Comparison of 19 major infectious diseases during COVID-19 epidemic and previous years in Zhejiang, implications for prevention measures

Abstract

Background: The global pandemic of coronavirus disease 2019 (COVID-19) has attracted great public health efforts across the world. Few studies, however, have described the potential impact of these measures on other important infectious diseases.

Methods: The incidence of 19 major infectious diseases in Zhejiang Province was collected from the National Notifiable Infectious Disease Surveillance System from January 2017 to October 2020. The entire epidemic control phase was divided into three stages. The government deployed the first level response from 24 January to 2 March (the most rigorous measures). When the outbreak of COVID-19 was under control, the response level changed to the second level from 3 to 23 March, and then the third level response was implemented after 24 March. We compared the epidemiological characteristics of 19 major infectious diseases during different periods of the COVID-19 epidemic and previous years.

Results: A total of 1,814,881 cases of 19 infectious diseases were reported in Zhejiang from January 2017 to October 2020, resulting in an incidence rate of 8088.30 cases per 1,000,000 person-years. After the non-pharmaceutical intervention, the incidence of 19 infectious diseases dropped by 70.84%, from 9436.32 cases per 1,000,000 person-years to 2751.51 cases per 1,000,000 person-years, with the large decrease in the first response period of influenza. However, we observed that the daily incidence of severe fever with thrombocytopenia syndrome (SFTS) and leptospirosis increased slightly (from 1.11 cases per 1,000,000 person-years to 1.82 cases per 1,000,000 person-years for SFTS and 0.30 cases per 1,000,000 person-years to 1.24 cases per 1,000,000 person-years for leptospirosis). There was no significant difference in the distribution of epidemiological characteristic of most infectious diseases before and during the implementation of COVID-19 control measures.

Conclusion: Our study summarizes the epidemiological characteristics of 19 infectious diseases and indicates that the rigorous control measures for COVID-19 are also effective for majority of infectious diseases.

Keywords: COVID-19; Communicable diseases; Prevention and control.

Fig. 1

Number of COVID-19 cases from 1 January to 1 May in 2020

Fig. 2

Spatiotemporal distribution of 19 infectious diseases (per 1,000,000 person-years). A Monthly incidence density of each infectious disease. B The total incidence density of each infectious disease in 11 cities. A circle represents a disease, and a radial column represents a month (left) or one city (right). HFMD hand, foot, and mouth disease, Others infectious diarrheal diseases other than cholera, dysentery, typhoid, and paratyphoid, AHC acute hemorrhagic conjunctivitis, SFTS severe fever with thrombocytopenia syndrome

Fig. 3

Incidence density of each disease by sex and age (per 1,000,000 person-years). A The incidence of HFMD, other infectious diarrhea and influenza. B The overall incidence of the remaining 16 infectious diseases. Age was divided into groups every 5 years, ranging from less than 1 year old to over 85 years old. The left side of the dotted line is female and the right side is male. HFMD hand, foot, and mouth disease, Others infectious diarrheal diseases other than cholera, dysentery, typhoid, and paratyphoid, AHC acute hemorrhagic conjunctivitis. SFTS severe fever with thrombocytopenia syndrome

Fig. 4

Distribution of each disease by sex and occupation (per 1,000,000 person-years). A The incidence of HFMD, other infectious diarrhea and influenza. B The overall incidence of the remaining 16 infectious diseases. It divides occupations into children, students, farmers, peasant-workers, workers, business services, cadre staffs, medical staff, teachers, retirees, unemployment, others. The left side of the dotted line is female and the right side is male. HFMD hand, foot, and mouth disease, Others infectious diarrheal diseases other than cholera, dysentery, typhoid, and paratyphoid, AHC acute hemorrhagic conjunctivitis, SFTS severe fever with thrombocytopenia syndrome

Fig. 5

Contemporaneous comparison of the incidence of major infectious diseases in male (A) and female (B) before and after COVID-19. 17–19 Period 1 was from 24 January to 2 March in 2017, 2018, and 2019. 17–19 Period 2 was from 3 to 22 March in 2017, 2018, and 2019. 17–19 Period 3 was from 23 March to 31 October in 2017, 2018, and 2019. 20 Period 1, 20 Period 2, and 20 Period 3 were in the same way. HFMD hand, foot, and mouth disease, Others infectious diarrheal diseases other than cholera, dysentery, typhoid, and paratyphoid, AHC acute hemorrhagic conjunctivitis, SFTS severe fever with thrombocytopenia syndrome