Impact of Wearing Masks, Hand Hygiene, and Social Distancing on Influenza, Enterovirus, and All-Cause Pneumonia During the Coronavirus Pandemic: Retrospective National Epidemiological Surveillance Study

• Published in: Journal of medical Internet research Vol. 22; no. 8; p. e21257
• Main Authors: Chiu, Nan-Chang, Chi, Hsin, Tai, Yu-Lin, Peng, Chun-Chih, Tseng, Cheng-Yin, Chen, Chung-Chu, Tan, Boon Fatt, Lin, Chien-Yu
• Format: Journal Article
• Language: English
• Published: Canada Gunther Eysenbach MD MPH, Associate Professor 20.08.2020; JMIR Publications
• Subjects: Betacoronavirus - pathogenicity; Big Data; Coronavirus - pathogenicity; Coronavirus Infections - prevention & control; Coronavirus Infections - psychology; Coronaviruses; COVID-19; COVID-19 - prevention & control; COVID-19 - psychology; Disease transmission; Enterovirus Infections - epidemiology; Enterovirus Infections - prevention & control; Eye protection; Hand Hygiene - methods; Humans; Hygiene; Incidence; Infection Control - methods; Infections; Infectious diseases; Influenza; Influenza, Human - epidemiology; Influenza, Human - prevention & control; Masks; Masks - trends; Original Paper; Pandemics; Pandemics - prevention & control; Physical Distancing; Pneumonia; Pneumonia - epidemiology; Pneumonia - prevention & control; Pneumonia, Viral - epidemiology; Pneumonia, Viral - prevention & control; Pneumonia, Viral - psychology; Retrospective Studies; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Social distancing; Surveillance; Viral infections; Viruses; Taiwan; COVID-19; influenza; SARS-CoV-2; pneumonia; hygiene; novel coronavirus; surveillance; pandemic; incidence; prevention; social distancing
• DOI: 10.2196/21257
• ISSN: 1438-8871; 1439-4456

The coronavirus disease (COVID-19) pandemic is an important health crisis worldwide. Several strategies were implemented to combat COVID-19, including wearing masks, hand hygiene, and social distancing. The impact of these strategies on COVID-19 and other viral infections remains largely unclear. We aim to investigate the impact of implemented infectious control strategies on the incidences of influenza, enterovirus infection, and all-cause pneumonia during the COVID-19 pandemic. We utilized the electronic database of the Taiwan National Infectious Disease Statistics System and extracted incidences of COVID-19, influenza virus, enterovirus, and all-cause pneumonia. We compared the incidences of these diseases from week 45 of 2016 to week 21 of 2020 and performed linear regression analyses. The first case of COVID-19 in Taiwan was reported in late January 2020 (week 4). Infectious control strategies have been promoted since late January. The influenza virus usually peaks in winter and decreases around week 14. However, a significant decrease in influenza was observed after week 6 of 2020. Regression analyses produced the following results: 2017, R =0.037; 2018, R =0.021; 2019, R =0.046; and 2020, R =0.599. A dramatic decrease in all-cause pneumonia was also reported (R values for 2017-2020 were 0.435, 0.098, 0.352, and 0.82, respectively). Enterovirus had increased by week 18 in 2017-2019, but this was not observed in 2020. Using this national epidemiological database, we found a significant decrease in cases of influenza, enterovirus, and all-cause pneumonia during the COVID-19 pandemic. Wearing masks, hand hygiene, and social distancing may contribute not only to the prevention of COVID-19 but also to the decline of other respiratory infectious diseases. Further studies are warranted to elucidate the causal relationship.