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Non-Pharmacological Interventions During SARS-CoV-2 Pandemic: Effects on Pediatric Viral Respiratory Infections
Georgina Armero1, Carmina Guitart2, Aleix Soler-Garcia3
1Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain; Infectious Diseases and Microbiome Research Group. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.
Insights
Non-pharmacological interventions like isolation and masks significantly impacted pediatric respiratory virus circulation during the COVID-19 pandemic. These measures reduced virus detection, with effects seen even in younger children.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health Interventions
Background:
- Viral lower respiratory tract infections are a major cause of childhood illness and death.
- The COVID-19 pandemic prompted widespread non-pharmacological interventions (NPIs), altering respiratory virus dynamics.
- Understanding the impact of NPIs on pediatric respiratory virus circulation is crucial for public health strategies.
Purpose of the Study:
- To evaluate the effect of COVID-19-related NPIs and their subsequent lifting on the circulation of respiratory viruses in children.
- To analyze trends in pediatric respiratory virus detection before, during, and after pandemic-related measures.
Main Methods:
- Weekly time series analysis of molecular assays for respiratory viruses in children (0-18 years).
- Inclusion of patients from a Pediatric Intensive Care Unit (PICU) and those with risk pathologies.
- Adjustment of positive results for diagnostic effort and geographical location (Catalonia).
Main Results:
- Confinement measures led to a significant decrease in the detection of all tested respiratory viruses, particularly Rhinovirus (RV).
- Post-confinement, viral detection remained stable initially, with no immediate surge in transmission.
- Mandatory facemask use reduced viral circulation; however, influenza virus rebounded upon mask removal, alongside an interrupted decline in RV and RSV detection.
Conclusions:
- Non-pharmacological interventions demonstrably influence the circulation of respiratory viruses in pediatric populations.
- The impact of NPIs was observed across various age groups, including those not directly targeted by specific measures.
- School reopenings correlated with an increase in respiratory virus detections, especially RV.
Introduction:
Viral lower respiratory tract infections frequently cause morbidity and mortality in children. The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic led to isolation and hygiene measures, resulting in decreased respiratory virus transmission and pediatric admissions. This study aimed to assess the impact of these measures and their uplifting on respiratory virus circulation in children before and during the SARS-CoV-2 pandemic (January 2017-December 2022).
Methods:
We conducted a weekly time series analysis of multiple virus molecular assays in children. This included those admitted to a university reference hospital's Pediatric Intensive Care Unit (PICU) and those with risk pathologies exhibiting fever and/or respiratory symptoms. We included patients aged 0-18 years residing in Catalonia and adjusted the positive results to account for diagnostic effort.
Results:
We performed a total of 2991 respiratory virus tests during the period. Confinement significantly decreased the detection of all viruses, especially Rhinovirus (RV). After the deconfinement of children, the viral detection trend remained stable for all viruses, with no short-term impact on virus transmission. The mandatory implementation of facemasks in those aged ≥6 years led to decreased viral circulation, but we observed an influenza virus rebound after facemask removal. At that time, we also noticed an interrupted drop in the detection rates of RV and respiratory syncytial virus (RSV). The reopening of schools led to a progressive increase in viral detections, especially of Rhinovirus.
Conclusion:
Non-pharmacological interventions significantly impact the circulation of respiratory viruses among children. We observed these effects even when some measures did not specifically target preschool-aged children.
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