Reduction of Influenza and Enterovirus Infection in Taiwan during the COVID-19 Pandemic

Abstract

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is believed to be transmitted through respiratory droplets, aerosols, and contact. During the COVID-19 pandemic, Taiwan has implemented timely and accurate non-pharmaceutical intervention (NPI) measures on a national level (i.e., border control, quarantine and isolation, contact tracing, delay of school opening, and suspension of mass gatherings), and promoted personal hygiene habits to the public (i.e., frequent hand washing with soap, face masks wearing). Consequently, as of July 27, Taiwan has had relatively low number of confirmed cases (458) and deaths (7), and no locally transmitted cases for more than 30 consecutive days. We observed from data collected via Taiwan National Infectious Disease Statistics System that during the COVID-19 pandemic, outpatient visits for other infectious diseases such as influenza, which is also transmitted through droplets, aerosols, and contact, and enterovirus infections, transmitted via faecal-oral route or respiratory transmissions, have reduced significantly compared to previous two years. Epidemic trend for both diseases have also changed, with seasonal influenza activities ending weeks earlier than it did in 2018 and 2019, and lack of increase in enterovirus infections that is usually witnessed at the end of March. Our observation suggest the NPI measures and personal hygiene habits enforced against the COVID-19 pandemic may have inadvertently "flattened the curve" for influenza and enterovirus infections as well. This may indirectly relieve the stress on Taiwan's health system and healthcare workers during the COVID-19 crisis. More information will be needed to verify this hypothesis.

Differentiating impacts of non‐pharmaceutical interventions on non‐coronavirus disease‐2019 respiratory viral infections: Hospital‐based retrospective observational study in Taiwan

“…Our results provide compelling evidence that current NPIs may have limited impacts on combating non‐enveloped NCRVs. Contrary to existing findings from TNIDSS and the National Health Insurance Research Database, our hospital‐based research showed that test positivity rates in both adults and children for EnV/RhV remained stagnant 19 . The observed differentiated impacts of NPIs on enveloped and non‐enveloped viruses can be explained by three factors.…”

“…Subjected to such limitations, our test positivity rates of EnV/RhV can be biased and of limited use. Lastly, physical distancing, the universal wearing of masks, and hand hygiene have all been reported to be effective in reducing NCRVs transmission 16‐19 . While non‐pharmaceutical interventions might have had synergistic effects to prevent transmission of NCRVs, the size and extent of effectiveness should be carefully examined through a systemic approach.…”

COVID‐19 pandemic and its consequences disrupt epidemiology of enterovirus meningitis, South–East France

“…We also speculate that the continuous promotion of hygiene and social distancing measures may have played a role. Other studies showed that this pandemic affected the circulation of several viral pathogens particularly in the pediatric population [7][8][9][10][11][12] and results similar to ours were recently published (data from Minnesota, USA). 13 A better understanding of this phenomenon could help to control more effectively epidemic infectious diseases.…”

Detection of Cytopathic Effects Induced by Influenza, Parainfluenza, and Enterovirus Using Deep Convolution Neural Network

“…While enterovirus infections often present relatively mild symptoms, infections with polio enteroviruses are typically associated with severe complications. Every year in Taiwan, enterovirus infections begin to spread in late March and reach a peak around mid-June [ 3 ]. Therefore, it is crucial to diagnose these viral infections early and establish a surveillance program to monitor them further.…”