How the Norwegian population was affected by non-pharmaceutical interventions during the first six weeks of the COVID-19 lockdown.

AIMS: The aim of this study was to examine how the Norwegian general adult population was affected by non-pharmaceutical interventions during the first six weeks of the COVID-19 lockdown. We assessed quarantine, symptoms, social distancing, home office/school, work status, social contact and health-care contact through digital access and knowledge. METHODS: A cross-sectional survey was performed of 29,535 adults (aged 18-99) in Norway after six weeks of non-pharmaceutical interventions in March/April 2020. RESULTS: Most participants found the non-pharmaceutical interventions to be manageable, with 20% of all adults and 30% of those aged <30 regarding them as acceptable only to some or a limited degree. Sixteen per cent had been quarantined, 6% had experienced symptoms that could be linked to COVID-19 and 84% practiced social distancing. Eleven per cent reported changes in the use of health and social services. Three-quarters (75%) of those who had mental health or physiotherapy sessions at least monthly before the pandemic reported a reduction in their use of these services. A substantial reduction was also seen for home nursing, hospital services and dentists compared to usage before the non-pharmaceutical interventions. Immigrants were more likely to experience a reduction in follow-up from psychologists and physiotherapy. With regard to the use of general practitioners, the proportions reporting an increase and a reduction were relatively equal. CONCLUSIONS: The non-pharmaceutical interventions were perceived as manageable by the majority of the adult general population in Norway at the beginning of the COVID-19 pandemic. A substantial proportion of adults <30 years old experienced difficulties with social distancing, and those >70 years old lacked the digital tools and knowledge. Further, immigrant access to health services needs monitoring and future attention.

Effects of different levels of non-pharmaceutical interventions on hand, foot and mouth disease in Guangzhou, China.

BACKGROUND: Non-pharmaceutical interventions (NPIs) against coronavirus disease 2019 (COVID-19) may have suppressed the transmission of other infectious diseases. This study aimed to evaluate the impact of different degrees of NPIs during the COVID-19 pandemic on hand, foot and mouth disease (HFMD) in Guangzhou, China. METHODS: Weekly reported HFMD cases and pathogens information during 2015-2021 in Guangzhou were collected from the China National Notifiable Disease Reporting System. The observed number of HFMD cases in 2020 and 2021 was compared to the average level in the same period during 2015-2019. Then, an interrupted time-series segmented regression analysis was applied to estimate the impact of NPIs on HFMD, such as social distancing, suspension of schools, community management and mask wearing. The effects across different subgroups stratified by gender, children groups and enterovirus subtype of HFMD were also examined. RESULTS: A total of 13,224 and 36,353 HFMD cases were reported in 2020 and 2021, which decreased by 80.80% and 15.06% respectively compared with the average number of cases in the same period during 2015-2019. A significant drop in the number of HFMD cases during time when strict NPIs were applied (relative change: 69.07% [95% confidence interval (CI): 68.84%-69.30%]). The HFMD incidence rebounded to historical levels in 2021 as the lockdown eased. The slightest reduction of HFMD cases was found among children at kindergartens or childcare centres among the three children groups (children at kindergartens or childcare centres: 55.50% [95% CI: 54.96%-56.03%]; children living at home: 72.64% [95% CI: 72.38%-72.89%]; others: 74.06% [95% CI: 73.19%-74.91%]). CONCLUSIONS: The strong NPIs during the COVID-19 epidemic may have a significant beneficial effect on mitigating HFMD. However, the incidence of HFMD rebounded as the NPIs became less stringent. Authorities should consider applying these NPIs during HFMD outbreaks and strengthening personal hygiene in routine prevention.

Circulating trends of hand, foot, and mouth disease in Hubei Province, China: Impact from the COVID-19 pandemic.

Objectives: This study was performed to investigate the effect of non-pharmaceutical interventions on hand, foot, and mouth disease in Hubei Province China during the coronavirus disease 2019 pandemic. Methods: Data and samples were collected from the hand, foot, and mouth disease surveillance laboratory network in Hubei Province between 2018 and 2022. The samples were identified as Enterovirus A71, Coxsackievirus A6or Coxsackievirus A16 via real-time polymerase chain reaction. Representative Coxsackievirus A6 and Coxsackievirus A16 samples were sequenced and subjected to phylogenetic analyses. Results: A noticeable 3-fold reduction in the number of hand, foot, and mouth disease cases was observed from 2019 to 2020. The age and sex distributions of patients with hand, foot, and mouth disease were approximately the same from 2018 to 2022. The proportion of Coxsackievirus A6 accounted for 86 % in 2020 and 75 % in 2021 for hand, foot, and mouth disease compared with 48 % in 2018, 53 % in 2019, and 29 % in 2022. The proportions of Coxsackievirus A16 in 2020 and 2021 were 2 % and 17 %, respectively, showing a sharp decline in 2018 (37.8 %) and 2019 (35 %). In 2022, Coxsackievirus A16 was the dominant serotype (46 %). Only slight differences were found in the VP1 sequences across the different years. Conclusions: Our study confirmed that a series of non-pharmaceutical interventions during the coronavirus disease 2019 period reduced the transmission of enteroviruses and that long-term restrictions could significantly change the prevalence of enterovirus serotypes causing hand, foot, and mouth disease.

