The impact of SARS-CoV-2 on respiratory syndromic and sentinel surveillance in Israel, 2020: A new perspective on established systems

The Israeli Respiratory Viruses Surveillance Network (IRVSN)

Research output: Contribution to journalArticlepeer-review


Background: The COVID-19 pandemic presented new challenges for the existing respiratory surveillance systems, and adaptations were implemented. Systematic assessment of the syndromic and sentinel surveillance platforms during the pandemic is essential for understanding the value of each platform in the context of an emerging pathogen with rapid global spread. Aim: We aimed to evaluate systematically the performance of various respiratory syndromic surveillance platforms and the sentinel surveillance system in Israel from 1 January to 31 December 2020. Methods: We compared the 2020 syndromic surveillance trends to those of the previous 3 years, using Poisson regression adjusted for overdispersion. To assess the performance of the sentinel clinic system as compared with the national SARS-CoV-2 repository, a cubic spline with 7 knots and 95% confidence intervals were applied to the sentinel network's weekly percentage of positive SARS-CoV-2 cases. Results: Syndromic surveillance trends changed substantially during 2020, with a statistically significant reduction in the rates of visits to physicians and emergency departments to below previous years' levels. Morbidity patterns of the syndromic surveillance platforms were inconsistent with the progress of the pandemic, while the sentinel surveillance platform was found to reflect the national circulation of SARS-CoV-2 in the population. Conclusion: Our findings reveal the robustness of the sentinel clinics platform for the surveillance of the main respiratory viruses during the pandemic and possibly beyond. The robustness of the sentinel clinics platform during 2020 supports its use in locations with insufficient resources for widespread testing of respiratory viruses.

Original languageEnglish
Article number2100457
Issue number16
StatePublished - 28 Apr 2022

Bibliographical note

Funding Information:
We thank Maccabi Health Services and its Medical Informatics department for longstanding contribution to disease surveillance in Israel. We also thank Nadia Pekurovski, Chen Hadad and Sigal Saharabani, Esti Turgeman and Rachel Kuluf for dedicated technical assistance.

Publisher Copyright:
© 2022 European Centre for Disease Prevention and Control (ECDC). All rights reserved.

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health
  • Virology


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