The Invasive Respiratory Infection Surveillance (IRIS) Initiative reveals significant reductions in invasive bacterial infections during the COVID-19 pandemic
Brueggemann A., van Rensburg MJ., Shaw D., McCarthy N., Jolley K., Maiden MCJ., van der Linden MPG., Amin-Chowdhury Z., Bennett D., Borrow R., Brandileone M-C., Broughton K., Campbell R., Cao B., Casanova C., Choi EH., Chu YW., Clark S., Claus H., Coelho J., Corcoran M., Cottrell S., Cunney R., Dalby T., Davies H., de Gouveia L., Deghmane A-E., Demczuk W., Desmet S., Drew R., du Plessis M., Erlendsdottir H., Fry N., Fuursted K., Gray S., Henriques-Normark B., Hale T., Hilty M., Hoffmann S., Humphreys H., Ip M., Jacobsson S., Johnston J., Kozakova J., Kristinsson K., Krizova P., Kuch A., Ladhani S., Lâm T-T., Lebedova V., Lindholm L., Litt D., Martin I., Martiny D., Mattheus W., McElligott M., Meehan M., Meiring S., Mölling P., Morfeldt E., Morgan J., Mulhall R., Muñoz-Almagro C., Murdoch D., Murphy J., Musilek M., Mzabi A., Perez-Argüello A., Perrin M., Perry M., Redin A., Roberts R., Roberts M., Rokney A., Ron M., Scott K., Sheppard C., Siira L., Skoczyńska A., Sloan M., Slotved H-C., Smith A., Song JY., Taha M-K., Toropainen M., Tsang D., Vainio A., van Sorge N., Varon E., Vlach J., Vogel U., Vohrnova S., von Gottberg A., Zanella R., Zhou F.
Background Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis are leading causes of invasive diseases including bacteraemic pneumonia and meningitis, and of secondary infections post-viral respiratory disease. They are typically transmitted via respiratory droplets. We investigated rates of invasive disease due to these pathogens during the early phase of the COVID-19 pandemic. Methods Laboratories in 26 countries across six continents submitted data on cases of invasive disease due to S pneumoniae, H influenzae and N meningitidis from 1 January 2018 to 31 May 2020. Weekly cases in 2020 vs 2018-2019 were compared. Streptococcus agalactiae data were collected from nine laboratories for comparison to a non-respiratory pathogen. The stringency of COVID-19 containment measures was quantified by the Oxford COVID-19 Government Response Tracker. Changes in population movements were assessed by Google COVID-19 Community Mobility Reports. Interrupted time series modelling quantified changes in rates of invasive disease in 2020 relative to when containment measures were imposed. Findings All countries experienced a significant, sustained reduction in invasive diseases due to S pneumoniae, H influenzae and N meningitidis , but not S agalactiae , in early 2020, which coincided with the introduction of COVID-19 containment measures in each country. Similar impacts were observed across most countries despite differing stringency in COVID-19 control policies. There was no evidence of a specific effect due to enforced school closures. Interpretation The introduction of COVID-19 containment policies and public information campaigns likely reduced transmission of these bacterial respiratory pathogens, leading to a significant reduction in life-threatening invasive diseases in many countries worldwide.