Estimating the Impact of the COVID-19 Pandemic on Incidence of Medical Encounters Associated with Acute Gastroenteritis and Acute Respiratory Infections Among U.S. Military Personnel and Dependents Open Access

Manuelpillai, Bevin (Spring 2024)

Permanent URL: https://etd.library.emory.edu/concern/etds/0r9675129?locale=en
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Abstract

Abstract

Estimating the Impact of the COVID-19 Pandemic on Incidence of Medical Encounters Associated with Acute Gastroenteritis and Acute Respiratory Infections Among U.S. Military Personnel and Dependents

Introduction

The lifting of many non-pharmaceutical interventions (NPIs) put in place during the COVID-19 pandemic resulted in a resurgence of many non-SARS-CoV-2 viral diseases exceeding pre- pandemic levels.

Methods

We fit a time-series regression model of medical encounters with at least one gastrointestinal or respiratory cause in a population of active duty military personnel and their dependents to quantify the association between pandemic year and count of medical encounters. Pandemic year was used as a proxy for extent of NPIs in place and count of medical encounters were used as a proxy for incidence of gastrointestinal and respiratory viral diseases. A secondary analysis was conducted to determine whether demographics factors such as sex, race/ethnicity, age, and beneficiary status had a differential impact on the rates of medical encounters at different stages of the pandemic.

Results

Both acute respiratory infection (ARI) and acute gastroenteritis (AGE) medical encounters declined as a result of the introduction of NPIs. ARI medical encounters experienced a greater resurgence in late 2022 and early 2023 compared to AGE medical encounters. Active duty military maintained a reduced level of AGE medical encounters compared to dependents during this same time period.

Discussion

One possible explanation for why ARI medical encounters experienced a greater resurgence than AGE medical encounters between late 2022 and early 2023 is that immunity to respiratory viral diseases wanes faster than gastrointestinal viral diseases, resulting in greater population susceptibility buildup to respiratory infections. One explanation for why active duty military personnel had a reduced level of AGE medical encounters is that they continued to maintain certain NPI (such as handwashing and wiping surfaces) that are targeted towards more gastrointestinal viral diseases and decreased their use of other NPIs (such as masking), which are targeted towards respiratory viral diseases.

Table of Contents

Table of Contents

1. Introduction ................................................................................... 1

2. Methods ....................................................................................... 6

3. Results ......................................................................................... 11

4. Discussion .................................................................................... 19

5. References ..................................................................................... 25

6. Appendix ...................................................................................... 28

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