Assessing the impact of COVID-19 interventions on the hand, foot and mouth disease in Guangdong Province, China: a Bayesian modeling study.

Background: The non-pharmaceutical interventions (NPIs) against COVID-19 may have affected the transmission of hand, foot and mouth disease (HFMD). We aimed to assess the impact of the NPIs on HFMD in the high epidemic area of HFMD, Guangdong Province. Methods: The data of HFMD cases, etiological information, and meteorological factors in Guangdong from January 1, 2012, to December 31, 2021, were collected. Using a Bayesian structural time series (BSTS) model integrated counterfactual framework, we assessed the effect of NPIs on HFMD by different intervention periods, populations (gender, age, occupation), and cities. We further explored the correlation between the reduction of HFMD and socioeconomic factors in 21 cities. Results: A total of 351,217 HFMD cases were reported and 455,327 cases were averted in Guangdong Province during 2020-2021 with a reduction of 84.94% (95%CI: 81.63-87.22%) in 2020 and 29.49% (95%CI: 15.26-39.54%) in 2021. The impact of NPIs on HFMD differed by age and gender. The effects of NPIs were more remarkable for children aged 0-2 years and scattered children. We found that the relative reductions in 21 cities were related to the composition ratio of children and COVID-19 incidence. Conclusion: The reduction of HFMD incidence was significantly associated with COVID-19 NPIs, and school closure was an effective intervention to prevent HFMD outbreaks. Our findings will contribute to the development of HFMD prevention and control measures.

Viral infections in hospitalized children in Germany during the COVID-19 pandemic: Association with non-pharmaceutical interventions.

Background: Non-pharmaceutical interventions (NPI) during the COVID-19 pandemic aimed at prevention of SARS-CoV-2 transmission also influenced transmission of viruses other than SARS-CoV-2. The aim of this study was to describe and compare the burden of common viral respiratory and gastrointestinal infections in children admitted to Berlin University Children's Hospital (BCH) before and during the COVID-19 pandemic at different levels of public NPI measures. Methods: In this retrospective study, we analyzed the frequency of detection of common human respiratory and gastrointestinal viruses from January 2016 through January 2022 in all patients admitted to BCH. We compared virus detection before and during the COVID-19 pandemic at different levels of public NPI measures. Results: The frequency of detection of seasonal enveloped and non-enveloped viruses [Boca-, Corona-, Influenza-, Metapneumo-, Parainfluenza-, Rota-, and Respiratory Syncytial Viruses (RSV)] was diminished during the COVID-19 pandemic, whereas detection rates of non-seasonal viruses (Rhino-/Entero-, and Adenoviruses) were stable during the pandemic. After withdrawal of major NPI measures, we observed an out of season surge of the detection rates of Boca-, Corona-, Parainfluenzaviruses, and RSV. In contrast, no increased detection frequency was observed for Influenza-, Metapneumo-, and Rotaviruses as of January 2022. Conclusion: Corona-, Boca-, Parainfluenzaviruses, and RSV returned as frequently detected pathogens after withdrawal of major NPI measures. The out of season rise might be attributed to an "immune-debt" due to missing contact to viral antigens resulting in waning of population immunity during the COVID-19 pandemic.

Covid-19 pandemic policy monitor (COV-PPM) - European level tracking data of non-pharmaceutical interventions.

The Covid-19 Pandemic Policy Monitor (COV-PPM) dataset prospectively documents non-pharmaceutical interventions (NPIs) taken to contain SARS-Cov-2 transmission across countries in EU27, EEA and UK. In Germany, measures have also been recorded at the federal state and, partially, at the district levels. NPIs implemented since January 2020 have been retrieved and updated weekly from March 2020, from official governments webpages, Ministries of Health, National (Public) Health Institutes or Administrations. NPI categories collected refer to restrictions, closures or changes in functioning implemented in 13 domains: public events (gatherings in indoor or outdoor spaces); public institutions (kindergartens, schools, universities); public spaces (shops, bars, restaurants); public transport (trains, buses, trams, metro); citizens movement/mobility (e.g. pedestrians, cars, ships); border closures (air, land or sea, all incoming travels, from high-risk regions, only non-nationals); measures to improve the healthcare system (e.g. human resources or technical reinforcement, redistribution, material or infrastructural); measures for risk/vulnerable groups (e.g. elderly, chronically ill, pregnant); economic measures (e.g. lay-off rules establishment, actions to avoid job-loss, tax relaxation); testing policies (e.g. testing criteria changes); nose and mouth protection rules, vaccination and others/miscellaneous measures.