#16,253
While the COVID pandemic is far from over, the unseasonal return of RSV over the summer - and the expected return of influenza, and other seasonal respiratory viruses, this winter - are public health concerns that must be monitored and addressed as well.
For the past 18 months, limited surveillance resources have understandably been focused primarily on tracking and analysing COVID, but the lack of surveillance for other threats leaves us potentially open to being blindsided by other respiratory pathogens.
Since the spring of 2020, we've seen a 99% drop in influenza surveillance and genetic sequencing around the globe (see ECDC: Influenza Virus Characterisation - July 2021), making the selection of vaccine viruses for this fall's Northern Hemisphere Flu vaccine, and next year's Southern Hemisphere's vaccine more challenging.
The WHO, in announcing next year's flu vaccine, had this to say:
The volume of data available from recently circulating influenza viruses and the geographic representation have been significantly lower for this southern hemisphere vaccine recommendation meeting than was typical prior to the COVID-19 pandemic. The reduced number of characterised viruses raises uncertainties regarding the full extent of the genetic and antigenic diversity of currently circulating influenza viruses and those likely to pose a threat in forthcoming seasons.
Add in the expected return of avian influenza this winter to Europe and Asia, the recent uptick in human H5 infections around the globe, and the sporadic spillover of swine variant viruses to humans, and it becomes imperative that we restore some of our non-COVID surveillance system.
The laboratory and surveillance capabilities vary widely across EU/EEA countries, which means some trade offs will have to be made as limited resources are divided between COVID and other respiratory threats.
Today the ECDC has released a 13-page Technical Report in an attempt to prioritize goals.
COVID-19 surveillance guidance
Technical report
18 Oct 2021
This publication offers practical guidance to EU/EEA countries, encouraging them to transition from emergency surveillance for COVID-19 to more sustainable, objective-driven, surveillance systems.
Executive summary
Most European Union/European Economic Area (EU/EEA) countries have established comprehensive surveillance systems for COVID-19 with a large proportion reporting all positive cases regardless of indication for testing. Furthermore, testing policies have been different across countries, thus affecting data comparability at EU/EEA level. This guidance encourages countries to transition from emergency surveillance to more sustainable, objective-driven, surveillance systems according to the following key points:
- Systems should allow for integrated surveillance of COVID-19, influenza and other respiratory pathogens that are likely to co-circulate in the population.
- Current influenza surveillance systems are not sufficiently sensitive and representative to enable joint COVID-19 surveillance, thus countries should consider expanding the coverage of sentinel providers to improve sensitivity and to collect sufficient specimens for further characterisation.
- Countries should focus on reporting symptomatic cases, i.e. cases that have been tested because of experiencing COVID-19 compatible symptoms, as this will improve comparability.
- If comprehensive testing of all those presenting with symptoms is not feasible, a representative subset of symptomatic cases should be tested, preferably by PCR.
- A representative subset of SARS-CoV-2 positive specimens should be sequenced. Genomic surveillance of representative samples should be coupled with targeted comprehensive sampling in special settings or populations.
- Monitoring of vaccine effectiveness should be carried out through ad hoc studies, possibly embedded in surveillance systems.
- Countries should continue mortality monitoring and consider sero-epidemiological surveys among complementary systems which will help meet the main surveillance objectives.
COVID-19 surveillance guidance - EN - [PDF-308.83 KB]
