Figure 1: Surveillance domains and associated objectives for respiratory viruses of epidemic and pandemic potential
The COVID-19 pandemic generated innovations to support surveillance, including those related to improved point of care or self-test diagnostic technologies, environmental surveillance, community participatory surveillance, and the rapid improvement in global genomic surveillance (3) . To inform longer-term surveillance planning, this framework considers some of the benefits, limitations, and most appropriate applications of these innovations to inform possible surveillance strategies.
Critically, national surveillance strategies must be directed by the objectives and information needs of local authorities, locally available resources, and feasibility within the populations under surveillance. Surveillance methods that can help address needed objectives include but are not limited to event-based surveillance in health care facilities, the community and at the animal-human interface; sentinel surveillance using standardized case definitions and integrated laboratory testing; strong networks of connected public health and clinical laboratories; efficient and comprehensive nationally notifiable disease surveillance systems; targeted surveillance in specific high risk settings and vulnerable populations; sustained health care capacity monitoring; and enhanced clinical surveillance, among others. Surveillance systems need to be complemented with high quality and timely outbreak investigations and studies to obtain information not routinely available from ongoing systems.
There are also several structural or enabling factors that are critical to the success of any sustainable surveillance. These include strong governance and leadership, sustainable financing and workforce, and integration of data standards and appropriate innovations to promote timely and collaborative analyses of surveillance information from multiple sources. Given the complexity of the current respiratory surveillance landscape, national authorities now need an evidence-based framework to help their countries rapidly (Figure 2):
• identify priority respiratory virus surveillance objectives;
• identify the surveillance approaches that have been used to meet these objectives;
• prioritize required enhancements of existing surveillance;
• develop implementation plans according to the national context, resources and needs;
• strengthen collaborative synergies between surveillance systems; and
• prioritize and target technical assistance and financial investments from partners