Abstract Background During the COVID-19 pandemic, public health efforts focused on limiting the transmission of SARS-CoV-2, which also disrupted typical seasonal patterns of non-SARS-CoV-2 respiratory viruses. Prior studies relied on hospital- and laboratory-based methods, which represent medically attended illnesses, and fail to capture the full burden of community respiratory virus circulation. The study objective is to describe the detection rates of respiratory viruses circulating during the COVID-19 pandemic (May 2020-February 2021) among individuals from households with children. Methods From the HEROS cohort, a prospective viral surveillance study of SARS-CoV-2 infection in households with children, enriched for asthma and allergic diseases (N = 4,142), conducted from May 2020 to February 2021 in 12 US cities, we randomly selected 1,000 participants from unique households. Self- or caregiver-collected nasal swabs were obtained every two weeks, and during intervening illnesses. All swabs were tested for SARS-CoV-2 and common respiratory viruses. Infection rates (detections per person) were estimated for each respiratory virus. Viral detection rates over time were presented as rolling 7-day averages. Results We tested 9,338 nasal samples and detected at least one virus in 43% of participants. The median age of participants with any virus detected was 16 years (IQR 7-36) and of those with no virus 34 years (IQR 13-44). Overall, there were low detection rates of non-SARS-CoV-2 viruses compared to expected seasonal patterns. Detections of respiratory syncytial virus (RSV) and influenza viruses were rare. Rates of non-SARS-CoV-2 virus detection, primarily rhinovirus/enterovirus (RV/EV), progressively increased between July and October and peaked at 0.114/person, during a period of low SARS-CoV-2 detection; SARS-CoV-2 detection rate peaked at 0.033/person in November when non-SARS-CoV-2 virus detection declined. Discussion Leveraging the unique HEROS study design of household-based surveillance, this study provides a comprehensive view of community viral burden during the first year of the pandemic, before wide-spread vaccine introduction. Younger age of those infected suggests that children are drivers of viral transmission. RV/EV was the most frequently detected virus, and rates between RV/EV and SARS-CoV-2 appeared to be inversely related, supporting an ecological hypothesis of viral interference. Low detection rates of RSV and influenza may reflect the typical seasonal decrease in spring and the effectiveness of non-pharmaceutical interventions (NPIs) like masking and social distancing preventing the typical winter peak. Further study is needed to assess the respiratory viral circulation dynamics at ecologic, household, and personal levels to guide effective infectious disease preparedness and public health strategies. This abstract is funded by: UM1AI114271, U19AI095227, T32 HL087738
Cacho et al. (Fri,) studied this question.