Impact of the covid-19 pandemic on GP contacts for respiratory infections in children under 5 years

BACKGROUND: Social distancing measures to reduce transmission of SARS-CoV-2 during the covid-19 pandemic also impacted the transmission of many other respiratory pathogens. We describe the impact of the covid-19 pandemic on general practitioner (GP) contact rates for respiratory tract infections (RTIs) that may have been affected by social distancing in children <5 years in England. METHODS: Trends analysis from 1 April 2016 to 31 March 2021 using electronic health records from a nationally representative primary care database. We included all children aged <5 years registered with a primary care practice during the study period. Our main outcome was GP contact rates for transmissible RTIs including otitis media, tonsillitis, and pneumonia. We also calculated the rates of urinary tract infections as an index non-transmissible condition. We calculated annual rates for each year of age (<1, 1-<2, 2-<3, 3-<4, 4-<5) by summing the GP contacts divided by the number of days each child was registered with the GP practice. RESULTS: There were 415 622 RTIs among 1 955 946 children <5 years over the study period. From 2016-2020 GP contact rates for RTIs were falling steadily by ∼14%/ year in all age bands, with rates of otitis media, tonsillitis and pneumonia declining by 5-11% per year. However, in 2021 marked falls of around 80% occurred for all RTIs, otitis media, tonsillitis, and pneumonia. By contrast, trends for GP contact rates for urinary tract infections before and during the covid-19 pandemic steadily declined by ∼5%/year. CONCLUSIONS: Our study shows major reductions in the incidence of RTIs in under 5s during the pandemic, probably a result of SARS-CoV-2 containment measures. The impact of reduced exposure to RTIs during childhood on long term respiratory health is unknown. At the conference, we will report results up to March 2023. KEY MESSAGES: • GP contacts for respiratory infections in under 5s fell during the covid-19 pandemic in England. • Fewer respiratory infections in childhood may impact future health service use and requires monitoring.