Monitoring the health impact of the COVID-19 pandemic: How an existing syndromic surveillance system was used to periodically monitor youth health in the Netherlands (Preprint)

Abstract

BACKGROUND The COVID-19 pandemic challenged societies worldwide. The implementation of mitigation measures to limit the number of SARS-CoV-2 infections, resulted in unintended health effects among females and youth. OBJECTIVE To demonstrate how an existing syndromic surveillance system in primary care can be used to periodically monitor changes in health problems during and after the COVID-19 pandemic. We describe the methodology as applied during a first series of multiple cross-sectional quarterly monitoring cycles, targeting health problems presented in primary care among the Dutch youth performed since August 2021. METHODS Aggregated data from the surveillance system of Nivel Primary Care Database were analyzed quarterly to map twenty health problems that are often reported in the aftermath of disasters and environmental incidents. Results were stratified by age (i.e., 0-4, 5-14, and 15-24 years), sex and region (province). Weekly prevalence rates were calculated as the number of persons consulting their general practitioner in a particular week, using the number of enlisted persons as denominator. Findings were compared to quarterly survey panel data, collected in the context of the Integrated Health Monitor COVID-19, and the Dutch stringency index values, indicative for the intensity of COVID-19 mitigation measures. RESULTS Over time, weekly rates pointed to an increased number of consultations for depressive feelings and suicide (attempts) among youth and young adults (0-24 years of age), during and after periods with intensified domestic restrictions. CONCLUSIONS The results illustrate how, from a disaster health-research perspective, health consequences of the COVID-19 pandemic could be successfully followed over time using an existing infrastructure for syndromic surveillance and monitoring. Particular areas of health concern can be defined beforehand (and modified or expanded) during the monitoring activities to track relevant developments. Although an association between patterns and changes between periods (e.g., spread of the virus, strictness of mitigation measures) might seem probable, claims about causality should be made with caution. Nevertheless, the pilot described here – based on the routine registration of general practitioners functioning as a gatekeeper in a stepped care healthcare system – served as a meaningful contribution to the monitoring toolbox to guide local, regional, and national policymakers and professionals in times of the COVID-19 pandemic.