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Rapid identification of COVID-19 and influenza in health care institutions
The coronavirus pandemic and seasonal influenza affect residents of homes for the elderly and nursing homes particularly hard. An important arena for the protection of risk groups is therefore nursing homes and other health care institutions. The monitoring of COVID-19 in the municipal health service, particularly in nursing homes, is essential in order to prevent severe illness and death during the pandemic.
At the same time, we know that COVID-19 and seasonal influenza are difficult to distinguish clinically. Outbreaks of both types can lead to severe illness which requires many of the same resources within the health service. Early knowledge concerning cases of COVID-19 and seasonal influenza, and the interaction between these at healthcare institutions, can prevent this and ensure that the health service is functioning properly.
During the pandemic, municipal medical officers and infectious disease professionals in the specialist health service have lacked sufficient information to rapidly identify cases of COVID-19 and influenza, and to assess testing activity. The systems for monitoring infection and testing for COVID-19 have been, and still are, inadequate, and there is a need to strengthen the monitoring of influenza in hospitals.
About the priority project
The project is based around the use of the Emergency preparedness register for COVID-19 (Beredt C19) to supply measurements and analyses of COVID-19 to the municipal health services, particularly in nursing homes, and to measure and analyse the interaction between COVID-19 and seasonal influenza in both hospitals and nursing homes.
The overall aim is to provide the information and knowledge that are necessary in order for the municipal and specialist health services and the Norwegian Institute of Public Health to carry out effective infection control work and implement measures rapidly as and when necessary. The project will also strengthen the use of new data sources in the work of the Norwegian Institute of Public Health and establish permanent systems for this in the longer term. The initiative is cooperating the Norwegian Association of Local and Regional Authorities (KS), the Directorate of Health and the Norwegian Labour and Welfare Administration (NAV).
The development of new monitoring systems for influenza in hospitals and nursing homes will be tested during the 2020-2021 influenza season. The monitoring system for influenza in hospitals which was introduced in autumn 2020 is based on ICD-10 diagnostic codes from hospitals collected by the Norwegian Patient Registry. The system shows the number of people admitted per week by age, gender, health trust and respirator use. If necessary, it is also possible to obtain daily figures and draw comparisons with COVID-19.
During the project, we will also test out other new approaches for monitoring influenza in hospitals by linking data from the MSIS laboratory database and data from the hospitals, so that the monitoring can be laboratory-verified. Use of the laboratory database enables us to describe testing activity and cases of double infection of influenza viruses and SARS-CoV-2. In addition, by linking to other data sources such as SYSVAK, KUHR and the National Population Register, we will be able to provide a better description of those admitted to hospital, including whether they had been vaccinated against influenza, belonged to a risk group, and the number of people who died in hospital or within 30 days of being admitted.
Descriptive and more advanced analyses will also be prepared in order to obtain a better understanding of the risk profile of those who work in the health service in Norway. We have used NAV’s State Register of Employers and Employees (Aa-registeret) to identify around 370,000 people who worked as health professionals in the health service this year. We will also be able to provide figures concerning testing activity and infection where workers are the population. We have looked at the opportunities to use this data in monitoring.
The priority project is being led by Hanne-Merete Eriksen, Ragnhild Tønnessen and Kjetil Telle.
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