# Syndromic surveillance performance in Canada throughout the COVID-19 pandemic, March 1, 2020 to March 4, 2023

## TL;DR

This paper evaluates how well Canada's FluWatchers system tracked respiratory viruses, including COVID-19, during the pandemic.

## Contribution

The study assesses the performance of FluWatchers syndromic surveillance during the full duration of the COVID-19 pandemic in Canada.

## Key findings

- FluWatchers' ILI and ARI indicators showed correlation with total respiratory virus detections.
- The system's performance was examined for influenza, RSV, SARS-CoV-2, and other respiratory viruses.
- Structural changes improved data collection for non-specific respiratory virus surveillance.

## Abstract

The coronavirus disease 2019 (COVID-19) pandemic has highlighted the need for robust surveillance of respiratory viruses. Syndromic surveillance continues to be an important surveillance component recommended by the World Health Organization (WHO). While FluWatchers, Canada's syndromic surveillance system, has been in place since 2015, the COVID-19 pandemic provided a valuable opportunity to expand the program's scope and underlying technology infrastructure. Following some structural changes to FluWatchers syndromic questionnaire, participants are now able to contribute valuable data to the non-specific surveillance of respiratory virus activity across Canada. This article examines the performance of FluWatchers' syndromic surveillance over the three years of the COVID-19 pandemic in Canada. More specifically, this article examines FluWatchers' performance with respect to the correlation between the FluWatchers influenza-like illness (ILI) and acute respiratory infection (ARI) indicators and total respiratory virus detections (RVDs) in Canada, including influenza, respiratory syncytial virus (RSV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and other respiratory viruses.