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SARIntet and the expert consultation on the integration of surveillance COVID-19 with surveillance of influenza and other respiratory viruses.

Date

The consultation took place on March 29 and 30, 2022 and was attended by 25 participants with experience in the field of epidemiological and laboratory surveillance of respiratory viruses, representing 15 countries of the Americas and 3 collaborating agencies in the region. This consultation was divided into three blocks whose purpose was to respond to the three main objectives.

First, the current epidemiological context was presented at the regional and global levels. The guidelines that frame the current surveillance strategies were presented, as well as the situation of surveillance of COVID-19, influenza and other respiratory viruses in the region of the Americas. Subsequently, the participants identified the most relevant aspects for the consolidation of the current surveillance of COVID-19 and other respiratory viruses at present and in the long term.

Second, the consultation consisted of addressing the components of monitoring transmission trends, severity, impact, and genomic surveillance, taking into account the following strategies: a) representative for monitoring circulating variants/lineages; b) aimed at detecting potential variants of interest or concern.

In order to partially meet the second objective and the third in its entirety, a series of public health questions in general were subsequently analyzed in order to identify which of them can be answered in a sustainable way through sentinel surveillance, complementary systems or adjustments to existing systems.

Finally, the consultation was aimed at analyzing the progress and needs of the SARinet Network in its eight years of existence since its creation in 2014. Since then, the network has advanced with the initial proposed objectives and has additionally developed activities that have contributed to the strengthening surveillance of influenza and other respiratory viruses (RVO), including activities during the SARS-CoV-2 pandemic and integrating SC-2 surveillance into the VIOVR platform.

However, due to the pandemic, RVO surveillance has had varying degrees of interruption, so it was considered pertinent to discuss possible mechanisms to revitalize the network so that it can respond to the current needs and challenges of the countries of the Region. In this sense, a summary of the advances and achievements obtained by the network and an inventory of the different activities carried out in recent years were shown. Additionally, two similar experiences were presented: the surveillance network for influenza and COVID-19 in the European Region and the initiative of emergency medical teams (EMT) in the Americas. The participants considered that these experiences were inspiring and also invited to reflect on the aspects that SARInet needs to improve and venture into.

A proposal was also presented for the renewal of SARInet in terms of organization, updating of the terms of reference and management mechanisms. The invited members reviewed and discussed these issues and the commitments made at the inaugural meeting of SARInet in May 2014. The need to update the terms of reference was maintained, also adjusting the mission and vision of the network according to the current situation.

As conclusions of the consultation, it has been possible to identify that currently the countries of the region have developed a universal surveillance of COVID-19 that has allowed optimal monitoring of the epidemiological situation to guide public health measures. In turn, many countries previously had sentinel surveillance systems for influenza and other respiratory viruses that have been weakened in the current context. In addition, some countries in the region have acquired epidemiological and laboratory surveillance capabilities that they did not previously have.

From the consultation, 5 general recommendations to the countries: 1. maintain surveillance of COVID-19 to continue responding to the pandemic until alternative surveillance systems can respond robustly to identified public health needs; 2. Strengthen existing surveillance systems for influenza and other respiratory viruses, integrating SARS-CoV-2 when the epidemiological situation allows it and, in each context, initiate a transition that guarantees sustainable medium- and long-term surveillance without losing capacities acquired during the COVID-19 pandemic; 3. Maintain monitoring of transmission trends, severity, and impact, taking advantage of existing surveillance systems for influenza and other respiratory viruses, including SARS-CoV-2; 4. Strengthen genomic surveillance in the region, linking it to sentinel surveillance, as well as other complementary systems that allow compliance with the main objectives of this surveillance; 5. Strengthen or implement complementary surveillance systems that allow the detection of emerging events of interest to public health in relation to SARS-CoV-2, influenza and other respiratory viruses, with early detection and universal coverage.