{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T08:08:57Z","timestamp":1777536537896,"version":"3.51.4"},"reference-count":26,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:00:00Z","timestamp":1651795200000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,4,2]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to assess if emergency department (ED) syndromic surveillance during the first and second waves of the COVID-19 outbreak could have improved our surveillance system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and settings<\/jats:title>\n                    <jats:p>We did an observational study using aggregated data from the ED of a university hospital and public health authorities in western Switzerland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All patients admitted to the ED were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>The main outcome was intensive care unit (ICU) occupancy. We used time series methods for ED syndromic surveillance (influenza-like syndrome, droplet isolation) and usual indicators from public health authorities (new cases, proportion of positive tests in the population).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Based on 37 319 ED visits during the COVID-19 outbreak, 1421 ED visits (3.8%) were positive for SARS-CoV-2. Patients with influenza-like syndrome or droplet isolation in the ED showed a similar correlation to ICU occupancy as confirmed cases in the general population, with a time lag of approximately 13 days (0.73, 95% CI 0.64 to 0.80; 0.79, 95% CI 0.71 to 0.86; and 0.76, 95% CI 0.67 to 0.83, respectively). The proportion of positive tests in the population showed the best correlation with ICU occupancy (0.95, 95% CI 0.85 to 0.96).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ED syndromic surveillance is an effective tool to detect and monitor a COVID-19 outbreak and to predict hospital resource needs. It would have allowed to anticipate ICU occupancy by 13 days, including significant aberration detection at the beginning of the second wave.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-054504","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T12:39:58Z","timestamp":1651840798000},"page":"e054504","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Lessons from COVID-19 syndromic surveillance through emergency department activity: a prospective time series study from western Switzerland"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0520-3619","authenticated-orcid":false,"given":"Francois-Xavier","family":"Ageron","sequence":"first","affiliation":[{"name":"Emergency Department, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2312-1625","authenticated-orcid":false,"given":"Olivier","family":"Hugli","sequence":"additional","affiliation":[{"name":"Emergency Department, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrice","family":"Dami","sequence":"additional","affiliation":[{"name":"Emergency Department, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Caillet-Bois","sequence":"additional","affiliation":[{"name":"Emergency Department, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie","family":"Pittet","sequence":"additional","affiliation":[{"name":"Centre for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Eckert","sequence":"additional","affiliation":[{"name":"General Directorate, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3561-1250","authenticated-orcid":false,"given":"Nicolas","family":"Beysard","sequence":"additional","affiliation":[{"name":"Emergency Department, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre-Nicolas","family":"Carron","sequence":"additional","affiliation":[{"name":"Emergency Department, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,5,6]]},"reference":[{"key":"2025121511300758000_12.5.e054504.1","unstructured":"WHO . 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