A national COVID-19 surveillance system: Achieving containment

This report describes the features and capabilities of a national surveillance system to mitigate the current COVID-19 pandemic wave and to limit and suppress future outbreaks. Developing these capabilities in each state and region will enable the U.S. to move beyond extreme and disruptive physical isolation measures. The proposed COVID-19 surveillance system builds on existing models and principles of public health surveillance, but recognizes that the transmissibility and virulence of COVID-19 require a much more substantial capacity for rapid detection and public health response.
Timely and efficient implementation of such a surveillance system will require ongoing coordination between health care providers and state and local public health authorities, with Federal support coordinated through the Centers for Disease Control and Prevention (CDC) to achieve effective implementation throughout the country as soon as possible, and certainly in time for the Fall, when COVID-19 may become a seasonal threat.
…At the same time that we confront the current crisis, we must plan for the future by putting in place tools to enhance our ability to conduct effective surveillance, containment, and case management. As incidence of COVID-19 declines, case-based interventions will again become an option. Building those capabilities now will enable us to move beyond the extreme and disruptive physical isolation measures in place across the United States.
Every region of the country should aim for the following outbreak surveillance and response capabilities:
1)Test and Trace Infrastructure: Capacity for Widespread Diagnostic Testing and DataSharing to Enable Rapid Case-Based Interventions
a)The capacity to conduct rapid diagnostic testingfor everyone with COVID-19 symptoms and those with exposures or at higher risk of contracting or transmitting the virus (health care workers, those in congregate settings), with a robust sentinel surveillance system that routinely monitors for infection among samples of the population to enable early identification of small outbreaks, particularly in vulnerable populations;
b)Routine, straightforward, and secure electronic data sharing to support surveillance;
2)Syndromic Surveillance: Integration of Test and Trace into an Enhanced National Syndromic Surveillance System
a)Surveillance based on syndromic indicators of spikes and falls in potential COVID-19 related symptoms, building on existing public health syndromic surveillance capabilities
b)Timely and transparent reporting of COVID-19 outbreaks and testing and response capacity atthe local level
3)Serologic Testing: Capacity to Conduct Widespread Serologic Testing to Identify Reliable Markers of Immunity
a)The development of regional measures of community exposure and immunity
b)The use and integration of accurate serologic testing of individuals for effective surveillance and containment
4)Rapid Response: Capacity for Isolation, Contact Tracing,and Quarantine
a)The capacity to isolate new cases and trace, test, and quarantine contacts rapidly
b)The capacity to treat new COVID-19 cases effectively, at home or in a hospital.
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A national COVID-19 surveillance system: Achieving containment