Overview and evaluation of a nationwide hospital-based surveillance system for Influenza and COVID-19 in Switzerland (CH-SUR): 2018-2023
Sobel, J. A.; Zanella, M. C.; Grant, R.; Valera, C. B.; Suveges, M.; Urbini, L.; Mostaguir, K.; Botero Mesa, S.; Roder, U.; Bosetti, D.; Sommerstein, R.; Heininger, U.; Zimmermann, P.; Schreiber, P. W.; Flury, D.; Niederer-Loher, A.; Jent, P.; Pittet, D.; Harbarth, S.; Iten, A.; Keiser, O.
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BackgroundIn 2018, a hospital-based surveillance system for influenza (CH-SUR) was established in six tertiary care hospitals in Switzerland. From March 2020 onwards, this surveillance system was expanded to include more institutions, as well as COVID-19. AimTo quantitatively evaluate the timeliness and completeness of CH-SUR data and to qualitatively assess stakeholder perceptions of the importance, reliability and adaptability of the surveillance system. MethodsAll patients admitted to one of the participating centres for more than 24 hours and who had a laboratory-confirmed influenza virus or SARS-CoV-2 infection were included in CH-SUR. For all cases, we evaluated the timeliness and completeness of reporting to CH-SUR. A qualitative survey among CH-SUR stakeholders assessed perceived importance, understanding, reliability and adaptability of CH-SUR. ResultsUp to 20 centres participated in CH-SUR. Between December 2018 and October 2023, 7,375 cases of influenza were reported and between March 2020 and October 2023, 49,235 cases of COVID-19 were reported to CH-SUR. During the COVID-19 pandemic, time to data entry and completeness improved over time; the median delay of data entry in CH-SUR was 5 days (IQR=2-23) for COVID-19 and 4 days (IQR=2-15) for influenza during the period 2018-2023. The completeness of variables was high (99.4%), with the exception of COVID-19 or annual influenza vaccination status (respectively 15% and 72% of "Unknown" responses). Stakeholders perceived the system as important, relevant, understandable and adaptable. ConclusionCH-SUR has provided critical epidemiological and clinical information on hospitalised influenza and COVID-19 cases across Switzerland during the pandemic. Our evaluation highlighted the importance and relevance of this system among CH-SUR stakeholders, as well as its importance for preparedness and response to future infectious disease outbreaks.
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