Objective To evaluate the changes in influenza epidemic levels and spatiotemporal clustering in Guangzhou before and after the outbreak of COVID-19 to provide references for the risk assessment of the influ-enza epidemic in the post-epidemic era.Methods By using the synthetic index method,the influenza surveil-lance data from 2015 to 2019 were selected to establish a graded evaluation system of influenza epidemic level and to evaluate the changes in influenza epidemic level in Guangzhou after the COVID-19 epidemic(from the 4th week of 2020 to the 52nd week of 2022,a total of 154 weeks).Additionally,retrospective spatiotemporal scan analysis was used to explore the temporal and spatial distribution changes of influenza cases before and after the COVID-19 epidemic.Results After the outbreak of COVID-19,the epidemic level of influenza dropped sharply,maintaining a non-epidemic level(Grade 1)from the 7th week of 2020 to the 46th week of 2021.A moderate epidemic(Grade 3)was observed during the winter weeks of the 52nd week of 2021 to the 1st week of 2022 and from the 8th to the 10th week of 2022.By the 20th week of 2022,influenza entered a summer epidemic phase,reaching a peak(Grade 5)from the 22nd to the 27th week.The average rank of influenza epidemic levels post-COVID-19(188.00)was significantly lower than that before the pandemic(Z=-3.325,P＜0.01).Spatiotemporal scan analysis shows that prior to the pandemic,significant clustering areas were concentrated in Haizhu,Yuexiu,and Tianhe districts.After the pandemic,these areas shifted to Nansha,Panyu,and Haizhu districts in the southern and central-southern regions,with clustering periods occurring in the summer and winter.Conclusion Overall,the influenza epidemic level in Guangzhou post-COVID-19 is lower than that prior to the pandemic,yet spatiotemporal clustering persists.The spatial area of the first-class gathering area changed compared with that before the COVID-19 epidemic,shifting from the central city to the central-southern city.Summer and winter were still the key seasons for prevention and control.Health authorities should prepare early inter-vention plans targeting these clustered areas and epidemic periods to effectively manage influenza outbreaks.
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