Impact of COVID-19 pandemic on influenza cases in Thailand, 2020–2022: An interrupted time–series analysis
Keywords:
influenza, COVID-19 pandemic, Thailand, interrupted time–seriesAbstract
Background: The COVID-19 pandemic has placed significant burdens on health, mental health, the economy, and healthcare systems. Implementation of COVID-19 control measures, such as mask–wearing, city lockdowns, and social distancing has not only aimed to control the spread of COVID-19 but has also affected the incidence of other respiratory diseases, including influenza. This study aimed to determine the impact of COVID-19 pandemic and control measures on reported influenza cases by comparing the observed with the expected number of cases during 2020 to 2022.
Methods: A secondary data analysis was conducted through interrupted time series. The number of reported influenza cases from 2014 to 2022 was retrieved from R506 surveillance (code 15) and the Health Data Center database or 43–files (ICD–10 J10–J11). Proportional adjustments were made to the number of influenza cases in R506 using data from the 43–files (R506 weight). Observed incidence, R506 weight, was compared to expected incidence or predicted incidence. The prediction was conducted by using the Autoregressive Integrated Moving Average (ARIMA) model. Training data consisted of 85% of influenza cases during 2014–2019, while testing data consisted of 15% of cases reported during 2020–2022. The prediction model with the lowest Mean Absolute Percentage Error (MAPE) and Root Mean Squared Error (RMSE) was selected, and the differences between expected and observed incidence were reported in terms of numbers and proportions.
Results: The number of influenza cases during the COVID-19 pandemic was lower compared to the period before the pandemic in both databases. Additionally, there was a decrease in the proportion of admission cases. Adjusting the number of influenza cases, R506 weight, revealed that, without pandemic or COVID-19 interventions, the number of influenza cases would be 1,237,380 cases higher than expectation.
Conclusion and Recommendation: The COVID-19 pandemic and the associated control measures may have impacted to lower the incidence of influenza cases in Thailand. Maintaining COVID-19 control measures should be encourage among Thai population.
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