TY  - JOUR
AU  - de Lusignan, Simon
AU  - Lopez Bernal, Jamie
AU  - Zambon, Maria
AU  - Akinyemi, Oluwafunmi
AU  - Amirthalingam, Gayatri
AU  - Andrews, Nick
AU  - Borrow, Ray
AU  - Byford, Rachel
AU  - Charlett, André
AU  - Dabrera, Gavin
AU  - Ellis, Joanna
AU  - Elliot, Alex J
AU  - Feher, Michael
AU  - Ferreira, Filipa
AU  - Krajenbrink, Else
AU  - Leach, Jonathan
AU  - Linley, Ezra
AU  - Liyanage, Harshana
AU  - Okusi, Cecilia
AU  - Ramsay, Mary
AU  - Smith, Gillian
AU  - Sherlock, Julian
AU  - Thomas, Nicholas
AU  - Tripathy, Manasa
AU  - Williams, John
AU  - Howsam, Gary
AU  - Joy, Mark
AU  - Hobbs, Richard
PY  - 2020
DA  - 2020/4/2
TI  - Emergence of a Novel Coronavirus (COVID-19): Protocol for Extending Surveillance Used by the Royal College of General Practitioners Research and Surveillance Centre and Public Health England
JO  - JMIR Public Health Surveill
SP  - e18606
VL  - 6
IS  - 2
KW  - general practice
KW  - medical record systems
KW  - computerized
KW  - sentinel surveillance
KW  - coronavirus
KW  - COVID-19
KW  - SARS-CoV-2
KW  - surveillance
KW  - infections
KW  - pandemic
KW  - records as topic
KW  - serology
AB  - Background: The Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) and Public Health England (PHE) have successfully worked together on the surveillance of influenza and other infectious diseases for over 50 years, including three previous pandemics. With the emergence of the international outbreak of the coronavirus infection (COVID-19), a UK national approach to containment has been established to test people suspected of exposure to COVID-19. At the same time and separately, the RCGP RSC’s surveillance has been extended to monitor the temporal and geographical distribution of COVID-19 infection in the community as well as assess the effectiveness of the containment strategy. Objectives: The aims of this study are to surveil COVID-19 in both asymptomatic populations and ambulatory cases with respiratory infections, ascertain both the rate and pattern of COVID-19 spread, and assess the effectiveness of the containment policy. Methods: The RCGP RSC, a network of over 500 general practices in England, extract pseudonymized data weekly. This extended surveillance comprises of five components: (1) Recording in medical records of anyone suspected to have or who has been exposed to COVID-19. Computerized medical records suppliers have within a week of request created new codes to support this. (2) Extension of current virological surveillance and testing people with influenza-like illness or lower respiratory tract infections (LRTI)—with the caveat that people suspected to have or who have been exposed to COVID-19 should be referred to the national containment pathway and not seen in primary care. (3) Serology sample collection across all age groups. This will be an extra blood sample taken from people who are attending their general practice for a scheduled blood test. The 100 general practices currently undertaking annual influenza virology surveillance will be involved in the extended virological and serological surveillance. (4) Collecting convalescent serum samples. (5) Data curation. We have the opportunity to escalate the data extraction to twice weekly if needed. Swabs and sera will be analyzed in PHE reference laboratories. Results: General practice clinical system providers have introduced an emergency new set of clinical codes to support COVID-19 surveillance. Additionally, practices participating in current virology surveillance are now taking samples for COVID-19 surveillance from low-risk patients presenting with LRTIs. Within the first 2 weeks of setup of this surveillance, we have identified 3 cases: 1 through the new coding system, the other 2 through the extended virology sampling. Conclusions: We have rapidly converted the established national RCGP RSC influenza surveillance system into one that can test the effectiveness of the COVID-19 containment policy. The extended surveillance has already seen the use of new codes with 3 cases reported. Rapid sharing of this protocol should enable scientific critique and shared learning. International Registered Report Identifier (IRRID): DERR1-10.2196/18606 
SN  - 2369-2960
UR  - https://publichealth.jmir.org/2020/2/e18606
UR  - https://doi.org/10.2196/18606
UR  - http://www.ncbi.nlm.nih.gov/pubmed/32240095
DO  - 10.2196/18606
ID  - info:doi/10.2196/18606
ER  -