Covid to be monitored like a flu

BarcelonaCoronavirus is now part of the portfolio of respiratory viruses closely monitored by the Department of Health. It will no longer attempt to find all cases, as it does with other pathogens with a practically stable or seasonal appearance, such as influenza or respiratory syncytial virus (RSV), which causes bronchiolitis in children-. The Health Dpt has presented a new system this Friday to check for the main respiratory pathogens affecting the health of the Catalan population. It is a step further towards the normalisation of covid, after two years with epidemiological network focused exclusively on it. "This system is nourished by the lessons of the last two years," summarised the secretary of Public Health, Carmen Cabezas.

Named Information System for the Surveillance of Infections in Catalonia (SIVIC), this new source of information will allow analysis and predictions of respiratory viruses to get a better picture of the viral diversity circulating in the community now that the coronavirus has ceased to overshadow the rest. The Health Deptartment proposes to monitor all viruses on the basis of about 400 weekly samples, most of which (330) will come from patients arriving at primary care, and the rest from hospitals, mainly cases of severe pneumonia. There will be both syndromic surveillance (at peaks of incidence or when there is no diagnostic test to be performed) and microbiological surveillance (laboratories will analyse representative samples). And it will be done throughout the year, unlike what was done until now, when efforts were concentrated mainly between October and May, the period with the highest prevalence of respiratory viruses.

Catalonia is the first territory in the State that has completed a reinforced surveillance system, a goal set by the Ministry of Health for before 2023 to all autonomous communities. "It integrates the functions of epidemiological surveillance of influenza, covid and other respiratory viruses with the aim of adapting surveillance to the current epidemiological situation of the pandemic", Cabezas explained. In addition to the availability of data which will be public and sent to state and European registries, it will also take into account determining and representative variables of the population such as region, sex, age and level of economic deprivation to understand the dynamics of the viruses. "With this new surveillance we will go from monitoring 0.9% of the population to 9%, i.e. ten times more," said Cabezas.

44 healthcare centers

The department's commitment also takes into account the need to overcome the voluntary nature of the healthcare professionals who until now supported and nurtured the information systems and to monitor from the primary care teams and hospital units themselves. The deputy director general of surveillance and emergency response of the Public Health Agency of Catalonia, Jacobo Mendioroz, is optimistic about the implementation of this system: "The circuit began on Monday with a trial run of 10 primary care teams and the relevant hospitals have joined. More teams and laboratories will soon follow. The Health Department wants to go from the 56 doctors who currently report data in the information plan for acute respiratory infections in Catalonia (Pidirac) to 33 primary teams, eleven hospitals and twelve laboratories throughout the country.

Although Barcelona will have a very significant weight in the data (it is also the most populated), all areas will have at least one centre issuing data. In this sense, the notification processes have been simplified: if until now most of the data were collected manually and it was the professional who had to fill in all the variables, now the sending of data will be automatic. "[This system] will allow us to characterize the evolution of the various viruses that appear throughout the year and to observe unexpected movements out of season," exoplained Catalan Helath minister, Josep Maria Argimon.

To make this change, Mendioroz explained, all the existing notification circuits, until now very fragmented, have been integrated into a single one. The system is based on four axes: collection of representative data in primary care to monitor possible peaks of incidence or outbreaks; follow-up of more seriously ill patients to gauge the impact it may have on hospitals; effort to detect viral load in wastewater and the sequencing of samples to know which variant is circulating and monitor the emergence of new ones; and the creation of an epidemiological intelligence network to issue early warnings.