# A Retrospective Study of the Effects of COVID-19 Non-Pharmaceutical Interventions on Influenza in Canada

## TL;DR

This study examines how non-pharmaceutical interventions during the pandemic reduced influenza cases in Canada.

## Contribution

The study quantifies how NPIs affected influenza transmission using an SIR model and historical data.

## Key findings

- Effective population size and reproduction number changed significantly during the pandemic.
- NPI fatigue and relaxation led to varying influenza trends from 2020 to 2022.
- Effective population size is a key factor in disease spread.

## Abstract

Background/Objectives: COVID-19 pandemic had a significant impact on endemic respiratory illnesses. Through behavioral changes in populations and government policy, mainly through non-pharmaceutical interventions (NPIs), Canada saw historic lows in the number of influenza A cases from 2020 through 2022. In this study, we use historical influenza A data for Canada and three provincial jurisdictions within Canada—Ontario, Quebec, and Alberta—to quantify the effects of these NPIs on influenza A. Methods: We aim to see which base parameters and derived parameters of an SIR model are most affected by NPIs. We fit a simple SIR model to historical influenza data to get average paramters for seasonal influenza. We then compare these parameters to those predicted by fitting influenza cases during the COVID-19 pandemic. Results: We find substantial differences in the effective population size and basic reproduction number during the COVID-19 pandemic. We also see the effects of fatigue and relaxation of NPIs when comparing the years 2020, 2021, and 2022. Conclusions: We find that the effective population size is the main driver of change to disease spread and discuss how these retrospective estimates can be used for future forecasting.