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A comparison of coronavirus disease 2019 and seasonal influenza surveillance in five European countries: France, Germany, Italy, Spain and the United Kingdom
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  • Hélène Bricout,
  • Rigoine de Fougerolles Thierry ,
  • Joan Puig-Barbera,
  • Georges Kassianos,
  • Philippe Vanhems,
  • Jorg Schelling,
  • Pascal Crepey,
  • Raul Ortiz de Lejarazu,
  • Filippo Ansaldi,
  • Markus Fruehwein,
  • Cristina Galli,
  • Anne Mosnier,
  • Elena Pariani,
  • Anvar Rasuli,
  • Olivier Vitoux,
  • John Watkins,
  • Thomas Weinke
Hélène Bricout
Sanofi Pasteur SA

Corresponding Author:helene.bricout@sanofi.com

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Rigoine de Fougerolles Thierry
Corporate Value Associates
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Joan Puig-Barbera
Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO)
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Georges Kassianos
Royal College of General Practitioners
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Philippe Vanhems
CNRS UMR 5558, University of Lyon
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Jorg Schelling
Ludwig Maximilians University Munich
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Pascal Crepey
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Raul Ortiz de Lejarazu
Hospital Clínico Universitario de Valladolid
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Filippo Ansaldi
University of Genoa
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Markus Fruehwein
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Cristina Galli
University of Milan
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Anne Mosnier
Groupes Régionaux d’Observation de la Grippe (GROG), Paris, France
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Elena Pariani
University of Milan
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Anvar Rasuli
Sanofi Pasteur
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Olivier Vitoux
Corporate Value Associates
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John Watkins
Cardiff University
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Thomas Weinke
Klinikum Ernst von Bergmann gGmbH
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Background: In response to the coronavirus disease (COVID-19) outbreak that unfolded across Europe in 2020, the World Health Organisation called for repurposing existing influenza surveillance systems to monitor COVID-19. This analysis aimed to compare descriptively the extent to which influenza surveillance systems were adapted and enhanced, and how COVID-19 surveillance could ultimately benefit or disrupt routine influenza surveillance. Methods: We used a previously developed framework in France, Germany, Italy, Spain and the United Kingdom to describe COVID-19 surveillance and its impact on influenza surveillance. The framework divides surveillance systems into 7 sub-systems and 20 comparable outcomes of interest, and uses 5 evaluation criteria based on WHO guidance. Information on influenza and COVID-19 surveillance systems were collected from publicly available resources shared by European and national public health agencies. Results: Overall, non-medically attended, virological, primary care and mortality surveillance were adapted in most countries to monitor COVID-19, whilst community, outbreak, and hospital surveillance were reinforced in all countries. Data granularity improved, with more detailed demographic and medical information recorded. A shift to systematic notification for cases and deaths enhanced both geographic and population representativeness whilst the sampling strategy benefited from the roll out of widespread molecular testing. Data communication was greatly enhanced, contributing to improved public awareness. Conclusions: Well-established influenza surveillance systems are a key component of pandemic preparedness and their upgrade allowed European countries to respond to the COVID-19 pandemic. However, uncertainties remain on how both influenza and COVID-19 surveillance can be jointly and durably implemented.
26 Oct 2021Submitted to Influenza and other respiratory viruses
27 Oct 2021Assigned to Editor
27 Oct 2021Submission Checks Completed
07 Nov 2021Editorial Decision: Accept