JMIR Publications

ABSTRACT

Background:

The Coronavirus Disease 2019 (COVID-19) pandemic resulted in a massive disruption in access to care and thus passive, hospital and clinic-based surveillance programs. During this period, human contact patterns began to shift with higher rates of greenspace usage and outdoor activities, ostensibly putting more people into contact with potential vectors and associated vector borne diseases.

Objective:

This study aimed to determine the likely under-ascertainment of cases of Lyme disease during the COVID-19 pandemic.

Methods:

We fit publicly available reported Lyme diseases cases for both the United States and North Carolina and prior to the year 2020 to predict the number of anticipated Lyme disease cases in the absence of the pandemic. We then compared this ratio to quantify the number of likely under-ascertained cases. We then fit geospatial models to further quantify the spatial distribution of the likely under-ascertained cases.

Results:

Our findings suggest that roughly 14,200 cases may have gone undetected given historical trends prior to the pandemic. Furthermore, we estimate 40-80% of Lyme diseases cases were detected in North Carolina between August 2020 to February 2021, the peak months of the COVID-19 pandemic in both the United States and North Carolina, with prior ascertainment rates returning to normal levels afterwards.

Conclusions:

In this study we estimate the impact of the COVID-19 pandemic on the ascertainment rate of Lyme disease cases in North Carolina using time series and spatiotemporal techniques. In 2020, the reported cases of Lyme disease were the lowest both across the United States and North Carolina in recent years.