forecasting

Abstract

Abstract Background Coronavirus disease 2019 (COVID-19) was first identified in South Korea during the 2019–2020 seasonal influenza epidemic. The social distancing measures, as effective non-pharmaceutical interventions (NPIs), adopted to mitigate the spread of COVID-19 might have influenced influenza activity. We evaluated IFV(influenza virus) activity during the COVID-19 pandemic and the effect of NPI intensity on influenza transmission. Methods IFV activity and epidemic duration during COVID-19 pandemic were predicted under a counterfactual scenario with no NPIs against COVID-19. The Seasonal Autoregressive Integrated Moving Average Model was used to quantify the effects of NPIs on the transmission of influenza virus. Influenza-like illness/1000 outpatients and IFV positivity rate from the 2011–2012 to 2021–2022 seasons were used in this study. Results Comparison of the 2020–2021 and 2021–2022 seasonal influenza activities with those in 2013–2019 showed that COVID-19 outbreaks and associated NPIs such as face mask use, school closures, and travel restrictions reduced the influenza incidence by 91%. Without NPIs against COVID-19, the rates of influenza-like illness and influenza virus positivity would have been high during the influenza epidemic season, as in previous seasons. NPI intensity decreased the transmission of influenza; the magnitude of the reduction increased as the intensity of social-distancing measures increased (step-by-step daily recovery, 58.10%; special quarantine measures, 95.12%). Conclusions Our results suggest that NPIs and personal hygiene can be used to suppress influenza transmission. NPIs against COVID-19 may be useful strategies for the prevention and control of influenza epidemics.