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Influenza and Respiratory Virus Surveillance, Vaccine Uptake, and Effectiveness at a Time of Cocirculating COVID-19: Protocol for the English Primary Care Sentinel System for 2020-2021.
de Lusignan, Simon; Lopez Bernal, Jamie; Byford, Rachel; Amirthalingam, Gayatri; Ferreira, Filipa; Akinyemi, Oluwafunmi; Andrews, Nick; Campbell, Helen; Dabrera, Gavin; Deeks, Alexandra; Elliot, Alex J; Krajenbrink, Else; Liyanage, Harshana; McGagh, Dylan; Okusi, Cecilia; Parimalanathan, Vaishnavi; Ramsay, Mary; Smith, Gillian; Tripathy, Manasa; Williams, John; Victor, William; Zambon, Maria; Howsam, Gary; Nicholson, Brian David; Tzortziou Brown, Victoria; Butler, Christopher C; Joy, Mark; Hobbs, F D Richard.
  • de Lusignan S; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Lopez Bernal J; Public Health England, London, United Kingdom.
  • Byford R; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Amirthalingam G; Public Health England, London, United Kingdom.
  • Ferreira F; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Akinyemi O; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Andrews N; Public Health England, London, United Kingdom.
  • Campbell H; Public Health England, London, United Kingdom.
  • Dabrera G; Public Health England, London, United Kingdom.
  • Deeks A; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Elliot AJ; Public Health England, London, United Kingdom.
  • Krajenbrink E; Royal College of General Practitioners, London, United Kingdom.
  • Liyanage H; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • McGagh D; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Okusi C; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Parimalanathan V; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Ramsay M; Public Health England, London, United Kingdom.
  • Smith G; Public Health England, London, United Kingdom.
  • Tripathy M; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Williams J; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Victor W; Royal College of General Practitioners, London, United Kingdom.
  • Zambon M; Public Health England, London, United Kingdom.
  • Howsam G; Royal College of General Practitioners, London, United Kingdom.
  • Nicholson BD; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Tzortziou Brown V; Royal College of General Practitioners, London, United Kingdom.
  • Butler CC; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Joy M; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
  • Hobbs FDR; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
JMIR Public Health Surveill ; 7(2): e24341, 2021 02 19.
Article in English | MEDLINE | ID: covidwho-1090464
ABSTRACT

BACKGROUND:

The Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) and Public Health England (PHE) are commencing their 54th season of collaboration at a time when SARS-CoV-2 infections are likely to be cocirculating with the usual winter infections.

OBJECTIVE:

The aim of this study is to conduct surveillance of influenza and other monitored respiratory conditions and to report on vaccine uptake and effectiveness using nationally representative surveillance data extracted from primary care computerized medical records systems. We also aim to have general practices collect virology and serology specimens and to participate in trials and other interventional research.

METHODS:

The RCGP RSC network comprises over 1700 general practices in England and Wales. We will extract pseudonymized data twice weekly and are migrating to a system of daily extracts. First, we will collect pseudonymized, routine, coded clinical data for the surveillance of monitored and unexpected conditions; data on vaccine exposure and adverse events of interest; and data on approved research study outcomes. Second, we will provide dashboards to give general practices feedback about levels of care and data quality, as compared to other network practices. We will focus on collecting data on influenza-like illness, upper and lower respiratory tract infections, and suspected COVID-19. Third, approximately 300 practices will participate in the 2020-2021 virology and serology surveillance; this will include responsive surveillance and long-term follow-up of previous SARS-CoV-2 infections. Fourth, member practices will be able to recruit volunteer patients to trials, including early interventions to improve COVID-19 outcomes and point-of-care testing. Lastly, the legal basis for our surveillance with PHE is Regulation 3 of the Health Service (Control of Patient Information) Regulations 2002; other studies require appropriate ethical approval.

RESULTS:

The RCGP RSC network has tripled in size; there were previously 100 virology practices and 500 practices overall in the network and we now have 322 and 1724, respectively. The Oxford-RCGP Clinical Informatics Digital Hub (ORCHID) secure networks enable the daily analysis of the extended network; currently, 1076 practices are uploaded. We are implementing a central swab distribution system for patients self-swabbing at home in addition to in-practice sampling. We have converted all our primary care coding to Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) coding. Throughout spring and summer 2020, the network has continued to collect specimens in preparation for the winter or for any second wave of COVID-19 cases. We have collected 5404 swabs and detected 623 cases of COVID-19 through extended virological sampling, and 19,341 samples have been collected for serology. This shows our preparedness for the winter season.

CONCLUSIONS:

The COVID-19 pandemic has been associated with a groundswell of general practices joining our network. It has also created a permissive environment in which we have developed the capacity and capability of the national primary care surveillance systems and our unique public health institute, the RCGP and University of Oxford collaboration.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Tract Infections / Vaccines / Clinical Protocols / Influenza, Human Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: JMIR Public Health Surveill Year: 2021 Document Type: Article Affiliation country: 24341

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Tract Infections / Vaccines / Clinical Protocols / Influenza, Human Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: JMIR Public Health Surveill Year: 2021 Document Type: Article Affiliation country: 24341