The Impact of COVID-19 on Foodborne Disease
By: Drew Barkley
One year ago, community transmission of COVID-19 in the United States led several states to impose stay-at-home orders to reduce person-to-person transmission of the virus. As the year went on, messaging on hand hygiene, mask wearing, and social distancing were stressed as public health measures that were our best tools for combatting COVID-19. While the measures used to prevent the spread of COVID-19 varied from state to state, the COVID-19 pandemic disrupted life as we knew it and changed the way we have been living our daily lives since then. Early on, there was speculation that these newly emphasized public health measures would reduce the spread of other diseases as well. Hand washing had always been recommended but not always followed. One year since the COVID-19 pandemic began, we now have the data to begin looking at how the reaction to the pandemic impacted the spread of other communicable diseases.
As many public health officials predicted, there has been an impact on rates of other respiratory diseases. The CDC has noted that flu activity is significantly down this flu season, compared to the previous flu seasons.1 This decrease in seasonal flu is hypothesized to be due to a combination of the improved public health measures as well as an increase in vaccinations compared to previous flu seasons. The increase in vaccinations could have been driven by a strong campaign to encourage vaccination.2 Two studies have also found that social distancing and travel restrictions have decreased other non-COVID hospital admissions as well.3 4 The first found a significant decrease in non-COVID-19 respiratory diseases and the second actually found a decrease in foodborne and sexually transmitted diseases. However, there is also evidence that the pandemic has reduced the number of people seeking healthcare as they want to avoid potential exposures in the clinics and hospitals.5 So while the decrease we see in some non-COVID illnesses may be due to the positive impact of social distancing and mask wearing, it may also be because people that have those illnesses are no longer seeking care, and so are not captured in the statistics.
So how does foodborne disease fit into all of this? Initially, the CDC had noticed that last summer, the expected counts from PulseNet, an active foodborne disease outbreak surveillance system, were lower than previous years. The question was whether this was due to improved hand hygiene and a rise in contactless delivery, or whether people with foodborne diseases were less likely to seek care during the pandemic.
At CFI, we are currently working with Ohio State’s Information Warehouse Database (IWD) of electronic health record data as part of a new project. This database contains health information for all adults seen within the OSU healthcare system. While we are primarily using the data to look at the impact of long-term health outcomes from an incident case of foodborne disease, we can also use the data to determine whether there is a true decrease in cases during the pandemic or whether it is due to a drop in healthcare-seeking behavior. The work done on this project should help clarify what is happening with foodborne disease during the pandemic.
3 Nolen, L. D., S. Seeman, D. Bruden, J. Klejka, C. Desnoyers, J. Tiesinga, and R. Singleton. 2020. Impact of Social Distancing and Travel Restrictions on Non–Coronavirus Disease 2019 (Non–COVID-19) Respiratory Hospital Admissions in Young Children in Rural Alaska. Clin. Infect. Dis. Oxford University Press (OUP).
4 de Miguel Buckley, R., E. Trigo, F. de la Calle-Prieto, M. Arsuaga, and M. Díaz-Menéndez. 2020. Social distancing to combat COVID-19 led to a marked decrease in food-borne infections and sexually transmitted diseases in Spain. J. Travel Med. NLM (Medline) 27.