Figure 1: Surveillance domains and associated objectives for
respiratory viruses of epidemic and pandemic potential
The COVID-19 pandemic generated innovations to support surveillance,
including those related to improved point of care or self-test
diagnostic technologies, environmental surveillance, community
participatory surveillance, and the rapid improvement in global genomic
surveillance (3) . To inform longer-term surveillance planning,
this framework considers some of the benefits, limitations, and most
appropriate applications of these innovations to inform possible
surveillance strategies.
Critically, national surveillance strategies must be directed by the
objectives and information needs of local authorities, locally available
resources, and feasibility within the populations under surveillance.
Surveillance methods that can help address needed objectives include but
are not limited to event-based surveillance in health care facilities,
the community and at the animal-human interface; sentinel surveillance
using standardized case definitions and integrated laboratory testing;
strong networks of connected public health and clinical laboratories;
efficient and comprehensive nationally notifiable disease surveillance
systems; targeted surveillance in specific high risk settings and
vulnerable populations; sustained health care capacity monitoring; and
enhanced clinical surveillance, among others. Surveillance systems need
to be complemented with high quality and timely outbreak investigations
and studies to obtain information not routinely available from ongoing
systems.
There are also several structural or enabling factors that are critical
to the success of any sustainable surveillance. These include strong
governance and leadership, sustainable financing and workforce, and
integration of data standards and appropriate innovations to promote
timely and collaborative analyses of surveillance information from
multiple sources. Given the complexity of the current respiratory
surveillance landscape, national authorities now need an evidence-based
framework to help their countries rapidly (Figure 2):
• identify priority respiratory virus surveillance objectives;
• identify the surveillance approaches that have been used to meet these
objectives;
• prioritize required enhancements of existing surveillance;
• develop implementation plans according to the national context,
resources and needs;
• strengthen collaborative synergies between surveillance systems; and
• prioritize and target technical assistance and financial investments
from partners