The impact of the COVID-19 pandemic on chlamydia infection in South Korea: a comparison between the pre-pandemic and during-pandemic periods.

Background: Prior to COVID-19 pandemic, a yearly upward trajectory in the number of chlamydia infection cases was observed in South Korea. However, in response to the COVID-19 pandemic, Korea implemented several public health and social measures, which were shown to have an impact on the epidemiology of other infectious diseases. This study aimed to estimate the impact of the COVID-19 pandemic on the incidence and number of reported chlamydia infections in South Korea. Methods: Using the monthly number of reported chlamydia infection data between 2017 and 2022, we compared the trends in the reported numbers, and the incidence rates (IR) of chlamydia infection stratified by demographic characteristics (sex, age group, and region) in the pre- and during COVID-19 pandemic period (January 2017-December 2019 and January 2020-December 2022). Results: We observed an irregular downward trajectory in the number of chlamydia infection in the during-pandemic period. A 30% decrease in the total number of chlamydia infection was estimated in the during-pandemic compared to the pre-pandemic period, with the decrease greater among males (35%) than females (25%). In addition, there was a decrease in the cumulative incidence rate of the during COVID-19 pandemic period (IR: 0.43; 95% CI: 0.42-0.44) compared to the pre-pandemic period (IR: 0.60; 95% CI: 0.59-0.61). Conclusions: We identified decrease in the number of chlamydia infection during COVID-19 pandemic which is likely due to underdiagnosis and underreporting for the infection. Therefore, strengthening surveillance for sexually transmitted infections including chlamydia is warranted for an effective and timely response in case of an unexpected rebound in the number of the infections.

Impact of travel restrictions for travellers from China on the internal spread of SARS-CoV-2 in South Korea.

South Korea implemented restrictions on travel from China in January of 2023. In this scenario-based model, we estimated that the travel restrictions for inbound travellers from China were associated with a 0.3%-9.8% decrease in the internal spread of SARS-CoV-2 in South Korea (95% Confidence Interval, 0.2%-11.7%).

Correction: Relative bradycardia in patients with COVID-19.

[This corrects the article DOI: 10.1186/s42444-022-00073-z.].

Corrigendum to: Temporal Changes in the Risk of Superspreading Events of Coronavirus Disease 2019.

[This corrects the article DOI: 10.1093/ofid/ofab350.].

Epidemiology and Transmission Dynamics of Infectious Diseases and Control Measures.

The epidemiology and transmission dynamics of infectious diseases must be understood at the individual and community levels to improve public health decision-making for real-time and integrated community-based control strategies. Herein, we explore the epidemiological characteristics for assessing the impact of public health interventions in the community setting and their applications. Computational statistical methods could advance research on infectious disease epidemiology and accumulate scientific evidence of the potential impacts of pharmaceutical/nonpharmaceutical measures to mitigate or control infectious diseases in the community. Novel public health threats from emerging zoonotic infectious diseases are urgent issues. Given these direct and indirect mitigating impacts at various levels to different infectious diseases and their burdens, we must consider an integrated assessment approach, 'One Health', to understand the dynamics and control of infectious diseases.

Prediction of upcoming global infection burden of influenza seasons after relaxation of public health and social measures during the COVID-19 pandemic: a modelling study.

BACKGROUND: The transmission dynamics of influenza were affected by public health and social measures (PHSMs) implemented globally since early 2020 to mitigate the COVID-19 pandemic. We aimed to assess the effect of COVID-19 PHSMs on the transmissibility of influenza viruses and to predict upcoming influenza epidemics. METHODS: For this modelling study, we used surveillance data on influenza virus activity for 11 different locations and countries in 2017-22. We implemented a data-driven mechanistic predictive modelling framework to predict future influenza seasons on the basis of pre-COVID-19 dynamics and the effect of PHSMs during the COVID-19 pandemic. We simulated the potential excess burden of upcoming influenza epidemics in terms of fold rise in peak magnitude and epidemic size compared with pre-COVID-19 levels. We also examined how a proactive influenza vaccination programme could mitigate this effect. FINDINGS: We estimated that COVID-19 PHSMs reduced influenza transmissibility by a maximum of 17·3% (95% CI 13·3-21·4) to 40·6% (35·2-45·9) and attack rate by 5·1% (1·5-7·2) to 24·8% (20·8-27·5) in the 2019-20 influenza season. We estimated a 10-60% increase in the population susceptibility for influenza, which might lead to a maximum of 1-5-fold rise in peak magnitude and 1-4-fold rise in epidemic size for the upcoming 2022-23 influenza season across locations, with a significantly higher fold rise in Singapore and Taiwan. The infection burden could be mitigated by additional proactive one-off influenza vaccination programmes. INTERPRETATION: Our results suggest the potential for substantial increases in infection burden in upcoming influenza seasons across the globe. Strengthening influenza vaccination programmes is the best preventive measure to reduce the effect of influenza virus infections in the community. FUNDING: Health and Medical Research Fund, Hong Kong.

