Early epidemiological investigations: World Health Organization UNITY protocols provide a standardized and timely international investigation framework during the COVID-19 pandemic

Isabel Bergeri*, Hannah C. Lewis, Lorenzo Subissi, Anthony Nardone, Marta Valenciano, Brianna Cheng, Ketevan Glonti, Bridget Williams, Ibukun Oluwa Omolade Abejirinde, Alice Simniceanu, Alessandro Cassini, Rebecca Grant, Angel Rodriguez, Andrea Vicari, Lubna Al Ariqi, Tasnim Azim, Pushpa Ranjan Wijesinghe, Soatiana Cathycia Rajatonirina, Joseph Chukwudi Okeibunor, Linh Vi LeMark Katz, Aisling Vaughan, Pernille Jorgensen, Gudrun Freidl, Richard Pebody, Maria D. Van Kerkhove

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: The declaration of Coronavirus disease 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) on 30 January 2020 required rapid implementation of early investigations to inform appropriate national and global public health actions. Methods: The suite of existing pandemic preparedness generic epidemiological early investigation protocols was rapidly adapted for COVID-19, branded the ‘UNITY studies’ and promoted globally for the implementation of standardized and quality studies. Ten protocols were developed investigating household (HH) transmission, the first few cases (FFX), population seroprevalence (SEROPREV), health facilities transmission (n = 2), vaccine effectiveness (n = 2), pregnancy outcomes and transmission, school transmission, and surface contamination. Implementation was supported by WHO and its partners globally, with emphasis to support building surveillance and research capacities in low- and middle-income countries (LMIC). Results: WHO generic protocols were rapidly developed and published on the WHO website, 5/10 protocols within the first 3 months of the response. As of 30 June 2021, 172 investigations were implemented by 97 countries, of which 62 (64%) were LMIC. The majority of countries implemented population seroprevalence (71 countries) and first few cases/household transmission (37 countries) studies. Conclusion: The widespread adoption of UNITY protocols across all WHO regions indicates that they addressed subnational and national needs to support local public health decision-making to prevent and control the pandemic.

Original languageEnglish
JournalInfluenza and other Respiratory Viruses
DOIs
Publication statusAccepted/In press - 2021
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by the COVID‐19 Solidarity Response Fund for WHO and German Federal Ministry of Health (BMG) COVID‐19 Research and Development grant for WHO.

Publisher Copyright:
© 2021 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.

Keywords

  • COVID-19
  • SARS-CoV-2
  • infectious diseases
  • seroepidemiology
  • serology
  • seroprevalence

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