BACKGROUND
Acute gastrointestinal illnesses are of the most common problems evaluated by physicians, and some of the most preventable. There is evidence of GI pathogen transmission when people are in close contact. The COVID-19 pandemic led to the sudden implementation of wide spread social distancing measures in the United States. There is strong evidence that social distancing measures impact the spread of SARS-CoV-2, and a growing body of research indicates that these measures also decrease the transmission of other respiratory pathogens.
OBJECTIVE
To our knowledge, there are no peer-reviewed studies examining the impact of social distancing measures on the transmission of GI pathogens. This study aims to investigate the impact of COVID-19 social distancing mandates on the GI pathogen positivity rates.
METHODS
De-identified gastrointestinal panel PCR test results from a routinely collected diagnostic database from January 2019 through August 2020 were analyzed for positivity percentage. An interrupted time series was performed, using social distancing mandate issuance dates as the intervention date. Three target organisms were chosen for the final analysis to represent different primary transmission routes: adenovirus F40/41, norovirus GI/GII, and Escherichia coli O157.
RESULTS
In total, 84,223 total test results from nine states were included in the final dataset. With the exception of E. coli O157 in Kansas, Michigan and Nebraska, we observed an immediate decrease in positivity percentage during the week of social distancing mandates for all other targets and states. Norovirus GI/GII showed the most notable drop in positivity, while E. coli O157 appeared to be least impacted by social distancing mandates. While we acknowledge the analysis has a multiple testing problem, the majority of our significant results showed significance even at the 0.01 level.
CONCLUSIONS
This study aimed to investigate the impact of social distancing mandates meant for COVID-19 on GI pathogen positivity, and we discovered that social distancing measures did in fact decrease positivity initially. The use of similar measures may prove useful in GI pathogen outbreaks. The use of a unique diagnostic database in this study exhibits the potential for its use as a public health surveillance tool.