Incubation period of wild type of SARS-CoV-2 infections by age, gender, and epidemic periods

Background The incubation period of the coronavirus disease 2019 (COVID-19) is estimated to vary by demographic factors and the COVID-19 epidemic periods. Objective This study examined the incubation period of the wild type of SARS-CoV-2 infections by the different age groups, gender, and epidemic periods in South Korea. Methods We collected COVID-19 patient data from the Korean public health authorities and estimated the incubation period by fitting three different distributions, including log-normal, gamma, and Weibull distributions, after stratification by gender and age groups. To identify any temporal impact on the incubation period, we divided the study period into two different epidemic periods (Period-1: 19 January−19 April 2020 and Period-2: 20 April−16 October 2020), and assessed for any differences. Results We identified the log-normal as the best-fit model. The estimated median incubation period was 4.6 (95% CI: 3.9–4.9) days, and the 95th percentile was 11.7 (95% CI: 10.2–12.2) days. We found that the incubation period did not differ significantly between males and females (p = 0.42), age groups (p = 0.60), and the two different epidemic periods (p = 0.77). Conclusions The incubation period of wild type of SARS-CoV-2 infection during the COVID-19 pandemic 2020, in South Korea, does not likely differ by age group, gender and epidemic period.

Decreased door-to-balloon time in patients with ST-segment elevation myocardial infarction during the early COVID-19 pandemic in South Korea: An observational study.

The coronavirus disease 2019 (COVID-19) resulted in a marked decrease in the number of patient visits for acute myocardial infarction and delayed patient response and intervention in several countries. This study evaluated the effect of the COVID-19 pandemic on the number of patients, patient response time (pain-to-door), and intervention time (door-to-balloon) for patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Patients with STEMI or NSTEMI visiting a hospital in South Korea who underwent primary coronary intervention during the COVID-19 pandemic (January 29, 2020, to December 31, 2020) were compared with those in the equivalent period from 2018 to 2019. Patient response and intervention times were compared for the COVID-19 pandemic window (2020) and the equivalent period from 2018 to 2019. We observed no decrease in the number of patients with STEMI (P = .88) and NSTEMI (P = 1.00) during the COVID-19 pandemic compared to that in the previous years. Patient response times (STEMI: P = .39; NSTEMI: P = .59) during the overall COVID-19 pandemic period did not differ significantly. However, we identified a significant decrease in door-to-balloon time among patients with STEMI (14%; P < .01) during the early COVID-19 pandemic. We found that the number of patients with STEMI and NSTEMI was consistent during the COVID-19 pandemic and that no time delays in patient response and intervention occurred. However, the door-to-balloon time among patients with STEMI significantly reduced during the early COVID-19 pandemic, which could be attributed to decreased emergency care utilization during the early pandemic.

Estimating the incubation period of SARS-CoV-2 Omicron BA.1 variant in comparison with that during the Delta variant dominance in South Korea.

Based on exposure history and symptom onset of 22 Omicron BA.1 cases in South Korea from November to December 2021, we estimated mean incubation period of 3.5 days (95% CI: 2.5, 3.8), and then compared to that of 6.5 days (95% CI: 5.3, 7.7) for 64 cases during Delta variants' dominance in June 2021. For Omicron BA.1 variants, we found that 95% of symptomatic cases developed clinical conditions within 6.0 days (95% CI: 4.3, 6.6) after exposure. Thus, a shorter quarantine period may be considered based on symptoms, or similarly laboratory testing, when Omicron BA.1 variants are circulating.

