The Invasive Respiratory Infection Surveillance (IRIS) Initiative reveals significant reductions in invasive bacterial infections during the COVID-19 pandemic
Authors: Brueggemann Angela B , van Rensburg Melissa J Jansen , Shaw David , McCarthy Noel , Jolley Keith A , Maiden Martin CJ , van der Linden Mark PG , Amin-Chowdhury Zahin , Bennett Désirée E , Borrow Ray , Brandileone Maria-Cristina C , Broughton Karen , Campbell Ruth , Cao Bin , Casanova Carlo , Choi Eun Hwa , Chu Yiu Wai , Clark Stephen A , Claus Heike , Coelho Juliana , Corcoran Mary , Cottrell Simon , Cunney Robert J , Dalby Tine , Davies Heather , de Gouveia Linda , Deghmane Ala-Eddine , Demczuk Walter , Desmet Stefanie , Drew Richard J , du Plessis Mignon , Erlendsdottir Helga , Fry Norman K , Fuursted Kurt , Gray Steve J , Henriques-Normark Birgitta , Hale Thomas , Hilty Markus , Hoffmann Steen , Humphreys Hilary , Ip Margaret , Jacobsson Susanne , Johnston Jillian , Kozakova Jana , Kristinsson Karl G , Krizova Pavla , Kuch Alicja , Ladhani Shamez N , Lâm Thiên-Trí , Lebedova Vera , Lindholm Laura , Litt David , Martin Irene , Martiny Delphine , Mattheus Wesley , McElligott Martha , Meehan Mary , Meiring Susan , Mölling Paula , Morfeldt Eva , Morgan Julie , Mulhall Robert M , Muñoz-Almagro Carmen , Murdoch David R , Murphy Joy , Musilek Martin , Mzabi Alexandre , Perez-Argüello Amaresh , Perrin Monique , Perry Malorie , Redin Alba , Roberts Richard , Roberts Maria , Rokney Assaf , Ron Merav , Scott Kevin , Sheppard Carmen L. , Siira Lotta , Skoczyńska Anna , Sloan Monica , Slotved Hans-Christian , Smith Andrew J , Song Joon Young , Taha Muhamed-Kheir , Toropainen Maija , Tsang Dominic , Vainio Anni , van Sorge Nina M , Varon Emmanuelle , Vlach Jiri , Vogel Ulrich , Vohrnova Sandra , von Gottberg Anne , Zanella Rosemeire C , Zhou Fei 
Published: November 2020

AbstractBackgroundStreptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis are leading causes of invasive diseases including bacteraemic pneumonia and meningitis, and of secondary infections post-viral respiratory disease. They are typically transmitted via respiratory droplets. We investigated rates of invasive disease due to these pathogens during the early phase of the COVID-19 pandemic.MethodsLaboratories in 26 countries across six continents submitted data on cases of invasive disease due to S pneumoniae, H influenzae and N meningitidis from 1 January 2018 to 31 May 2020. Weekly cases in 2020 vs 2018-2019 were compared. Streptococcus agalactiae data were collected from nine laboratories for comparison to a non-respiratory pathogen. The stringency of COVID-19 containment measures was quantified by the Oxford COVID-19 Government Response Tracker. Changes in population movements were assessed by Google COVID-19 Community Mobility Reports. Interrupted time series modelling quantified changes in rates of invasive disease in 2020 relative to when containment measures were imposed.FindingsAll countries experienced a significant, sustained reduction in invasive diseases due to S pneumoniae, H influenzae and N meningitidis, but not S agalactiae, in early 2020, which coincided with the introduction of COVID-19 containment measures in each country. Similar impacts were observed across most countries despite differing stringency in COVID-19 control policies. There was no evidence of a specific effect due to enforced school closures.InterpretationThe introduction of COVID-19 containment policies and public information campaigns likely reduced transmission of these bacterial respiratory pathogens, leading to a significant reduction in life-threatening invasive diseases in many countries worldwide.