COVID and Influenza Preparedness in Europe

The COVID-19 pandemic and its repercussions will continue for some time and is likely to continue to place an ongoing burden on already stretched healthcare workers and patients in Europe, which will be exacerbated if it coincides with the seasonal influenza outbreak this Winter.

On 15 June 2020, WHO Director General, Tedros Adhanom Ghebreyesus, said: “Despite the ongoing global response to COVID-19, the world can not lose sight of the significant public health risk posed by influenza, which affects every country every year and takes its own deadly toll. Tedros pointed to WHO guidance on how to integrate surveillance for COVID-19 into routine influenza surveillance as an efficient way to track the two respiratory illnesses. He continued: “This is not only cost-effective, it’s also essential for protecting the world against the next flu season.” (1)

In addition to integrated surveillance, several diagnostic tests that allow differential detection of SARS CoV2 and seasonal diseases like influenza virus are in development and are likely to become available soon after Summer 2020 including:

Combined PCR (polymerase chain reaction) tests, which diagnostically differentiates COVID-19, influenza and other respiratory viruses at the same time, will be available within a few weeks, including one developed by the CDC (2); and
Point-of-care COVID-19 tests, with results in 15 minutes, and high degrees of sensitivity and specificity, are already approved by the FDA and available in the US and will be very soon in Europe. In July, the US government purchased thousands of these point-of-care tests for nursing homes (3). The CDC in the US has just published Interim Guidance for Rapid Antigen Testing for SARS-CoV-2 for diagnostic use and in screening in congregate settings. In Europe, point-of-care tests with high levels of sensitivity and specificity are already available for influenza and other respiratory viruses.

This new arsenal of diagnostic tests will facilitate innovative testing and triage strategies in different healthcare settings and patient populations. A clear and integrated approach to testing in Europe, leveraging the latest technologies available, has the potential to save time and resources in both the public and private healthcare sectors and most importantly to deliver the best outcomes for patients.

These new and innovative point-of-care tests have many benefits, including simplicity of use and speedier results, that allow faster clinical decision-making and deployment in a wide variety of locations, such as primary care, nursing homes, prisons, schools ,army and emergency departments in acute care settings. They also provide the following benefits to healthcare and other workers in congregate settings in Europe:

Enhanced protection and prevention of exposure of healthcare and other workers in congregate settings like nursing homes, prisons, military units and other healthcare settings.
Quick diagnosis of symptomatic healthcare and other workers.
Enhanced protection and prevention of exposure of teachers and other workers in educational settings through quick identification and repetitive screening.
Faster turnaround of patients in emergency units, reducing the pressure and stress on healthcare workers and the system in those units.

Any qualified healthcare professional in any EU Member State should be able to perform these easy-to-use rapid combined point-of-care tests, including nurses or doctors and any healthcare technician like pharmacists or laboratory technicians etc. Again, this will reduce the burden on hard pressed healthcare workers.

The European Biosafety Network believes, alongside other EU stakeholders, that the European Commission, the European Centre for Disease Prevention and Control and Member States need to be better prepared for the anticipated next healthcare crisis this Winter by:

Developing recommendations on:
- Diagnostic and screening programs with rapid point-of-care tests in educational settings to prevent the spread of infection and protect teachers and other workers in educational settings.
- diagnostic and screening in congregate settings like nursing homes, prisons, military units and other healthcare settings.
Developing diagnostic algorithms, guidelines and protocols for the differential and combined diagnosis of COVID-19 and influenza in primary care, acute care, home care etc., and in the wider patient population, including new combined PCR and rapid point- of-care tests to prevent the spread of infection and protect healthcare workers.
Integrating the results of the testing within existing European and national surveillance systems.
Speeding up the path to market for the new differential diagnostic test.
Ensuring that the necessary diagnostic tests are deployed in advance of the influenza season.