Predicted norovirus resurgence in 2021–2022 due to the relaxation of nonpharmaceutical interventions associated with COVID-19 restrictions in England: a mathematical modeling study

Kathleen M. O’Reilly*, Frank Sandman, David Allen, Christopher I. Jarvis, Amy Gimma, Amy Douglas, Lesley Larkin, Kerry L.M. Wong, Marc Baguelin, Ralph S. Baric, Lisa C. Lindesmith, Richard A. Goldstein, Judith Breuer, W. John Edmunds

*Corresponding author for this work

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Abstract

Background: To reduce the coronavirus disease burden in England, along with many other countries, the government implemented a package of non-pharmaceutical interventions (NPIs) that have also impacted other transmissible infectious diseases such as norovirus. It is unclear what future norovirus disease incidence is likely to look like upon lifting these restrictions. 

Methods: Here we use a mathematical model of norovirus fitted to community incidence data in England to project forward expected incidence based on contact surveys that have been collected throughout 2020–2021. 

Results: We report that susceptibility to norovirus infection has likely increased between March 2020 and mid-2021. Depending upon assumptions of future contact patterns incidence of norovirus that is similar to pre-pandemic levels or an increase beyond what has been previously reported is likely to occur once restrictions are lifted. Should adult contact patterns return to 80% of pre-pandemic levels, the incidence of norovirus will be similar to previous years. If contact patterns return to pre-pandemic levels, there is a potential for the expected annual incidence to be up to 2-fold larger than in a typical year. The age-specific incidence is similar across all ages. 

Conclusions: Continued national surveillance for endemic diseases such as norovirus will be essential after NPIs are lifted to allow healthcare services to adequately prepare for a potential increase in cases and hospital pressures beyond what is typically experienced.

Original languageEnglish
Article number299
JournalBMC Medicine
Volume19
Issue number1
DOIs
Publication statusPublished - 9 Nov 2021

Bibliographical note

Funding Information: This research was primarily funded by the Wellcome Trust ‘Noropatrol’ [grant code203268/Z/16/Z]. Additional funding is acknowledged from Public Health England (PHE), which is an executive agency of the Department of Health and Social Care (DHSC), and National Institute for Health, USA (NIAID 1R01 AI148260). CoMix is funded by the EU Horizon 2020 Research and Innovations Programme - project EpiPose (Epidemic Intelligence to Minimize COVID-19’s Public Health, Societal and Economical Impact, No 101003688) and the Medical Research Council (understanding the dynamics and drivers of the COVID-2019 epidemic using real-time outbreak analytics MC_PC 19065).

Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Publisher Copyright: © 2021, The Author(s).

Citation: O’Reilly, K.M., Sandman, F., Allen, D. et al. Predicted norovirus resurgence in 2021–2022 due to the relaxation of nonpharmaceutical interventions associated with COVID-19 restrictions in England: a mathematical modeling study. BMC Med 19, 299 (2021).

DOI: https://doi.org/10.1186/s12916-021-02153-8

Keywords

  • COVID-19
  • Mathematical modelling
  • Norovirus
  • Seasonality
  • Surveillance
  • Transmission

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