{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:35:16Z","timestamp":1753878916730,"version":"3.41.2"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early in the COVID\u201019 pandemic, due to limited testing, a potential gap in capturing SARS\u2010CoV\u20102\u2010positive community deaths was identified. Post\u2010mortem testing for respiratory viruses had never been implemented in the United Kingdom.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>Through implementing and evaluating a pilot, we aimed to establish feasibility and acceptability of post\u2010mortem SARS\u2010CoV\u20102 surveillance using funeral directors (FDs) to capture \u2018missed\u2019 COVID\u201019 community deaths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between January 2021 and February 2022, four FDs took upper respiratory tract samples from eligible people who died outside hospital. We tested for SARS\u2010CoV\u20102 and other respiratory viruses using reverse transcription\u2010polymerase chain reaction and matched results to the national COVID\u201019 mortality dataset. We evaluated the pilot for acceptability, data completeness and timeliness, and simplicity, using semi\u2010structured interviews, a questionnaire, and data audit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two thousand eight hundred sixty\u2010five deaths were handled by FDs: 998 were assessed for eligibility, 342 were eligible 81 were tested. Eight were SARS\u2010CoV\u20102\u2010positive, of which three were not identified by ante\u2010mortem clinical testing. The programme was acceptable in principle to FDs and families, but FDs' participation was limited by the burden of legal requirements and existing workloads. Families' willingness to consent fluctuated (monthly consent rate 4\u201383%, overall 30%); fewer consented when overall cases were low. Completeness and timeliness of data was good. FDs judged the programme simple.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The pilot established feasibility and demonstrated, even with small numbers, the ability to detect \u2018missed\u2019 deaths. There were significant obstacles to implementation. Alternative settings for taking specimens are being explored instead to address this gap in national surveillance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/irv.70116","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T06:24:07Z","timestamp":1749623047000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post\u2010Mortem Community Surveillance of COVID\u201019: Implementation and Evaluation of a Pilot System in the Funeral Sector in England, UK, January 2021 to February 2022"],"prefix":"10.1111","volume":"19","author":[{"given":"Hannah\u00a0E.","family":"Emmett","sequence":"first","affiliation":[{"name":"UK Field Epidemiology Training Programme UK Health Security Agency  London UK"},{"name":"COVID\u201019 Vaccines and Epidemiology Division UK Health Security Agency  London UK"},{"name":"North London Health Protection Team UK Health Security Agency  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Hall","sequence":"additional","affiliation":[{"name":"COVID\u201019 Vaccines and Epidemiology Division UK Health Security Agency  London UK"},{"name":"EGA Institute for Women's Health University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harriet\u00a0H.","family":"Webster","sequence":"additional","affiliation":[{"name":"COVID\u201019 Vaccines and Epidemiology Division UK Health Security Agency  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abigail","family":"Izzard","sequence":"additional","affiliation":[{"name":"COVID\u201019 Vaccines and Epidemiology Division UK Health Security Agency  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anika","family":"Singanayagam","sequence":"additional","affiliation":[{"name":"COVID\u201019 National Virology Cell UK Health Security Agency  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Zambon","sequence":"additional","affiliation":[{"name":"COVID\u201019 National Virology Cell UK Health Security Agency  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4606-5945","authenticated-orcid":false,"given":"Gavin","family":"Dabrera","sequence":"additional","affiliation":[{"name":"COVID\u201019 Vaccines and Epidemiology Division UK Health Security Agency  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.31083\/j.rcm2202035"},{"key":"e_1_2_14_3_1","unstructured":"Department of Health and Social Care.Technical Report on the COVID\u201019 Pandemic in the UK. Chapter\u00a06: Testing. December 2020: gov.uk; 2020 [updated January 2023] https:\/\/www.gov.uk\/government\/publications\/technical\u2010report\u2010on\u2010the\u2010covid\u201019\u2010pandemic\u2010in\u2010the\u2010uk\/chapter\u20106\u2010testing."},{"key":"e_1_2_14_4_1","unstructured":"A.Briggs D.Jenkins andC.Fraser. \u201cNHS Test and Trace: The Journey So Far: The Health Foundation \u201d [updated 23\/09\/2020] 2020 https:\/\/www.health.org.uk\/publications\/long\u2010reads\/nhs\u2010test\u2010and\u2010trace\u2010the\u2010journey\u2010so\u2010far."},{"key":"e_1_2_14_5_1","unstructured":"S.Hopkins. \u201cLateral Flow Testing \u2010 Rapid Tests to Detect COVID\u201019: UK Health Security Agency \u201d [updated 08\/12\/20] 2020 https:\/\/ukhsa.blog.gov.uk\/2020\/12\/08\/lateral\u2010flow\u2010testing\u2010new\u2010rapid\u2010tests\u2010to\u2010detect\u2010covid\u201019\/."},{"volume-title":"The 2009 Influenza Pandemic: An Independent Review of the UK Response to the 2009 Influenza Pandemic","year":"2010","author":"Hine D.","key":"e_1_2_14_6_1"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiab270"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2407.180162"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2701.203112"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n334"},{"key":"e_1_2_14_11_1","unstructured":"Office for National Statistics. \u201cDeaths registered weekly in England and Wales \u201d provisional. gov.uk 2021."},{"key":"e_1_2_14_12_1","unstructured":"Human Tissue Act (2004)."},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.2807\/ese.14.22.19230-en"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.46234\/ccdcw2020.116"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1086\/596311"},{"key":"e_1_2_14_16_1","unstructured":"Office for National Statistics.Developing Standard Tools for Data Linkage: February 2021: gov.uk; 2021 [updated 03\/02\/2021] https:\/\/www.ons.gov.uk\/methodology\/methodologicalpublications\/generalmethodology\/onsworkingpaperseries\/developingstandardtoolsfordatalinkagefebruary2021."},{"volume-title":"Communicable Disease Surveillance and Response Systems \u2010 Guide to Monitoring and Evaluating","year":"2006","author":"World Health Organization","key":"e_1_2_14_17_1"},{"volume-title":"Public Health Surveillance Atlanta","year":"2012","author":"US Centers for Disease Control and Prevention","key":"e_1_2_14_18_1"},{"volume-title":"Data Quality Monitoring and Surveillance System Evaluation \u2010 A Handbook of Methods and Applications","year":"2014","author":"European Centre for Disease Prevention and Control","key":"e_1_2_14_19_1"},{"volume-title":"Weekly National Influenza and COVID\u201019 Surveillance Report: Week 36 Report (Up to Week 35 Data)","year":"2021","author":"Public Health England","key":"e_1_2_14_20_1"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41562-021-01181-x"},{"key":"e_1_2_14_22_1","unstructured":"S.HopkinsandR.Aml\u00f4t Coronavirus (COVID\u201019): Self\u2010isolating protects your friends family and community: gov.uk; 2020 [updated 28\/09\/2020 https:\/\/ukhsa.blog.gov.uk\/2020\/09\/28\/coronavirus\u2010covid\u201019\u2010self\u2010isolating\u2010protects\u2010your\u2010friends\u2010family\u2010and\u2010community\/."}],"container-title":["Influenza and Other Respiratory Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.70116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T02:32:53Z","timestamp":1751509973000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/irv.70116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/irv.70116"],"URL":"https:\/\/doi.org\/10.1111\/irv.70116","archive":["Portico"],"relation":{},"ISSN":["1750-2640","1750-2659"],"issn-type":[{"type":"print","value":"1750-2640"},{"type":"electronic","value":"1750-2659"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2024-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70116"}}