National surveillance for Coronavirus disease (COVID-19)

Last updated: September 29, 2023

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Purpose

The following documents the integrated approach to national COVID-19 surveillance activities being led, supported and coordinated by the Public Health Agency of Canada. We outline the recommended goals, objectives and activities for COVID-19 surveillance in Canada.

This guidance is based on current available scientific evidence and expert opinion, and is subject to change as new information becomes available. It should be read in conjunction with relevant local, provincial and territorial legislation, regulations and policies.

This guidance has been developed based on the situation in Canada. Therefore, it may differ from surveillance guidance developed by other countries.

Background

On March 11, 2020, the World Health Organization (WHO) declared a global pandemic of COVID-19. Since the beginning of the pandemic, surveillance of domestic, international and community transmission of COVID-19 was established across Canada. On May 5, 2023, WHO determined that COVID-19 was an established and ongoing health issue which no longer constituted a public health emergency of international concern (PHEIC); however, WHO advised that COVID-19 remains a global health threat. As such, the systematic, ongoing collection, analysis and interpretation of COVID-19 information must continue to be conducted in a timely manner to inform public health decision making.

The Public Health Agency of Canada's current COVID-19 surveillance system is comprised of multiple data streams to monitor COVID-19 epidemiology in Canada and continues to build on lessons learned through the pandemic. It is done in collaboration with:

This surveillance system has been used to track the progression and severity of COVID-19 disease throughout the course of the pandemic. It combines a variety of data streams, including:

For information regarding the current epidemiology of COVID-19 in Canada, refer to the COVID-19 epidemiology update.

Surveillance goals and objectives

The pandemic public health response goal is to minimize serious illness and overall deaths while minimizing societal disruption. As the pandemic continues to evolve with the virus, so too do our surveillance goals and objectives. They were developed to:

Surveillance goals

  1. To monitor, detect, and assess signals of COVID-19.
  2. To describe the clinical and epidemiological features of COVID-19 cases with severe outcomes.
  3. To monitor the impacts of public health interventions, such as vaccination.

Surveillance objectives

  1. Monitor, characterize and conduct timely detection of emerging and circulating COVID-19 variants.
  2. Describe the epidemiology of COVID-19 cases in Canada.
  3. Describe population-level trends as an indicator of community circulation.
  4. Assess circulating COVID-19 activity in Canada to describe trends over time and intensity of transmission.
  5. Characterize the epidemiology, impact and burden of COVID-19 cases with severe outcomes.
  6. Describe the distribution of COVID-19 among population groups.
  7. Participate and contribute to global surveillance initiatives.
  8. Monitor COVID-19 vaccination coverage, safety, effectiveness and the level of population immunity.

Integrated COVID-19 surveillance

The COVID-19 surveillance system is comprised of multiple data streams and is organized into the following components.

Community surveillance encompasses the overall epidemiology of acute COVID-19 and longer-term impacts, such as post-COVID condition or new or worsening chronic disease. It is done to provide information on transmission risk to people living in Canada.

Virologic surveillance identifies, tracks and evaluates the specific lineages of SARS-CoV-2. It allows for the detection of emerging variants and characterization of genotypic and phenotypic viral changes to inform associated risks.

Severe outcome surveillance monitors hospitalizations and deaths associated with COVID-19. It also tracks associated characteristics to examine the burden of COVID-19 on the health of people in Canada and the impact on the healthcare system.

Vaccine and immunity monitoring provides information on:

This is done to support immunization-related decision making and public health action.

International monitoring provides clear international situational awareness of COVID-19 and risk levels at home and abroad by describing:

Public health surveillance continues to be key to preparedness, particularly given the potential for multiple respiratory threats. Approaches to assessing the epidemiological situation through surveillance have shifted to monitor ongoing viral evolution and emergence of new variants over time, while rebalancing the approach to be less exclusively focused on COVID-19 and integrating it with other respiratory and emerging disease surveillance systems.

National case reporting

The COVID-19 surveillance system is comprised of multiple data streams, one of which is the national case dataset. Provinces and territories voluntarily report detailed information on confirmed and probable cases of COVID-19 to the Public Health Agency of Canada. National case reporting contributes key information towards many components of integrated COVID-19 surveillance.

Case definitions

We have developed the national COVID-19 surveillance case definitions for classification and reporting COVID-19 probable and confirmed cases. It also classifies resolved, deceased and reinfection cases. These definitions are updated as necessary.

Case data reported nationally

Provinces and territories are asked to provide required data elements (as found on the COVID-19 case report form) to help us with national surveillance. We collect demographic, clinical, epidemiologic, vaccination and laboratory information on all reported probable and confirmed cases. A data dictionary is available that outlines the definitions, format and values for each variable as part of the case report form.

Data are submitted via an electronic extract from the provincial or territorial information system. It uses the secure methods established between the Public Health Agency of Canada and provincial and territorial partners.

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