1887
Surveillance Open Access
Like 0

Abstract

Background

A multi-tiered surveillance system based on influenza surveillance was adopted in the United Kingdom in the early stages of the coronavirus disease (COVID-19) epidemic to monitor different stages of the disease. Mandatory social and physical distancing measures (SPDM) were introduced on 23 March 2020 to attempt to limit transmission.

Aim

To describe the impact of SPDM on COVID-19 activity as detected through the different surveillance systems.

Methods

Data from national population surveys, web-based indicators, syndromic surveillance, sentinel swabbing, respiratory outbreaks, secondary care admissions and mortality indicators from the start of the epidemic to week 18 2020 were used to identify the timing of peaks in surveillance indicators relative to the introduction of SPDM. This timing was compared with median time from symptom onset to different stages of illness and levels of care or interactions with healthcare services.

Results

The impact of SPDM was detected within 1 week through population surveys, web search indicators and sentinel swabbing reported by onset date. There were detectable impacts on syndromic surveillance indicators for difficulty breathing, influenza-like illness and COVID-19 coding at 2, 7 and 12 days respectively, hospitalisations and critical care admissions (both 12 days), laboratory positivity (14 days), deaths (17 days) and nursing home outbreaks (4 weeks).

Conclusion

The impact of SPDM on COVID-19 activity was detectable within 1 week through community surveillance indicators, highlighting their importance in early detection of changes in activity. Community swabbing surveillance may be increasingly important as a specific indicator, should circulation of seasonal respiratory viruses increase.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2021.26.11.2001062
2021-03-18
2021-10-26
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.11.2001062
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/26/11/eurosurv-26-11-4.html?itemId=/content/10.2807/1560-7917.ES.2021.26.11.2001062&mimeType=html&fmt=ahah

