Collateral effects of COVID-19 pandemic control on the US infectious disease landscape.

Using data from the United States Centers for Disease Control and Prevention (CDC) disease surveillance systems, we sought to quantify the indirect effects of the COVID-19 pandemic, and the possibility of lack of exposure to common pathogens resulting in immune deficits. Clustering analysis on pandemic-era time-series data identified pathogen groupings according to transmission mechanism. Counterfactual analysis, using Bayesian structural time-series (BSTS) modeling, confirmed that infectious diseases that are directly transmitted via airborne droplets (aerosols) experienced the greatest disruption to transmission. By contrast, sexually transmitted infections (STIs) experienced a smaller transient disruption, and increasing trends in incidence prepandemic appear to have been curtailed. Using epidemiological theory, we demonstrate that the observed magnitudes and durations of notifications deficits were determined by fundamental disease system properties, namely, the serial interval, basic reproductive number, and susceptible recruitment. Editor's summary: The massive range and costs of interventions undertaken to limit the harms caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had many side effects. Using surveillance data from the Centers for Disease Control and Prevention for notifiable infectious diseases, Brett and Rohani made a comprehensive statistical analysis of the indirect impact of the pandemic on a range of infections occurring in the US (see the Perspective by Durrheim). Although several endemic infections have rebounded to prepandemic levels of notification since 2020, the overall burden from infectious disease has been reduced. —Caroline Ash [ABSTRACT FROM AUTHOR]