The COVID-19 pandemic: A new challenge for syndromic surveillance

Alex Elliot*, Sally Harcourt, Helen Hughes, Paul Loveridge, Roger Morbey, Sue Smith, Ana Soriano, Amardeep Bains, Gillian Smith, Obaghe Edeghere, Isabel Oliver

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

30 Citations (Scopus)
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The COVID-19 pandemic is exerting major pressures on society, health and social care services and science. Understanding the progression and current impact of the pandemic is fundamental to planning, management and mitigation of future impact on the population. Surveillance is the core function of any public health system, and a multi-component surveillance system for COVID-19 is essential to understand the burden across the different strata of any health system and the population. Many countries and public health bodies utilise 'syndromic surveillance' (using real-time, often non-specific symptom/preliminary diagnosis information collected during routine healthcare provision) to supplement public health surveillance programmes. The current COVID-19 pandemic has revealed a series of unprecedented challenges to syndromic surveillance including: The impact of media reporting during early stages of the pandemic; changes in healthcare seeking behaviour resulting from government guidance on social distancing and accessing healthcare services; changes in clinical coding and patient management systems. These have impacted on the presentation of syndromic outputs, with changes in denominators creating challenges for the interpretation of surveillance data. Monitoring changes in healthcare utilisation is key to interpreting COVID-19 surveillance data which can then be used to better understand the impact of the pandemic on the population. Syndromic surveillance systems have had to adapt to encompass these changes, whilst also innovating, taking opportunities to work with data providers to establish new data feeds and develop new COVID-19 indicators. These developments are supporting the current public health response to COVID-19, and will also be instrumental in the continued and future fight against the disease.

Original languageEnglish
Article numbere122
JournalEpidemiology and Infection
Early online date18 Jun 2020
Publication statusE-pub ahead of print - 18 Jun 2020

Bibliographical note

Funding Information: AJE, HEH, GS and OE receive support from the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections. AJE, RAM and GES receive support from the NIHR HPRU in Emergency Preparedness and Response. IO receives support from the NIHR HPRU in Behavioural Science and Evaluation. The views expressed are those of the author(s) and not necessarily those of the NIHR, Public Health England or the Department of Health and Social Care.

Open Access: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Publisher Copyright: © The Author(s), 2020. Published by Cambridge University Press.

Citation: Elliot, Alex J., et al. "The COVID-19 pandemic: a new challenge for syndromic surveillance." Epidemiology & Infection 148 (2020).



  • Challenges
  • Coronavirus
  • Covid-19
  • Pandemic
  • Surveillance
  • Syndromic surveillance


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