Understanding the potential drivers for respiratory syncytial virus rebound during the COVID-19 pandemic

You Li, Xin Wang, Bingbing Cong, Shuyu University, Daniel R. Feikin, Harish Nair

Research output: Contribution to journalArticlepeer-review


Non-pharmaceutical interventions (NPIs) were widely introduced to combat the COVID-19 pandemic. These interventions also likely led to substantially reduced activity of respiratory syncytial virus (RSV). From late 2020, some countries observed out-of-season RSV epidemics. Here, we analyzed the role of NPIs, population mobility, climate, and SARS-CoV-2 circulation in RSV rebound through a time-to-event analysis across 18 countries. Full (re)-opening of schools was associated with an increased risk for RSV rebound (HR = 23.29 [95% CI: 1.09–495.84]); every 5°C increase in temperature was associated with a decreased risk (HR = 0.63 [0.40–0.99]). There was an increasing trend in the risk for RSV rebound over time, highlighting the role of increased population susceptibility. No other factors were found statistically significant. Further analysis suggests increasing population susceptibility and full (re)-opening of schools could both override the counter-effect of high temperatures, which explains the out-of-season RSV epidemics during the COVID-19 pandemic.
Original languageEnglish
Pages (from-to)957-964
JournalJournal of Infectious Diseases
Issue number6
Publication statusPublished - 14 Jan 2022


  • COVID-19/epidemiology
  • Climate
  • Humans
  • Pandemics
  • Respiratory Syncytial Virus Infections/epidemiology
  • Respiratory Syncytial Virus, Human/pathogenicity
  • Seasons
  • Temperature


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