• K Kehoe, E Morden, N Zinyakatira, A Heekes, H E Jones, S R Walter, T Jacobs, J Murray, H Buys, M T Redaniel, and M-A Davies.
• Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa; Population Health Sciences, Bristol Medical School, University of Bristol, UK; Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa. kathleen.kehoe@westerncape.gov.za.
• S. Afr. Med. J. 2024 Mar 18; 114 (3): e1560e1560.

BackgroundThe COVID-19 pandemic resulted in the implementation of strict public health and social measures (PHSMs) (including mobility restrictions, social distancing, mask-wearing and hand hygiene), limitations on non-essential healthcare services, and public fear of COVID-19 infection, all of which potentially affected transmission and healthcare use for other diseases such as lower respiratory tract infections (LRTIs).ObjectiveTo determine changes in LRTI hospital admissions and in-facility mortality in children aged <5 years in the Western Cape Province during the pandemic.MethodsWe conducted a retrospective analysis of LRTI admissions and in-facility deaths from January 2019 to November 2021. We estimated changes in rates and trends of LRTI admissions during the pandemic compared with pre-pandemic period using interrupted time series analysis, adjusting for key characteristics.ResultsThere were 36 277 children admitted for LRTIs during the study period, of whom 58% were male and 51% were aged 28 days - 1 year. COVID-19 restrictions were associated with a 13% step reduction in LRTI admissions compared with the pre-COVID-19 period (incidence rate ratio (IRR) 0.87, 95% confidence interval (CI)) 0.80 - 0.94). The average LRTI admission trend increased on average by 2% per month during the pandemic (IRR 1.02, 95% CI 1.02 - 1.04).ConclusionsThe COVID-19 surges and their associated measures were linked to declining LRTI admissions and in-facility deaths, likely driven by a combination of reduced infectious disease transmission and reduced use of healthcare services, with effects diminishing over time. These findings may inform future pandemic response policies.

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