Having spent several summers in Taiwan to immerse my children in the language, I’m somewhat accustomed to the culture of mask-wearing, unlike many Americans. Thus, it didn’t surprise me to find out that since the onset of the pandemic, the transmission of almost every common respiratory and gastrointestinal virus, aside from COVID-19, has significantly declined.
As of February 4, 2021, Taiwan recorded just 9 COVID-19 fatalities. It’s ironic to think my relatives cautioned me against visiting last summer due to safety concerns, when in fact, it was the U.S. that faced severe challenges.
Epidemiologists suggest that global lockdowns and public health measures, including social distancing, mask usage, and frequent handwashing, have been effective in curbing the coronavirus. Other illnesses like influenza A and B, norovirus, respiratory syncytial virus (RSV), parainfluenza, and human metapneumovirus, as well as bacterial infections like whooping cough and pneumonia, have all seen a dramatic decrease.
For context, during the third week of December 2019, just before COVID-19 impacted the U.S., the Centers for Disease Control and Prevention (CDC) noted that 16.2% of clinical lab samples tested positive for influenza A. By the third week of December 2020, that figure plummeted to 0.3%. Lynnette Brammer, leader of the CDC’s Domestic Influenza Surveillance team, stated, “This is my 30th flu season. I never would have expected to see flu activity this low.”
In August 2020, the CDC alerted healthcare providers and parents about a potential surge in acute flaccid myelitis (AFM), a rare polio-like condition thought to be linked to enterovirus-D68. From 2014 to 2018, AFM cases peaked every other year, but only 29 cases were reported in 2020. Pediatric infectious-disease specialist Alex Dawson from Children’s Hospital in Colorado noted a significant absence of enterovirus D68 and other common childhood infections that usually lead to hospitalizations.
Across the board, the CDC reported similar declines in norovirus, RSV, parainfluenza, metapneumovirus, and several other types of coronaviruses.
While non-pharmaceutical interventions play a significant role, they aren’t the sole reason for this downturn.
Increased Vaccination Rates
Interestingly, more adults opted for flu vaccinations in 2020 compared to previous years. Although some demographics, including non-Hispanic Black adults and children, exhibited lower vaccination rates, a record 192.5 million flu doses were distributed in the U.S. during the 2020 flu season, aided by earlier community vaccination efforts.
Reduced International Travel
Even in places with less stringent COVID-19 measures, flu rates have decreased. Virologist Maria Chen from St. Jude’s Hospital in Memphis suggested that diminished international travel contributed to this decline, as the flu typically travels the globe, following winter across hemispheres.
Viral Interference
Research published in October 2020 indicates that infection by one virus can activate the immune system to release interferons, hindering the replication of other viruses. The study found that a prior rhinovirus infection could lower the risk of contracting influenza A, supporting the notion that rhinoviruses may have mitigated the influenza pandemic in Europe in 2009. This mechanism might also clarify why children are less affected by COVID-19, as rhinovirus remains one of the few circulating viruses, primarily among kids.
Why is COVID-19 Still Spreading?
If our precautions have led to a decline in other viruses, why does COVID-19 continue to spread? The answer lies in the nature of the viruses themselves. Common viruses are endemic, meaning they are always present, and many people have built immunity over time. In contrast, COVID-19 is a novel coronavirus, unfamiliar to our immune systems, making it harder to control its spread. This necessitates more stringent measures.
Epidemiologists worry that the extended period of non-exposure to common viruses could weaken herd immunity, potentially leading to outbreaks of these endemic viruses once society returns to normal. However, since this phenomenon hasn’t occurred in our lifetimes, the exact implications remain uncertain.
Personally, I support some of the social distancing measures remaining in place after the pandemic transitions to an endemic phase. The convenience of curbside pickups and enhanced delivery options is something I would welcome. As for masks, I plan to adopt them into my family’s lifestyle, inspired by my Taiwanese relatives.
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Summary:
The pandemic has led to a dramatic reduction in the spread of various respiratory and gastrointestinal viruses, aside from COVID-19. Factors such as increased flu vaccinations, reduced international travel, and viral interference contributed to this decline. While precautions have helped control many illnesses, COVID-19, being a novel virus, continues to spread due to a lack of pre-existing immunity in the population. The long-term implications of these changes on public health and immunity remain uncertain.