Characterizing superspreading potential of infectious disease: Decomposition of individual transmissibility.

In the context of infectious disease transmission, high heterogeneity in individual infectiousness indicates that a few index cases can generate large numbers of secondary cases, a phenomenon commonly known as superspreading. The potential of disease superspreading can be characterized by describing the distribution of secondary cases (of each seed case) as a negative binomial (NB) distribution with the dispersion parameter, k. Based on the feature of NB distribution, there must be a proportion of individuals with individual reproduction number of almost 0, which appears restricted and unrealistic. To overcome this limitation, we generalized the compound structure of a Poisson rate and included an additional parameter, and divided the reproduction number into independent and additive fixed and variable components. Then, the secondary cases followed a Delaporte distribution. We demonstrated that the Delaporte distribution was important for understanding the characteristics of disease transmission, which generated new insights distinct from the NB model. By using real-world dataset, the Delaporte distribution provides improvements in describing the distributions of COVID-19 and SARS cases compared to the NB distribution. The model selection yielded increasing statistical power with larger sample sizes as well as conservative type I error in detecting the improvement in fitting with the likelihood ratio (LR) test. Numerical simulation revealed that the control strategy-making process may benefit from monitoring the transmission characteristics under the Delaporte framework. Our findings highlighted that for the COVID-19 pandemic, population-wide interventions may control disease transmission on a general scale before recommending the high-risk-specific control strategies.

Collateral Impact of Public Health and Social Measures on Respiratory Virus Activity during the COVID-19 Pandemic 2020-2021.

Many countries have implemented public health and social measures (PHSMs) to control the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Although the PHSMs are targeted at SARS-CoV-2 transmission control, they directly or indirectly impact the epidemiology of different respiratory viral diseases. The purpose of this study was to investigate the collateral impact of PHSMs used during the coronavirus disease 2019 (COVID-19) pandemic on the epidemiology of other respiratory viruses, including influenza, parainfluenza, respiratory syncytial virus, rhinovirus, and adenovirus infections. We conducted a systematic review of the published literature on changes in the incidence of respiratory viral diseases and detection rates of the respiratory viruses during COVID-19 pandemic, lasting from 2020-2021, published between December 2019 and March 2022 in PubMed, Embase, and Cochrane Library databases. We identified an overall decrease of 23-94% in the incidence of respiratory viral diseases and a decrease of 0-98% in the detection of the viruses. Our study suggests that the PHSMs implemented during COVID-19 pandemic reduced the incidence of respiratory viral diseases and transmission of respiratory viruses. At the time of this study, and as governments relax PHSMs, public health authorities should prepare for a probable increase in the burden of respiratory viral diseases.

Estimation of Serial Interval and Reproduction Number to Quantify the Transmissibility of SARS-CoV-2 Omicron Variant in South Korea.

The omicron variant (B.1.1.529) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was the predominant variant in South Korea from late January 2022. In this study, we aimed to report the early estimates of the serial interval distribution and reproduction number to quantify the transmissibility of the omicron variant in South Korea between 25 November 2021 and 31 December 2021. We analyzed 427 local omicron cases and reconstructed 73 transmission pairs. We used a maximum likelihood estimation to assess serial interval distribution from transmission pair data and reproduction numbers from 74 local cases in the first local outbreak. We estimated that the mean serial interval was 3.78 (standard deviation, 0.76) days, which was significantly shorter in child infectors (3.0 days) compared to adult infectors (5.0 days) (p < 0.01). We estimated the mean reproduction number was 1.72 (95% CrI, 1.60-1.85) for the omicron variant during the first local outbreak. Strict adherence to public health measures, particularly in children, should be in place to reduce the transmission risk of the highly transmissible omicron variant in the community.

Decreased patient visits for ankle sprain during the COVID-19 pandemic in South Korea: A nationwide retrospective study.