References

  1. Lillie PJ, Samson A, Li A, Adams K, Capstick R, Barlow GD, et al. Novel coronavirus disease (Covid-19): The first two patients in the UK with person to person transmission. J Infect. 2020;80(5):578-606.  https://doi.org/10.1016/j.jinf.2020.02.020  PMID: 32119884 
  2. Spiteri G, Fielding J, Diercke M, Campese C, Enouf V, Gaymard A, et al. First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020. Euro Surveill. 2020;25(9):2000178.  https://doi.org/10.2807/1560-7917.ES.2020.25.9.2000178  PMID: 32156327 
  3. Prime Minister’s Office. Prime Minister's statement on coronavirus (COVID-19): 12 March 2020. London: UK Government. 12 Mar 2020. Available from: https://www.gov.uk/government/speeches/pm-statement-on-coronavirus-12-march-2020
  4. Prime Minister’s Office. Prime Minister's statement on coronavirus (COVID-19): 16 March 2020. London: UK Government. 16 Mar 2020. Available from: https://www.gov.uk/government/speeches/pm-statement-on-coronavirus-16-march-2020
  5. UK Cabinet Office. Staying at home and away from others (social distancing). London: UK Cabinet Office. [Accessed: 13 Apr 2020]. Available from: https://www.gov.uk/government/publications/full-guidance-on-staying-at-home-and-away-from-others/full-guidance-on-staying-at-home-and-away-from-others
  6. Jarvis CI, Van Zandvoort K, Gimma A, Prem K, Klepac P, Rubin GJ, et al. Quantifying the impact of physical distance measures on the transmission of COVID-19 in the UK. BMC Med. 2020;18(1):124.  https://doi.org/10.1186/s12916-020-01597-8  PMID: 32375776 
  7. World Health Organization (WHO). Coronavirus disease 2019 (COVID-19): Situation Report – 73. Geneva: WHO; 2 Apr 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf?sfvrsn=5ae25bc7_2
  8. Lopez Bernal J, Panagiotopoulos N, Byers C, Garcia Vilaplana T, Boddington NL, Zhang X, et al. Transmission dynamics of COVID-19 in household and community settings in the United Kingdom. medRxiv. 2020:2020.08.19.20177188.
  9. Public Health England (PHE). National COVID-19 surveillance reports. London: PHE; 2020. Available from: https://www.gov.uk/government/publications/national-covid-19-surveillance-reports
  10. Public Health England (PHE). Sources of UK flu data: influenza surveillance in the UK. London: PHE. [Accessed: 13 Apr 2020]. Available from: https://www.gov.uk/guidance/sources-of-uk-flu-data-influenza-surveillance-in-the-uk
  11. Public Health England (PHE). London School of Hygiene and Tropical Medicine. Flusurvey Platform. [Accessed: 13 Apr 2020]. Available from: https://flusurvey.net/en/the-project/
  12. Lampos V, Majumder MS, Yom-Tov E, Edelstein M, Moura S, Hamada Y, et al. Tracking COVID-19 using online search. NPJ Digit Med. 2021;4(1):17.  https://doi.org/10.1038/s41746-021-00384-w  PMID: 33558607 
  13. Boddington NL, Charlett A, Elgohari S, Byers C, Coughlan L, Vilaplana TG, et al. Epidemiological and clinical characteristics of early COVID-19 cases, United Kingdom of Great Britain and Northern Ireland. Bull World Health Organ. 2021;99(3):178-89.  https://doi.org/10.2471/BLT.20.265603  PMID: 33716340 
  14. Public Health England (PHE). Syndromic surveillance: systems and analyses. London: PHE. [Accessed: 13 Apr 2020]. Available from: https://www.gov.uk/government/collections/syndromic-surveillance-systems-and-analyses
  15. de Lusignan S, Lopez Bernal J, Zambon M, Akinyemi O, Amirthalingam G, Andrews N, et al. Emergence of a Novel Coronavirus (COVID-19): Protocol for Extending Surveillance Used by the Royal College of General Practitioners Research and Surveillance Centre and Public Health England. JMIR Public Health Surveill. 2020;6(2):e18606.  https://doi.org/10.2196/18606  PMID: 32240095 
  16. Pathirannehelage S, Kumarapeli P, Byford R, Yonova I, Ferreira F, de Lusignan S. Uptake of a Dashboard Designed to Give Realtime Feedback to a Sentinel Network About Key Data Required for Influenza Vaccine Effectiveness Studies. Stud Health Technol Inform. 2018;247:161-5. PMID: 29677943 
  17. Public Health England (PHE). Laboratory reporting to Public Health England: A guide for diagnostic laboratories. London: PHE; 2020. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/739854/PHE_Laboratory_Reporting_Guidelines.pdf
  18. Nielsen J, Vestergaard LS, Richter L, Schmid D, Bustos N, Asikainen T, et al. European all-cause excess and influenza-attributable mortality in the 2017/18 season: should the burden of influenza B be reconsidered? Clin Microbiol Infect. 2019;25(10):1266-76.  https://doi.org/10.1016/j.cmi.2019.02.011  PMID: 30790685 
  19. Greenhalgh T, Koh GCH, Car J. Covid-19: a remote assessment in primary care. BMJ. 2020;368:m1182.  https://doi.org/10.1136/bmj.m1182  PMID: 32213507 
  20. European Centre for Disease Prevention and Control (ECDC). Strategies for the surveillance of COVID-19. Stockholm: ECDC; 9 Apr 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-surveillance-strategy-9-Apr-2020.pdf
  21. World Health Organization (WHO). Surveillance strategies for COVID-19 human infection - Interim guidance. Geneva: WHO; 10 May 2020. Available from: https://apps.who.int/iris/handle/10665/332051
  22. McAloon CG, Collins A, Hunt K, Barber A, Byrne A, Butler F, et al. The incubation period of COVID-19: A rapid systematic review and meta-analysis of observational research. medRxiv. 2020:2020.04.24.20073957.
  23. Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, et al. Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility. N Engl J Med. 2020;382(22):2081-90.  https://doi.org/10.1056/NEJMoa2008457  PMID: 32329971 
  24. Ferguson N, Laydon D, Nedjati Gilani G, Imai N, Ainslie K, Baguelin M, et al. Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand. London: Imperial College London; 16 Mar 2020. Available from: https://www.imperial.ac.uk/media/imperial-college/medicine/mrc-gida/2020-03-16-COVID19-Report-9.pdf
  25. Koo JR, Cook AR, Park M, Sun Y, Sun H, Lim JT, et al. Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study. Lancet Infect Dis. 2020;20(6):678-88.  https://doi.org/10.1016/S1473-3099(20)30162-6  PMID: 32213332 
  26. Kissler SM, Tedijanto C, Lipsitch M, Grad Y. Social distancing strategies for curbing the COVID-19 epidemic. medRxiv. 2020:2020.03.22.20041079.
  27. Laura M, Tiffany L. Evaluating the Effectiveness of Social Distancing Interventions to Delay or Flatten the Epidemic Curve of Coronavirus Disease. Emerging. Infect Dis J. 2020;26(8).
  28. de Figueiredo AM, Codina AD, Moreira DC, Figueiredo M, Saez M, León AC. Impact of lockdown on COVID-19 incidence and mortality in China: an interrupted time series study. Bull World Health Organ. E-pub. 2020;6.  https://doi.org/10.2471/BLT.20.256701 
  29. Flaxman S, Mishra S, Gandy A, Unwin HJT, Coupland H, Mellan TA, et al. Estimating the number of infections and the impact of non-pharmaceutical interventions on COVID-19 in European countries: technical description update. arXiv preprint arXiv:200411342. 2020.
  30. Lai S, Ruktanonchai NW, Zhou L, Prosper O, Luo W, Floyd JR, et al. Effect of non-pharmaceutical interventions to contain COVID-19 in China. Nature. 2020;585(7825):410-3.  https://doi.org/10.1038/s41586-020-2293-x  PMID: 32365354 
  31. Lau H, Khosrawipour V, Kocbach P, Mikolajczyk A, Schubert J, Bania J, et al. The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China. J Travel Med. 2020;27(3):taaa037. PMID:32181488
  32. Cowling BJ, Ali ST, Ng TWY, Tsang TK, Li JCM, Fong MW, et al. Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health. 2020;5(5):e279-88.  https://doi.org/10.1016/S2468-2667(20)30090-6  PMID: 32311320 
  33. de Lusignan S, Lopez Bernal J, Byford R, Amirthalingam G, Ferreira F, Akinyemi O, et al. Influenza and Respiratory Virus Surveillance, Vaccine Uptake, and Effectiveness at a Time of Cocirculating COVID-19: Protocol for the English Primary Care Sentinel System for 2020-2021. JMIR Public Health Surveill. 2021;7(2):e24341.  https://doi.org/10.2196/24341  PMID: 33605892 
/content/10.2807/1560-7917.ES.2021.26.11.2001062
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error