The Impact Of Preventative Measures Against COVID-19 On The Outbreak Of Acute Respiratory Disease In Hangzhou City During COVID-19 Pandemic:a Time-series Study

Objective:To describe the distribution characteristics of outpatient and emergency visits of the common acute respiratory diseases of the otorhinolaryngology depart in Hangzhou City during the period that before and after the implementation of the Coronavirus disease 2019（COVID-19）epidemic prevention and control measures.At the same time to analyze the impact of epidemic prevention and control measures in Zhejiang Province on the risk of acute diseases of the common upper respiratory tract in the Department of otorhinolaryngology.And through these two aspects to provide targeted guidance for the prevention of common acute diseases of upper respiratory tract in otorhinolaryngology department.Methods:The clinical data of common acute diseases of upper respiratory tract（acute rhinosinusitis,acute tonsillitis,acute laryngitis and acute otitis media）and non-respiratory diseases（acute cholecystitis,acute urethritis and cerebral infarction）in outpatient and emergency departments of four large tertiary general hospitals in the main urban area of Hangzhou,Zhejiang Province from January 1,2013 to May 31,2020 were collected,and the characteristics of these data over time were analyzed by descriptive statistics.Seasonal autoregressive integrated moving average（SARIMA）and Poisson regression analysis were used to establish the incidence time series model of acute diseases of upper respiratory tract,and analyze the impact of epidemic prevention and control measures on the incidence risk of common acute diseases of upper respiratory tract in otorhinolaryngology.Results:The descriptive analysis results of outpatient and emergency visits for acute upper respiratory diseases and non-respiratory diseases indicate that:1.Before the epidemic prevention and control period,the daily average number of patients with acute upper respiratory diseases in the Department of otorhinolaryngology in the main urban area of Hangzhou reached 179.9 times,and the number of patients increased year by year.The majority of people aged 5-14 years old,accounting for 47.4%.The annual number of visits showed significant seasonal differences,while the average daily number of visits in the cold season（from November to April）was 187.6 times,which was significantly higher than that in the warm season（from May to October）of 166.2 times;2.During the epidemic prevention and control period,the total number of visits for acute diseases of upper respiratory tract decreased from 179.9 times per day to 41.1 times per day,while the average daily number of visits for acute rhinosinusitis decreased from 22.4 times to 6.7 times,acute tonsillitis from 135.3 times to 30.3 times,acute laryngitis from 10.9 times to 1.7 times,and acute otitis media from 11.2 times to 2.4 times.The number of outpatient and emergency visits for various acute diseases of upper respiratory tract remained at a low level from February to early April 2020.With the adjustment of epidemic prevention and control measures,the number of visits for acute diseases of upper respiratory tract has gradually increased since late April,but it has not reached the level of the same period in previous years at May 31,2020;3.The revised SARIMA model shows that during the period of covid-19 epidemic prevention and control in the main urban area of Hangzhou,the actual number of visits for common acute diseases of upper respiratory tract decreased by 53.85%（P<0.05）,among which the number of visits for acute laryngitis,acute rhinosinusitis,acute tonsillitis and acute otitis media decreased by 83.51%,82.61%,82.73%and 76.41%respectively,which was significantly higher than that of acute cholecystitis,acute urethritis decreased by 33.84%,28.72%and 21.94%.Compared with non-respiratory diseases,the decline degree of acute diseases of upper respiratory tract decreased by 58.00%（P<0.05）.Conclusion:1.The covid-19 epidemic prevention and control measures in the main urban area of Hangzhou have a significant blocking effect on the incidence of acute diseases of upper respiratory tract of otolaryngology,suggesting that the epidemic prevention measures can effectively reduce the incidence of acute diseases of otolaryngology.2.The incidence of acute diseases of upper respiratory tract of otolaryngology in the main urban area of Hangzhou is increasing year by year,among which acute rhinosinusitis and acute tonsillitis are the most significant.Therefore,it is particularly necessary to study and formulate corresponding protection policies from the perspective of etiology and epidemiology.3.The acute diseases of upper respiratory tract of otolaryngology tend to occur most common in the age group of 5-14 years old,and the incidence has obvious seasonality,while the effect of cold season is significantly higher than that of warm season.