ABSTRACT
OBJECTIVE: We aimed to assess if emergency department (ED) syndromic surveillance during the first and second waves of the COVID-19 outbreak could have improved our surveillance system. DESIGN AND SETTINGS: We did an observational study using aggregated data from the ED of a university hospital and public health authorities in western Switzerland. PARTICIPANTS: All patients admitted to the ED were included. PRIMARY OUTCOME MEASURE: The main outcome was intensive care unit (ICU) occupancy. We used time series methods for ED syndromic surveillance (influenza-like syndrome, droplet isolation) and usual indicators from public health authorities (new cases, proportion of positive tests in the population). RESULTS: Based on 37 319 ED visits during the COVID-19 outbreak, 1421 ED visits (3.8%) were positive for SARS-CoV-2. Patients with influenza-like syndrome or droplet isolation in the ED showed a similar correlation to ICU occupancy as confirmed cases in the general population, with a time lag of approximately 13 days (0.73, 95% CI 0.64 to 0.80; 0.79, 95% CI 0.71 to 0.86; and 0.76, 95% CI 0.67 to 0.83, respectively). The proportion of positive tests in the population showed the best correlation with ICU occupancy (0.95, 95% CI 0.85 to 0.96). CONCLUSION: ED syndromic surveillance is an effective tool to detect and monitor a COVID-19 outbreak and to predict hospital resource needs. It would have allowed to anticipate ICU occupancy by 13 days, including significant aberration detection at the beginning of the second wave.
Subject(s)
COVID-19 , Influenza, Human , COVID-19/epidemiology , Emergency Service, Hospital , Humans , Influenza, Human/epidemiology , Prospective Studies , SARS-CoV-2 , Sentinel Surveillance , Switzerland/epidemiology , Time FactorsSubject(s)
Betacoronavirus/genetics , Coronavirus Infections/physiopathology , Early Warning Score , Intensive Care Units , Patient Admission , Pneumonia, Viral/physiopathology , Adult , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Polymerase Chain Reaction , Prognosis , Risk Factors , SARS-CoV-2 , Sensitivity and Specificity , Time FactorsABSTRACT
The COVID-19 crisis is an unprecedented event. It is therefore essential for dispatch centres to share their experiences while the crisis is underway, similar to hospitals, so that we will all benefit from feedback.This letter to the editor describes the Lausanne dispatch centre response to COVID-19 and the lessons learned so far.