SAINT-MAURICE (Val-de-Marne), November 7, 2024 (APMnews) – In order to prepare for future exceptional health situations and in particular the emergence of new viruses, Public Health France (SPF) is modernizing its epidemiological surveillance system by part put in place during the Covid-19 pandemic, according to articles published Tuesday in the Weekly Epidemiological Bulletin (BEH).
“The emergence of the Covid-19 pandemic in 2020 has highlighted […] the need to have robust, responsive and adapted information systems to monitor the possible emergence and spread of viruses”, we can read in the BEH editorial.
During the pandemic, the multisource surveillance system (city medicine, medical biology laboratories, hospitals) allowed SPF to publish “more than 150 indicators per day”. The challenge, in the post-Covid era, is to capitalize on the information systems deployed and ensure the development of tools, in order to prepare for future exceptional health situations and in particular the emergence of new viruses.
Currently, the production of real-time indicators is based on SOS-Médecin and Oscour data, transmitted to SPF every night. However, at the hospital, “we have no visibility outside of emergencies, we do not have a monitoring system for conventional hospitalizations, resuscitation, etc.”, listed Yann Le Strat, interviewed by APMnews .
During the pandemic, real-time hospital monitoring relied on SI-VIC (Victim Monitoring Information System, initially created to inform relatives of victims of attacks), an application that required time-consuming entry of information for each patient by healthcare professionals.
The Orchid project (Organization of a network of hospital centers involved in epidemiological surveillance and response to outbreaks), launched in October, aims to respond to this challenge (see dispatch from 10/15/2024 at 10:37). The 25 volunteer university hospitals will produce hospital surveillance indicators from data captured during patient care and centralized in their health data warehouses (EDS).
The innovation of this system also lies in the “federated model”, explained the researcher, since the CHUs will directly produce the indicators without data output. In order to respond to the methodological “challenge” of harmonization of data between CHUs, a common computer program will allow them to produce identical and comparable epidemiological indicators.
The indicators produced by the CHUs will include the SPF acute respiratory infection bulletins from the next winter season. Furthermore, “a first working group on healthcare-associated infections has been set up” and another on arboviruses will also be set up during the year, detailed Yann Le Strat.
Capitalize on surveillance systems deployed during the pandemic
Furthermore, “certain information systems, set up during Covid, have shown their usefulness and we want to rely on these gains for epidemiological surveillance,” commented the researcher.
For example, before the pandemic, SPF did not have access to biological test results. SI-DPE (population screening information system) was set up, during the health crisis, to systematically and automatically receive all the results of tests (PCR, antigens) carried out daily.
The “LABOé-SI” project aims to replace SI-DEP in order to guarantee the reporting of results from public and private laboratories, and will allow the sustainability of virological surveillance for Covid-19 but also the progressive integration of other diseases.
A surveillance system, an alternative to the VAC-SI system, could also make it possible to monitor future vaccination campaigns because currently only data on vaccinations reimbursed on an individual basis is reported.
Other areas of development are also cited in the BEH, such as the creation of a national information system in social and medico-social establishments (ESMS), the extension of the microbiological monitoring system for wastewater (Sum’eau) to pathogens other than Sars-CoV-2 or the acceleration of the deployment of electronic certification of deaths.
The challenge of open data
SPF is also considering overhauling its open data tools. “A new site is planned for February to replace Géodes and InfoCovidFrance, with more visualizations and easier search for indicators,” explained Yann Le Strat.
“It’s also feedback from Covid,” he continued. Visitation to the portal, which remained limited to an informed public (doctors, scientists), increased exponentially from one million visitors in 2019 to 15 million in 2020.
Furthermore, the proliferation of open data platforms complicates readability and the methodological differences in construction between the indicators produced can give rise to questions, even distrust. The concern for transparency and open data access must nevertheless guarantee the confidentiality of data and their security, we can read in the BEH.
(BEH, November 5, n°21, p437-490)
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