Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan;19(1):e70066.
doi: 10.1111/irv.70066.

Assessing the Impact of Non-Pharmaceutical Interventions During the COVID-19 Pandemic on RSV Seasonality in Europe

Susanne Heemskerk  1 , Christos Baliatsas  1 , Foekje Stelma  1 , Harish Nair  2   3 , John Paget  1 , Peter Spreeuwenberg  1
Affiliations

Assessing the Impact of Non-Pharmaceutical Interventions During the COVID-19 Pandemic on RSV Seasonality in Europe

Susanne Heemskerk et al. Influenza Other Respir Viruses. 2025 Jan.

Erratum in

Abstract

Background: During the COVID-19 pandemic, atypical respiratory syncytial virus (RSV) circulation patterns emerged, with the occurrence of RSV activity outside the typical winter season. This study investigates the impact of COVID-19 and associated non-pharmaceutical interventions (NPIs) on RSV seasonality.

Methods: The onset, offset and peak of RSV epidemics from 2018 to 2022 across 12 European countries were determined using the 3% positivity threshold method. A multilevel longitudinal logit regression model for proportions assessed the associations between five NPIs (school closures, mask use, workplace measures, public gathering restrictions and closure of public spaces) and RSV, utilising RSV surveillance data, two NPI databases (ECDC-JRC and Oxford) and COVID-19 surveillance data.

Results: Before 2020, consistent RSV seasonality patterns were observed, but the seasonal increase of RSV-positive cases in winter remained absent during the COVID-19 pandemic (2020-2022). Analysis revealed inconsistent associations between individual NPIs and RSV. The associations differed depending on the data source used (ECDC-JRC or Oxford), not only in magnitude but also in the direction of the coefficients. Public gathering restrictions and closure of public spaces exhibited significant negative associations with RSV incidence. However, this was only observed when using surveillance data for the entire epidemiological year and not when only examining weeks with increased RSV activity.

Conclusions: This study highlights the need for standardised international data collection and procedures for infectious disease modelling, as varying NPI implementations, NPI registration and RSV surveillance across countries complicate the understanding of RSV dynamics during the pandemic. Caution is recommended when interpreting the effects of NPIs on RSV circulation.

Keywords: RSV; epidemiology; non‐pharmaceutical interventions; pandemic; public health; seasonality.

PubMed Disclaimer

Conflict of interest statement

JP declared that Nivel has received unrestricted grants from the World Health Organization, Sanofi and the Foundation for Influenza Epidemiology outside the submitted work. HN reports grants from the World Health Organization, the National Institute for Health Research, Pfizer and Icosavax and personal fees from the Bill & Melinda Gates Foundation, Pfizer, GSK, Merck, AbbVie, Janssen, Icosavax, Sanofi and Novavax outside the submitted work.

Figures

FIGURE 1
FIGURE 1
Percentage of RSV‐positive detections of included countries; grey areas indicate RSV epidemics. RSV, respiratory syncytial virus.
See this image and copyright information in PMC

References

    1. McLaughlin J. M., Khan F., Begier E., Swerdlow D. L., Jodar L., and Falsey A. R., “Rates of Medically Attended RSV Among US Adults: A Systematic Review and Meta‐Analysis,” Open Forum Infectious Diseases 9, no. 7 (2022): ofac300. - PMC - PubMed
    1. Savic M., Penders Y., Shi T., Branche A., and Pirçon J. Y., “Respiratory Syncytial Virus Disease Burden in Adults Aged 60 Years and Older in High‐Income Countries: A Systematic Literature Review and Meta‐Analysis,” Influenza and Other Respiratory Viruses 17, no. 1 (2023): e13031. - PMC - PubMed
    1. Li Y., Wang X., Blau D. M., et al., “Global, Regional, and National Disease Burden Estimates of Acute Lower Respiratory Infections due to Respiratory Syncytial Virus in Children Younger Than 5 Years in 2019: A Systematic Analysis,” Lancet 399, no. 10340 (2022): 2047–2064. - PMC - PubMed
    1. Broberg E. K., Waris M., Johansen K., Snacken R., and Penttinen P., “Seasonality and Geographical Spread of Respiratory Syncytial Virus Epidemics in 15 European Countries, 2010 to 2016,” Euro Surveillance 23, no. 5 (2018): 17‐00284. - PMC - PubMed
    1. Delestrain C., Danis K., Hau I., et al., “Impact of COVID‐19 Social Distancing on Viral Infection in France: A Delayed Outbreak of RSV,” Pediatric Pulmonology 56, no. 12 (2021): 3669–3673. - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources