Modeling the impact of COVID-19 nonpharmaceutical interventions on respiratory syncytial virus transmission in South Africa

Samantha J. Bents*, Cécile Viboud, Bryan T. Grenfell, Alexandra B. Hogan, Stefano Tempia, Anne von Gottberg, Jocelyn Moyes, Sibongile Walaza, Chelsea Hansen, Cheryl Cohen, Rachel E. Baker

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: The South African government employed various nonpharmaceutical interventions (NPIs) to reduce the spread of SARS-CoV-2. Surveillance data from South Africa indicates reduced circulation of respiratory syncytial virus (RSV) throughout the 2020–2021 seasons. Here, we use a mechanistic transmission model to project the rebound of RSV in the two subsequent seasons. Methods: We fit an age-structured epidemiological model to hospitalization data from national RSV surveillance in South Africa, allowing for time-varying reduction in RSV transmission during periods of COVID-19 circulation. We apply the model to project the rebound of RSV in the 2022 and 2023 seasons. Results: We projected an early and intense outbreak of RSV in April 2022, with an age shift to older infants (6–23 months old) experiencing a larger portion of severe disease burden than typical. In March 2022, government alerts were issued to prepare the hospital system for this potentially intense outbreak. We then assess the 2022 predictions and project the 2023 season. Model predictions for 2023 indicate that RSV activity has not fully returned to normal, with a projected early and moderately intense wave. We estimate that NPIs reduced RSV transmission between 15% and 50% during periods of COVID-19 circulation. Conclusions: A wide range of NPIs impacted the dynamics of the RSV outbreaks throughout 2020–2023 in regard to timing, magnitude, and age structure, with important implications in a low- and middle-income countries (LMICs) setting where RSV interventions remain limited. More efforts should focus on adapting RSV models to LMIC data to project the impact of upcoming medical interventions for this disease.

Original languageEnglish
Article numbere13229
JournalInfluenza and Other Respiratory Viruses
Volume17
Issue number12
ISSN1750-2640
DOIs
Publication statusPublished - Dec 2023

Bibliographical note

Funding Information:
Anne von Gottberg, Cheryl Cohen, Jocelyn Moyes, and Sibongile Walaza acknowledge grants from Sanofi Pasteur, PATH, Bill & Melinda Gates Foundation, and SA‐Medical Research Council, The Centers for Disease Control and Prevention (US), and Wellcome Trust.

Keywords

  • COVID-19
  • epidemiological models
  • low- and middle-income countries
  • respiratory syncytial virus

Cite this