Abstract
Syndromic surveillance through web or phone-based polling has been used to track the course of infectious diseases worldwide. Our study objective was to describe the characteristics, symptoms, and self-reported testing rates of respondents in three different COVID-19 symptom surveys in Canada. This was a cross-sectional study using three distinct Canada-wide web-based surveys, and phone polling in Ontario. All three sources contained self-reported information on COVID-19 symptoms and testing. In addition to describing respondent characteristics, we examined symptom frequency and the testing rate among the symptomatic, as well as rates of symptoms and testing across respondent groups. We found that over March- April 2020, 1.6% of respondents experienced a symptom on the day of their survey, 15% of Ontario households had a symptom in the previous week, and 44% of Canada-wide respondents had a symptom in the previous month. Across the three surveys, SARS-CoV-2-testing was reported in 2-9% of symptomatic responses. Women, younger and middle-aged adults (versus older adults) and Indigenous/First nations/Inuit/Métis were more likely to report at least one symptom, and visible minorities were more likely to report the combination of fever with cough or shortness of breath. The low rate of testing among those reporting symptoms suggests significant opportunity to expand testing among community-dwelling residents of Canada. Syndromic surveillance data can supplement public health reports and provide much-needed context to gauge the adequacy of SARS-CoV-2 testing rates.
Highlights
While SARS-CoV-2 has rapidly spread globally, ascertaining its true incidence remains a challenge [1, 2]
Syndromic surveillance data can supplement public health reports and provide much-needed context to gauge the adequacy of SARS-CoV-2 testing rates
In this study of syndromic surveillance data from three different survey sources, we find that described symptoms of COVID-19 were commonly reported by Canadian respondents
Summary
While SARS-CoV-2 has rapidly spread globally, ascertaining its true incidence remains a challenge [1, 2]. This is because a large proportion of those infected (20–75%) are minimally symptomatic or asymptomatic [3, 4]. Because of the broad range of symptomatic presentations observed in SARS-CoV2-infected individuals, a highly specific definition is likely to lack sensitivity and miss most people who would be eligible for testing [7]. Whereas grouping symptoms into clinical syndromes is likely to increase specificity, looking at the occurrence of any described symptom is the most sensitive way to measure all those who would be eligible for COVID-19 testing. Our study objective was to describe the characteristics, symptoms, and self-reported testing rates of respondents in three different COVID-19 symptom surveys in Canada
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