Skip to main content

Main menu

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • COVID-19 submission information
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • COVID-19 submission information
    • Institutional open access agreements
    • Peer reviewer login
  • Alerts
  • Subscriptions

Impact of general social distancing measures on incidence of influenza in Australia

Daniel P Steinfort, Benjamin Cowie, Douglas F Johnson
ERJ Open Research 2020 6: 00507-2020; DOI: 10.1183/23120541.00507-2020
Daniel P Steinfort
1Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Daniel P Steinfort
  • For correspondence: Daniel.steinfort@mh.org.au
Benjamin Cowie
2WHO Collaborating Centre for Viral Hepatitis, The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Douglas F Johnson
3Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Australia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Abstract

General social distancing measures enacted for control of the #SARSCoV2 pandemic have achieved a profound reduction in incidence of #influenza in Australia https://bit.ly/3hXjOkl

To the Editor:

We read with interest the work by McQuaid et al. [1] exploring the potential impact of social distancing on global transmission of tuberculosis. Influenza is responsible for a large number of deaths, with the World Health Organization estimating up to 650 000 deaths per year globally [2]. We have explored the impact of social distancing on incidence of influenza in Australia.

The Centers for Disease Control and Prevention (Atlanta, GA, USA) recently published a systematic review examining the efficacy of six individual social distancing measures in limiting the spread of community influenza transmission, including isolation of ill persons, contact tracing, quarantine of exposed persons, school and work closures, and avoiding crowding [3]. Following the emergence of the SARS-CoV-2 pandemic, in addition to closure of international borders, Australia (population 25 million) enacted all six social distancing measures simultaneously and has, to date, been highly successful in “flattening the curve” of COVID-19 [4], with (as of 11 June 2020) 7285 confirmed cases and just 102 deaths [5].

We report a major impact of these same measures on the incidence of influenza within Australia. Laboratory-confirmed influenza is a notifiable disease in Australia, with collation of surveillance conducted by Australian jurisdictions reported nationally in the National Notifiable Diseases Surveillance System. The notification rate for laboratory-confirmed cases of influenza in the first 3 months of 2020 was consistent with data from the previous 5 years (figure 1) [6]. In response to the COVID-19 pandemic, on 23 March 2020, Australia enacted a series of measures including significant social distancing measures to limit spread. Data for April and May indicate a striking fall in influenza incidence. Reported cases for May 2020 numbered 228, which is <1% of those observed in May 2019 (30 568 cases, 122.3 per 106) and only 3% of the average of the previous 5 years (8034, 32.1 per 106) [6]. While these comparisons are, to some degree, affected by the high notification rate reported in 2019, it remains striking that in the month of July, the notification rate for laboratory-confirmed influenza is <1% of the 5-year average, and even if 2019 data are excluded, remains only 1.3% of the average rate for the years 2015–2018.

FIGURE 1
  • Download figure
  • Open in new tab
  • Download powerpoint
FIGURE 1

Notifications of laboratory-confirmed influenza in Australia for January–July by year 2015–2020. Notifications are reported by the date the positive specimen was collected.

This does not appear to be primarily related to a reduction in testing, with numbers of generic molecular detection studies (∼80% of which are for influenza testing) [7] performed under Australia's universal national insurance scheme during April 2020 (154 000) falling only minimally in comparison to 2019 (181 000, 15% reduction) and remaining 16% higher than the previous 5-year average for May (133 400) [8].

Previous interventions for reduction in influenza cases predominantly focused on isolation of suspected/confirmed cases, and limited antiviral treatment for cases and rare antiviral prophylaxis for contacts, which has a moderate impact on influenza transmission. Interventions for confirmed COVID-19 cases, including isolation, quarantine, and contact tracing, will not affect influenza transmission and, therefore, the striking fall in influenza incidence appears to be the result of widespread, whole-of-population social distancing measures, including school and work closures, and avoidance of all nonessential social mixing outside the home.

While social distancing measures have played a key role in mitigating previous pandemics, these observations emphasise the profound impact of a combination of general social distancing measures on influenza and demonstrate the value of these measures in future pandemic planning.

Footnotes

  • Conflict of interest: D.P. Steinfort has nothing to disclose.

  • Conflict of interest: B. Cowie has nothing to disclose.

  • Conflict of interest: D.F. Johnson has nothing to disclose.

