Using an Administrative and Clinical Database to Determine the Early Spread of COVID-19 at the US Department of Veterans Affairs during the Beginning of the 2019–2020 Flu Season: A Retrospective Longitudinal Study

Abstract

Background. Previous studies examining the early spread of COVID-19 have used influenza-like illnesses (ILIs) to determine the early spread of COVID-19. We used COVID-19 case definition to identify COVID-like symptoms (CLS) independently of other influenza-like illnesses (ILIs). Methods. Using data from Emergency Department (ED) visits at VA Medical Centers in CA, TX, and FL, we compared weekly rates of CLS, ILIs, and non-influenza ILIs encounters during five consecutive flu seasons (2015–2020) and estimated the risk of developing each illness during the first 23 weeks of the 2019–2020 season compared to previous seasons. Results. Patients with CLS were significantly more likely to visit the ED during the first 23 weeks of the 2019–2020 compared to prior seasons, while ED visits for influenza and non-influenza ILIs did not differ substantially. Adjusted CLS risk was significantly lower for all seasons relative to the 2019–2020 season: RR15–16 = 0.72, 0.75, 0.72; RR16–17 = 0.81, 0.77, 0.79; RR17–18 = 0.80, 0.89, 0.83; RR18–19 = 0.82, 0.96, 0.81, in CA, TX, and FL, respectively. Conclusions. The observed increase in ED visits for CLS indicates the likely spread of COVID-19 in the US earlier than previously reported. VA data could potentially help identify emerging infectious diseases and supplement existing syndromic surveillance systems.

Effectiveness of early warning systems in the detection of infectious diseases outbreaks: a systematic review

“…All ED-EWS studies were in high-income countries (HICs) and distributed as the following; among all the studies 3 were from Australia (New South Wales NSW), [14,16,18] and the rest was divided into 3,2,1,1,1 for the United States [17,19,23], Italy [13,21], UK [15], Taiwan [20], and Korea [22], respectively. The majority demonstrated overall good capacity as an EWS where performance evaluation revealed the independent effectiveness of 5 systems (US [17], Italy [13], UK [15], Taiwan [20], Korea [22]) and the complementary usefulness of 3 (US [19], Italy [21], Australia [18]) in addition to the supplementary effectiveness of one US EWS [23]. Only 2 Australian ED-EWSs were deemed either of mere potential benefit or ineffective overall [14,16].…”

“…An example of this is that the passive surveillance through lab reporting of pertussis cases was 7 days more proactive than surveilling ED visits with cough [14]. On the other hand, the only included ED-EWS of adjunct effectiveness was in a recent study surveilling COVIDlike symptoms rather than influenza-like illnesses [23].…”

Detecting early signals of COVID-19 outbreaks in 2020 in small areas by monitoring healthcare utilisation databases: first lessons learned from the Italian Alert_CoV project

“…An alert system automatically monitoring a variety of syndromic tracers in HCU databases has the potential to be applied in near real-time, as well as to cover an extremely large population and to ensure small area analysis, while requiring little expense. Nevertheless, HCU data have rarely been used in this setting [14], except for those concerning emergency departments [22,23], which have recently enabled to reveal regional or national clusters of COVID-19 cases or increases in their numbers [24,25].…”

Theoretical Molecular Mechanism and Long-Life of SARS-CoV-2 on the Phone Screen: Electronegativity Between Crystal Liquid Atoms and SARS-CoV-2 Spike Protein

“…SARS-CoV-2 has spread worldwide, infecting more than 70 million people and caused more than 1.6 million deaths as of early December 2020 [4]. The researches have put forward that SARS-CoV-2 was transmitted faster and more efficiently compared to the other two epidemic coronaviruses SARS-CoV and MERS-CoV [5]. To control and prevent disease transmission, many countries have implemented mass quarantine measures [6].…”