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Background <p>The COVID-19 pandemic has had a profound global impact. This study aims to assess the impact of lifting COVID-19 restrictions on the transmission dynamics of influenza across various countries, investigating how the timing of these policy changes influences influenza outbreaks and public health responses.</p> Methods <p>We used daily COVID-19 case data and weekly influenza case data to estimate the effective reproduction number (<InlineEquation ID="IEq1"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="13662_2025_3872_Article_IEq1.gif" Format="GIF" Height="16" Rendition="HTML" Resolution="72" Type="Linedraw" Width="21" /> </InlineMediaObject> <EquationSource Format="MATHML"><math> <msub> <mi>R</mi> <mi>t</mi> </msub> </math></EquationSource> <EquationSource Format="TEX">$R_{t}$</EquationSource> </InlineEquation>) for both diseases before and after reopening. Additionally, we conducted counterfactual analyzes using Seasonal ARIMA models to predict influenza positivity rates.</p> Results <p>Lifting COVID-19 restrictions led to COVID-19 transmission increase, but postponed the outbreak of influenza. Countries were categorized based on the timing of easing restrictions relative to the influenza season: near the influenza peak (China, UK), outside the season (USA, South Africa), and without clear seasonality (Singapore, Indonesia). For the first group, reopening delayed the influenza peak; for the second, the impact on peak duration was minimal; for the third, lifting restrictions led to a rapid but controlled outbreak. Specifically in China, the influenza peak was delayed by 10 weeks and the peak infection rate was 10.4% higher following the reopening.</p> Conclusion <p>The findings underscore the complex interplay between COVID-19 and influenza transmission and highlight the divergent impacts of reopening measures on infectious diseases, indicating that the timing of policy measures is crucial for mitigating influenza outbreaks. Then insights gained can enhance resource allocation and offer a new perspective for public health.</p>

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The impact of lifting COVID-19 restrictions on influenza transmission across countries

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月31日

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  • Wenyu Du,
  • Zhenghui Feng,
  • Yi Zhao

摘要

Background

The COVID-19 pandemic has had a profound global impact. This study aims to assess the impact of lifting COVID-19 restrictions on the transmission dynamics of influenza across various countries, investigating how the timing of these policy changes influences influenza outbreaks and public health responses.

Methods

We used daily COVID-19 case data and weekly influenza case data to estimate the effective reproduction number ( R t $R_{t}$ ) for both diseases before and after reopening. Additionally, we conducted counterfactual analyzes using Seasonal ARIMA models to predict influenza positivity rates.

Results

Lifting COVID-19 restrictions led to COVID-19 transmission increase, but postponed the outbreak of influenza. Countries were categorized based on the timing of easing restrictions relative to the influenza season: near the influenza peak (China, UK), outside the season (USA, South Africa), and without clear seasonality (Singapore, Indonesia). For the first group, reopening delayed the influenza peak; for the second, the impact on peak duration was minimal; for the third, lifting restrictions led to a rapid but controlled outbreak. Specifically in China, the influenza peak was delayed by 10 weeks and the peak infection rate was 10.4% higher following the reopening.

Conclusion

The findings underscore the complex interplay between COVID-19 and influenza transmission and highlight the divergent impacts of reopening measures on infectious diseases, indicating that the timing of policy measures is crucial for mitigating influenza outbreaks. Then insights gained can enhance resource allocation and offer a new perspective for public health.