Assessment of COVID-19 surveillance case definitions and data reporting in the European Union

16-07-2020

In a rapidly evolving pandemic, it is fundamental to ensure consistency of definitions across Member States to provide the necessary comparability to evaluate the public health response, the stress on the health system and the impact on the population’s health. All institutional bodies in the Member States follow, or base their approaches, on technical guidance by the European Centre for Diseases and Control (ECDC). The approach to defining possible and probable cases shows considerable heterogeneity, while for confirmed cases, all Member States use the same definition requiring laboratory detection of SARS-CoV-2 with Reverse transcription polymerase chain reaction (RT-PCR). Comparability of the numbers of confirmed cases across the EU is still heavily dependent on the testing policies adopted. This heterogeneity seems rooted in rapidly evolving scientific advances and the different perceptions of risk in the technical institutions of Member States. Many Member States still do not have an official definition of death due to COVID-19 available online and do not report on whether COVID-19 is the a primary or a secondary cause of death. Recovery definition is broadly based on either clinical criteria or testing criteria (SARS-CoV-2 not detected anymore); only a few countries adopted a definition of recovery based solely on clinical criteria. While recovery based on clinical criteria has some advantages, it also carries some risks of early discharge / end of isolation when still infectious. Harmonisation of COVID-19 case definitions is essential to mitigate disputes about data quality between Member States and coordinate, implement and evaluate EU policies.

In a rapidly evolving pandemic, it is fundamental to ensure consistency of definitions across Member States to provide the necessary comparability to evaluate the public health response, the stress on the health system and the impact on the population’s health. All institutional bodies in the Member States follow, or base their approaches, on technical guidance by the European Centre for Diseases and Control (ECDC). The approach to defining possible and probable cases shows considerable heterogeneity, while for confirmed cases, all Member States use the same definition requiring laboratory detection of SARS-CoV-2 with Reverse transcription polymerase chain reaction (RT-PCR). Comparability of the numbers of confirmed cases across the EU is still heavily dependent on the testing policies adopted. This heterogeneity seems rooted in rapidly evolving scientific advances and the different perceptions of risk in the technical institutions of Member States. Many Member States still do not have an official definition of death due to COVID-19 available online and do not report on whether COVID-19 is the a primary or a secondary cause of death. Recovery definition is broadly based on either clinical criteria or testing criteria (SARS-CoV-2 not detected anymore); only a few countries adopted a definition of recovery based solely on clinical criteria. While recovery based on clinical criteria has some advantages, it also carries some risks of early discharge / end of isolation when still infectious. Harmonisation of COVID-19 case definitions is essential to mitigate disputes about data quality between Member States and coordinate, implement and evaluate EU policies.

Externe Autor

André PERALTA-SANTOS