Covid-19: Surveillance systems for the new normal

Tancredi, Stefano; Cullati, Stéphane

doi:10.1136/bmj.o710

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…The COVID‐19 pandemic provided a major challenge to public health services and an unprecedented opportunity for collaboration and innovation across health care organizations, public health departments, civic structures, local businesses, and the communities they serve. Our qualitative study supports our initial prediction that close collaboration between the leaders of public health, health care, government, and community organizations would accelerate the speed and effectiveness of the required responses to the pandemic in specific communities, and that availability of data to track local variation in infections and the vaccination efforts in those communities is essential for planning and implementation of that response 15 . Our survey also confirmed the critically important role of trust in driving effective partnerships and community behaviors, and the role of data transparency and true collaboration with communities in building (or undermining, when absent) that trust.…”

Section: Discussionsupporting

confidence: 75%

Learning from an equitable, data‐informed response to COVID‐19: Translating knowledge into future action and preparation

Stanzler

Figueroa

Beck

et al. 2023

Learning Health Systems

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IntroductionThe COVID‐19 pandemic revealed numerous barriers to effectively managing public health crises, including difficulties in using publicly available, community‐level data to create learning systems in support of local public health decision responses. Early in the COVID‐19 pandemic, a group of health care partners began meeting to learn from their collective experiences. We identified key tools and processes for using data and learning system structures to drive equitable public health decision making throughout different phases of the pandemic.MethodsIn fall of 2021, the team developed an initial theory of change directed at achieving herd immunity for COVID‐19. The theoretical drivers were explored qualitatively through a series of nine 45‐min telephonic interviews conducted with 16 public health and community leaders across the United States. Interview responses were analyzed into key themes to inform potential future practices, tools, and systems. In addition to the interviews, partners in Dallas and Cincinnati reflected on their own COVID‐19 experiences.ResultsInterview responses fell broadly into four themes that contribute to effective, community driven responses to COVID‐19: real‐time, accessible data that are mindful of the tension between community transparency and individual privacy; a continued fostering of public trust; adaptable infrastructures and systems; and creating cohesive community coalitions with shared alignment and goals. These themes and partner experiences helped us revise our preliminary theory of change around the importance of community collaboration and trust building and also helped refine the development of the Community Protection Dashboard tool.ConclusionsThere was broad agreement amongst public health and community leaders about the key elements of the data and learning systems required to manage public health responses to COVID‐19. These findings may be informative for guiding the use of data and learning in the management of future public health crises or population health initiatives.

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Section: Discussionsupporting

confidence: 75%

Learning from an equitable, data‐informed response to COVID‐19: Translating knowledge into future action and preparation

Stanzler

Figueroa

Beck

et al. 2023

Learning Health Systems

View full text Add to dashboard Cite

show abstract

“…These health consequences concerning an increasing part of the population 69 , public health policies should intend reducing the number of infections for all persons, vaccinated or not, with effective and socially acceptable nonpharmaceutical interventions such as air purification 70 , 71 , ventilation 72 , 73 , or mask wearing 74 . Finally, to be able to study the evolution of the SARS-CoV-2 among the population, it is of prime importance to continue to monitor the infections in the community and the general population 75 .…”

Section: Discussionmentioning

confidence: 99%

Effect of SARS-CoV-2 prior infection and mRNA vaccination on contagiousness and susceptibility to infection

Mongin,

Bürgisser,

Laurie

et al. 2023

Nat Commun

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The immunity conferred by SARS-CoV-2 vaccines and infections reduces the transmission of the virus. To answer how the effect of immunity is shared between a reduction of infectiousness and an increased protection against infection, we examined >50,000 positive cases and >110,000 contacts from Geneva, Switzerland (June 2020 to March 2022). We assessed the association between secondary attack rate (i.e. proportion of new cases among contacts) and immunity from natural infection and/or vaccination, stratifying per four SARS-CoV-2 variants and adjusting for index cases and contacts’ socio-demographic characteristics and the propensity of the contacts to be tested. Here we show that immunity protected contacts from infection, rather than reducing infectiousness of index cases. Natural infection conferred the strongest immunity. Hybrid immunity did not surpass recent infection. Although of smaller amplitude, the reduction in infectiousness due to vaccination was less affected by time and by the emergence of new SARS-CoV-2 variants than the susceptibility to infection. These findings support the role of vaccine in reducing infectiousness and underscore the complementary role of interventions reducing SARS-CoV-2 propagation, such as mask use or indoor ventilation.

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“…Indeed, since air purification and ventilation require no individual effort, they can be implemented everywhere, thus avoiding individual behavioural barriers. Finally, to be able to study the evolution of the SARS-CoV-2 among the population, it is of prime importance to continue to monitor the infections in the community and the general population 81 .…”

Section: Discussionmentioning

confidence: 99%

Effect of mRNA vaccination and previous infections on SARS-CoV-2 transmission across four variants: adjusted analysis of 111’432 declared contacts

Mongin

Bürgisser

Laurie

et al. 2023

Preprint

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The immunity conferred by SARS-CoV-2 vaccines and infections reduces the transmission of the virus. But it is not clear how the effect of immunity is shared between a reduction of the contagiousness and an increased protection against infection. To answer this question, we used a register of >50’000 SARS-CoV-2 positive index cases and their >110’000 declared contacts to estimate the association between secondary attack rate and immunity status (natural infection, vaccine, or both). Analyses were stratified per four SARS-Cov-2 variants and adjusted for index cases and contacts socio-demographic characteristics and the propensity of the contacts to be tested. The reduction of the propagation conferred by immunity was mainly a protection of the contacts against infection rather than a diminution of the contagiousness of the index cases. The largest immunity effect was conferred for both by natural infection, especially when recent for the contacts. Although of smaller amplitude, the effect of vaccination for index, i.e. the reduction of contagiousness, was less affected by SarS-CoV-2 variant and time since vaccination than the effect for contacts, i.e. the increase of protection against infection. Indeed, vaccination offered protection against infection only if given less than 6 months before and only for the variants preceding omicron, while the vaccination kept moderately reducing the index infectivity during the omicron wave, even when given more than 6 months ago. Hybrid immunity (vaccination and infection) did not have increased effectiveness than recent infection. These findings support the idea that vaccination also protects others, and highlight the need for the implementation of non-personal interventions reducing Sars-CoV-2 propagation, such as ventilation or air filtration.

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Covid-19: Surveillance systems for the new normal

Cited by 5 publications

References 5 publications

Learning from an equitable, data‐informed response to COVID‐19: Translating knowledge into future action and preparation

Learning from an equitable, data‐informed response to COVID‐19: Translating knowledge into future action and preparation

Effect of SARS-CoV-2 prior infection and mRNA vaccination on contagiousness and susceptibility to infection

Effect of mRNA vaccination and previous infections on SARS-CoV-2 transmission across four variants: adjusted analysis of 111’432 declared contacts

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