Social distancing measures including school closure and the cancelation of sports activity were enforced during the early phase of the coronavirus disease 2019 (COVID-19) pandemic to reduce the spread of severe acute respiratory syndrome coronavirus 2 in South Korea. To assess the impact of the COVID-19 pandemic on the nationwide burden of musculoskeletal injury in 2020, we analyzed data on the number of patient visits for ankle sprain in South Korea. We collected national reimbursement data on the number of patient visits for ankle sprain between August 2010 and July 2020. To quantify the impact of the COVID-19 pandemic on the number of reductions in patient visits for ankle sprain, we developed a regression model adjusting for the annual cycle of the patient visit during 2016/17-2018/19. During the COVID-19 pandemic in South Korea, the overall number of patient visits for ankle sprain dropped by 7.9%. The number of patient visits for ankle sprain substantially reduced by 23.4% among school-aged children (6-19 years) during the COVID-19 pandemic in South Korea. Our findings suggest that the social distancing measure has had a positive impact on reducing the burden of medical usages for ankle sprain.

Serial Interval and Transmission Dynamics during SARS-CoV-2 Delta Variant Predominance, South Korea.

We estimated mean serial interval and superspreading potential for the Delta variant of severe acute respiratory syndrome coronavirus 2 in South Korea. Intervals were similar for the first (3.7 days) and second (3.5 days) study periods. Risk for superspreading events was also similar; 23% and 25% of cases, respectively, seeded 80% of transmissions.

Transmission Dynamics of the Delta Variant of SARS-CoV-2 Infections in South Korea.

BACKGROUND: The Delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was the predominant variant worldwide at the time of this study. However, its transmission dynamics were unclear. METHODS: We analyzed 405 local cases infected with the Delta variant of SARS-CoV-2 and temporal patterns of viral shedding identified between 22 June and 31 July 2021 in Daejeon, South Korea. RESULTS: Overall, 20% were presymptomatic at the time of epidemiological investigation. We identified 6 clustered outbreaks, and all were associated with indoor facilities. In 23 household contacts, the secondary attack rate was 63%. We estimated the mean serial interval as 3.26 days (95% credible interval, 2.92-3.60), and 15% (95% confidence interval, 13%-18%) of cases seeded 80% of all local transmission. Analysis of the nasopharyngeal swab samples identified virus shedding from the presymptomatic cases and the highest viral load was observed 2 days after symptom onset. CONCLUSIONS: Our findings suggest that the Delta variant is highly transmissible in indoor settings and households. Rapid contact tracing, isolation of the asymptomatic contacts, strict adherence to public health measures, and increased uptake of coronavirus disease 2019 (COVID-19) vaccination, including booster doses, are needed to reduce community transmission of the Delta variant.

Factors associated with the difference between the incidence and case-fatality ratio of coronavirus disease 2019 by country.

Coronavirus disease (COVID-19) has been spreading all over the world; however, its incidence and case-fatality ratio differ greatly between countries and between continents. We investigated factors associated with international variation in COVID-19 incidence and case-fatality ratio (CFR) across 107 northern hemisphere countries, using publicly available COVID-19 outcome data as of 14 September 2020. We included country-specific geographic, demographic, socio-economic features, global health security index (GHSI), healthcare capacity, and major health behavior indexes in multivariate models to explain this variation. Multiple linear regression highlighted that incidence was associated with ethnic region (p < 0.05), global health security index 4 (GHSI4) (beta coefficient [ß] 0.50, 95% Confidence Interval [CI] 0.14-0.87), population density (ß 0.35, 95% CI 0.10-0.60), and water safety level (ß 0.51, 95% CI 0.19-0.84). The CFR was associated with ethnic region (p < 0.05), GHSI4 (ß 0.53, 95% CI 0.14-0.92), proportion of population over 65 (ß 0.71, 95% CI 0.19-1.24), international tourism receipt level (ß - 0.23, 95% CI - 0.43 to - 0.03), and the number of physicians (ß - 0.37, 95% CI - 0.69 to - 0.06). Ethnic region was the most influential factor for both COVID-19 incidence (partial [Formula: see text] = 0.545) and CFR (partial [Formula: see text] = 0.372), even after adjusting for various confounding factors.