A “Pandemic-Proof” Methodology for Outbreak Detection Adapted From COVID-19’s Impact on Notifications of Infectious Diseases in the Netherlands: Surveillance Study
Notice bibliographique
Résumé
Background: Reporting of notifiable infectious diseases was overall impacted by the COVID-19 pandemic. This could affect disease surveillance and thus, outbreak detection, as it is based on historical data. For effective outbreak detection, it is crucial that communicable disease control professionals can rely on accurate and valuable alarm thresholds to ensure timely and adequate response to potential outbreaks. Objective: In this study, we take the first steps in the development of a methodology that adjusts for the impact of the COVID-19 pandemic on the number of notifications of notifiable infectious diseases and provides corrected alarm thresholds for outbreak detection. We identify which infectious diseases were affected by the COVID-19 pandemic, assess the duration of these effects, and explore potential correction methods to improve outbreak detection. Methods: We analyzed cases of 25 notifiable infectious diseases reported from 2015-2023 in the Netherlands. Negative binomial regression was used to calculate the incidence rate ratios for each period: pre-COVID-19 pandemic, COVID 2020, COVID 2021, COVID 2022, and post-COVID-19 pandemic. To address the decrease in notifications during the COVID-19 pandemic, we tested 3 correction methods: (1) recoding COVID-19 years as missing; (2) imputing with the last pre-COVID-19 pandemic observation; and (3) imputing the historical moving average. Results: Between 2015-2023, a total of 74,990 notifications were reported in the Netherlands, of which 9,836 notifications (13%) occurred during the COVID-19 pandemic. Malaria, typhoid fever, hepatitis A, meningococcal infection, paratyphoid fever, Q-fever, shigellosis, measles, mumps, and pertussis had significantly lower notifications during the COVID-19 pandemic, but the duration and magnitude of the effect differed among the infections. The effect of the COVID-19 pandemic on the notifications of malaria (incidence rate ratio [IRR] 0.17, 95% CI 0.08-0.36) and typhoid fever (IRR 0.12, 95% CI 0.02-0.55) was only seen in 2020, while the notifications for measles (IRR 0.34, 95% CI 0.15-0.75) and pertussis (IRR 0.34, 95% CI 0.20-0.60) were still significantly lower in the post-COVID-19 pandemic period. In addition, the newly calculated alarm thresholds showed a noticeable difference compared with the original unadjusted alarm thresholds. However, the variation among the 3 different corrected alarm thresholds was not substantial. Conclusions: During the COVID-19 pandemic, notifications of 10 infectious diseases declined significantly. The duration of this decline varied among infections, highlighting the need for pattern-specific adjustments. Our study demonstrates that accounting for the reduced notifications impacts alarm threshold calculations for outbreak detection. We therefore recommend amending the alarm thresholds to account for this impact to ensure reliable outbreak detection, so that communicable disease control professionals can act in a timely and data-driven manner. The next step in the development of the "pandemic-proof" methodology is to determine which correction method is most suitable. Further validation by communicable disease control professionals is essential to assess the applicability of the adjusted alarm thresholds for outbreak detection.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,041 | 0,105 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».