Abstract
Objective: To establish the impact of the first 6 months of the COVID-19 outbreak response on gastrointestinal (GI) infection trends in England.
Design: Retrospective ecological study using routinely collected national and regional surveillance data from seven UK Health Security Agency coordinated laboratory, outbreak and syndromic surveillance systems using key dates of UK governmental policy change to assign phases for comparison between 2020 and historic data.
Results: Decreases in GI illness activity were observed across all surveillance indicators as COVID-19 cases began to peak. Compared with the 5-year average (2015-2019), during the first 6 months of the COVID-19 response, there was a 52% decrease in GI outbreaks reported (1544 vs 3208 (95% CI 2938 to 3478)) and a 34% decrease in laboratory confirmed cases (27 859 vs 42 495 (95% CI 40 068 to 44 922)). GI indicators began to rise during the first lockdown and lockdown easing, although all remained substantially lower than historic figures. Reductions in laboratory confirmed cases were observed across all age groups and both sexes, with geographical heterogeneity observed in diagnosis trends. Health seeking behaviour changed substantially, with attendances decreasing prior to lockdown across all indicators.
Conclusions: There has been a marked change in trends of GI infections in the context of the COVID-19 pandemic. The drivers of this change are likely to be multifactorial; while changes in health seeking behaviour, pressure on diagnostic services and surveillance system ascertainment have undoubtably played a role, there has likely been a true decrease in the incidence for some pathogens resulting from the control measures and restrictions implemented. This suggests that if some of these changes in behaviour such as improved hand hygiene were maintained, then we could potentially see sustained reductions in the burden of GI illness.
| Original language | English |
|---|---|
| Article number | 050469 |
| Pages (from-to) | e050469 |
| Number of pages | 12 |
| Journal | BMJ Open |
| Volume | 12 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 21 Mar 2022 |
Bibliographical note
Funding Information: NKL, AJE, RV, HH and GS receive support from the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, IO receives support from the NIHR HPRU in Behavioural Science and Evaluation. GS, RM and AJE receive support from the NIHR HPRU in Emergency Preparedness and Response. Funding was not applicable to this study. The views expressed are those of the author(s) and not necessarily those of the NIHR, UK Health Security Agency or the Department of Health and Social Care.Open Access: This is an open access article distributed in accordance with the
Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which
permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.
See: http://creativecommons.org/licenses/by-nc/4.0/.
Publisher Copyright: © Author(s) (or their employer(s)) 2022. Published by BMJ.
Citation: Love NK, Elliot AJ, Chalmers RM, et al. Impact of the COVID-19 pandemic on gastrointestinal infection trends in England, February–July 2020. BMJ Open 2022;12:e050469.
DOI: 10.1136/bmjopen-2021-050469
Keywords
- COVID-19
- epidemiology
- gastrointestinal infections
- DISEASE
- INFLUENZA