Impact of non-pharmaceutical interventions for COVID-19 on norovirus outbreaks in the United States July 2012–December 2020 公开

Abstract

A drop in the total number of suspected and confirmed norovirus outbreaks starting from March 2020 was observed in the panel of Norovirus Sentinel Testing and Tracking (NoroSTAT) network of Centers for disease control and prevention (CDC). A previous analysis was performed to determine if the declining incidence of norovirus outbreaks (July 2012–July 2020) was attributable to reduced exposure due to non-pharmaceutical interventions (NPIs), underreporting, or seasonal trends. The authors found that the decline in norovirus incidence could not be explained by underreporting or seasonal trends. In this research, NoroSTAT data were revisited in December 2020 to see if there are still reduced norovirus outbreaks. Generalized additive models (GAMs) and generalized linear models (GLMs) are used to evaluate if the decreased incidence of norovirus outbreaks is explained by NPIs, underreporting, or seasonality. A decline of over 85% in norovirus outbreak incidence was reported to NoroSTAT during April–December 2020 compared to the monthly norovirus outbreak incidence during the same period 2013–2019, indicating that the implementation of non-pharmaceutical interventions for SARS-CoV-2 may help reduce the number of norovirus outbreaks. This pattern is consistent across all 9 NoroSTAT states and settings, and persisted after accounting for seasonality, suggesting that this decreased norovirus outbreaks could not be explained by seasonality and underreporting. Our analysis suggests NPIs may provide merits for prevention of other pathogens, such as norovirus. When NPIs are rolled back entirely, increase of norovirus outbreak incidence may occur, which may aggravate the burden to health systems.

Table of Contents

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

Methods .......................................................................................................................................... 2

Results............................................................................................................................................. 9

Discussion ..................................................................................................................................... 10

Conclusion and Recommendations ............................................................................................ 14

References .................................................................................................................................... 15

Tables & Figures.......................................................................................................................... 18

Appendices ................................................................................................................................... 25

About this Master's Thesis

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School	Rollins School of Public Health
Department	Environmental Health
Degree	M.S.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
关键词	nonpharmaceutical interventions norovirus SARS-CoV-2
Committee Chair / Thesis Advisor	Benjamin Lopman, Emory University
Committee Members	Alicia Kraay, Emory University
Partnering Agencies	CDC

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