  • Received August 14, 2020.
  • Accepted August 18, 2020.
  • Copyright ©ERS 2020
http://creativecommons.org/licenses/by-nc/4.0/

This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

References

  1. ↵
    1. McQuaid CF,
    2. McCreesh N,
    3. Read JM, et al.
    The potential impact of COVID-19-related disruption on tuberculosis burden. Eur Respir J 2020; 56: 2001718. doi:10.1183/13993003.01718-2020
    OpenUrlAbstract/FREE Full Text
  2. ↵
    World Health Organization. Influenza (Seasonal). www.who.int/news-room/fact-sheets/detail/influenza-(seasonal). Date last accessed: 22 June 2020. Date last updated: 6 November 2018.
  3. ↵
    1. Fong MW,
    2. Gao H,
    3. Wong JY, et al.
    Nonpharmaceutical measures for pandemic influenza in nonhealthcare settings – social distancing measures. Emerging Infect Dis 2020; 26: 976–984. doi:10.3201/eid2605.190995
    OpenUrlCrossRefPubMed
  4. ↵
    1. McAnulty JM,
    2. Ward K
    . Suppressing the epidemic in New South Wales. N Engl J Med 2020; 382: e74. doi:10.1056/NEJMc2011592
    OpenUrl
  5. ↵
    The Age. COVID-19 data centre. www.theage.com.au/national/covid-19-data-centre-coronavirus-by-the-numbers-20200401-p54g4w.html?permanent_redirect=true. Data last accessed: 13 June 2020.
  6. ↵
    Australian Government DoH. National Notifiable Diseases Surveillance System. www9.health.gov.au/cda/source/cda-index.cfm. Date last accessed: 13 June 2020. Date last updated: 9 October 2020.
  7. ↵
    NSW Goverment. Influenza Surveillance Report. www.health.nsw.gov.au/Infectious/Influenza/Pages/reports.aspx. Date last updated: 12 April 2020.
  8. ↵
    Australian Government. Medicare Item Reports. http://medicarestatistics.humanservices.gov.au/statistics/mbs_item.jsp. Date last accessed: 11 June 2020. Date last updated: 24 July 2020.
PreviousNext
Back to top
Vol 6 Issue 4 Table of Contents
ERJ Open Research: 6 (4)
  • Table of Contents
  • Index by author
Email

Thank you for your interest in spreading the word on European Respiratory Society .

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Impact of general social distancing measures on incidence of influenza in Australia
(Your Name) has sent you a message from European Respiratory Society
(Your Name) thought you would like to see the European Respiratory Society web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Print
Citation Tools
Impact of general social distancing measures on incidence of influenza in Australia
Daniel P Steinfort, Benjamin Cowie, Douglas F Johnson
ERJ Open Research Oct 2020, 6 (4) 00507-2020; DOI: 10.1183/23120541.00507-2020

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Impact of general social distancing measures on incidence of influenza in Australia
Daniel P Steinfort, Benjamin Cowie, Douglas F Johnson
ERJ Open Research Oct 2020, 6 (4) 00507-2020; DOI: 10.1183/23120541.00507-2020
Reddit logo Technorati logo Twitter logo Connotea logo Facebook logo Mendeley logo
Full Text (PDF)

Jump To

  • Article
    • Abstract
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

Subjects

  • Respiratory infections and tuberculosis
  • Tweet Widget
  • Facebook Like
  • Google Plus One

More in this TOC Section

  • Interpreting lung oscillometry results
  • Interpreting lung oscillometry results
  • It is time to end our love affair with SABA in asthma?
Show more Correspondence

Related Articles

Navigate

  • Home
  • Current issue
  • Archive

About ERJ Open Research

  • Editorial board
  • Journal information
  • Press
  • Permissions and reprints
  • Advertising

The European Respiratory Society

  • Society home
  • myERS
  • Privacy policy
  • Accessibility

ERS publications

  • European Respiratory Journal
  • ERJ Open Research
  • European Respiratory Review
  • Breathe
  • ERS books online
  • ERS Bookshop

Help

  • Feedback

For authors

  • Instructions for authors
  • Publication ethics and malpractice
  • Submit a manuscript

For readers

  • Alerts
  • Subjects
  • RSS

Subscriptions

  • Accessing the ERS publications

Contact us

European Respiratory Society
442 Glossop Road
Sheffield S10 2PX
United Kingdom
Tel: +44 114 2672860
Email: journals@ersnet.org

ISSN

Online ISSN: 2312-0541

Copyright © 2023 by the European Respiratory Society