Changes in the incidence of seasonal influenza in response to COVID-19 social distancing measures: an observational study based on Canada’s national influenza surveillance system

Objectives: Seasonal influenza is an acute respiratory infection that presents a significant annual burden to Canadians and the Canadian healthcare system. Social distancing measures that were implemented to control the 2019–2020 novel coronavirus outbreak were investigated for their ability to lessen the incident cases of seasonal influenza. Methods: We conducted an ecological study using data from Canada’s national influenza surveillance system to investigate whether social distancing measures to control COVID-19 reduced the incident cases of seasonal influenza. Data taken from three separate time frames facilitated analysis of the 2019–2020 influenza season prior to, during, and following the implementation of COVID-19-related measures and enabled comparisons with the same time periods during three preceding flu seasons. The incidence, which referred to the number of laboratory-confirmed cases of specific influenza strains, was of primary focus. Further analysis determined the number of new laboratory-confirmed influenza or influenza-like illness outbreaks. Results: Our results indicate a premature end to the 2019–2020 influenza season, with significantly fewer cases and outbreaks being recorded following the enactment of many COVID-19 social distancing policies. The incidence of influenza strains A (H3N2), A (unsubtyped), and B were all significantly lower at the tail end of the 2019–2020 influenza season as compared with preceding seasons (p = 0.0003, p = 0.0007, p = 0.0019). Conclusion: Specific social distancing measures and behaviours may serve as effective tools to limit the spread of influenza transmission moving forward, as they become more familiar.