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The Epidemiology of Respiratory Syncytial Virus in Children Under Five Years-Old During the COVID-19 Pandemic Measured by Laboratory, Clinical and Syndromic Surveillance in England: A Retrospective Observational Study Including the 2020/21 Winter Season

16 Pages Posted: 22 Mar 2022

See all articles by Megan Jessica Bardsley

Megan Jessica Bardsley

UK Health Security Agency

Roger A. Morbey

UK Health Security Agency

Helen E. Hughes

UK Health Security Agency

Charles R. Beck

UK Health Security Agency

Conall H. Watson

UK Health Security Agency

Joanna Ellis

Government of the United Kingdom - Public Health England

Gillian Smith

University of Oxford - Nuffield Department of Primary Care Health Sciences

Alex J. Elliot

UK Health Security Agency

More...

Abstract

Background: Seasonal epidemics of respiratory syncytial virus (RSV) commonly cause a clinically significant burden of disease among young children. Following declaration of the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) targeted at SARS-CoV-2 have impacted the transmission of other respiratory pathogens. We describe the change in epidemiology of RSV among children under five years-old in England during winter 2020/21.

Methods: RSV surveillance data were extracted from national laboratory, clinical and syndromic surveillance systems from January 2015 to March 2021 for children under five years-old. Time-series analyses using generalised linear modelling estimated the impact of SARS-CoV-2 NPIs on RSV indicators during winter 2020/21.

Findings: RSV-associated activity was substantially reduced for all indicators studied during winter 2020/21. Within the scope of the surveillance systems included, we estimate that 99·7% (n=12,320) of laboratory cases, 81·0% (92,692) hospital admissions, 85·3% (27,486) emergency department attendances, 73·7% (96,672) NHS 111 calls, 88·8% (2,924) out-of-hours GP consultations and 89·9% (91,304) in-hours GP consultations were avoided among children under five years-old compared to that expected during a ‘normal’ RSV season.

Interpretation: We observed a substantial reduction in RSV-associated activity across numerous surveillance systems following the implementation of NPIs to prevent SARS-CoV-2 transmission in England. We hypothesise that the unprecedented absence of RSV during the 2020/21 winter has likely resulted in a cohort of young children lacking natural immunity to RSV, thereby raising the potential for future increased RSV incidence, out-of-season activity and increases in health service pressures. Our findings are therefore valuable for informing future seasonal RSV planning.

Funding Information: None.

Declaration of Interests: None.

Ethics Approval Statement: Analyses were limited to secondary use of datasets routinely collected as part of the public health function of UKHSA. This study is not considered research as defined by the UK Policy Framework for Health and Social Care Research, determined using the Health Research Authority decision tool. Therefore, review by a Research Ethics Committee was not required.

Keywords: COVID-19, SARS-CoV-2, Respiratory syncytial virus, RSV, laboratory surveillance, syndromic surveillance, respiratory pathogens, paediatric infections, non-pharmaceutical interventions

Suggested Citation

Bardsley, Megan Jessica and Morbey, Roger A. and Hughes, Helen E. and Beck, Charles R. and Watson, Conall H. and Ellis, Joanna and Smith, Gillian and Elliot, Alex J., The Epidemiology of Respiratory Syncytial Virus in Children Under Five Years-Old During the COVID-19 Pandemic Measured by Laboratory, Clinical and Syndromic Surveillance in England: A Retrospective Observational Study Including the 2020/21 Winter Season. Available at SSRN: https://ssrn.com/abstract=4060788 or http://dx.doi.org/10.2139/ssrn.4060788

Megan Jessica Bardsley (Contact Author)

UK Health Security Agency ( email )

London
United Kingdom

Roger A. Morbey

UK Health Security Agency ( email )

London
United Kingdom

Helen E. Hughes

UK Health Security Agency ( email )

London
United Kingdom

Charles R. Beck

UK Health Security Agency ( email )

London
United Kingdom

Conall H. Watson

UK Health Security Agency ( email )

London
United Kingdom

Joanna Ellis

Government of the United Kingdom - Public Health England ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Gillian Smith

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

Alex J. Elliot

UK Health Security Agency ( email )

23 Stephenson Street
Birmingham, B2 4BH
United Kingdom