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UNHCR Public Health Section: Surveillance for COVID-19

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Effective response to an outbreak of COVID-19 requires detection in the very earliest stages of the outbreak when the number of cases is small, and the geographical extent of spread is limited. In order to achieve this, a sensitive surveillance system capable of detecting small scale, unusual events is necessary.


Early identification of index case or possible human-to-human transmission of COVID-19.


  1. Event-based surveillance systems - include a broad range of activities such as rumour surveillance, monitoring of media sources, informal community-based reporting networks, the immediate reporting of signal/trigger events by community or facility health care workers. This approach uses the community case definition (see below).
  2. Indicator-based reporting – using case definitions in outpatient and inpatient departments at health facilities.

UNHCR Health Information System

  • UNHCR case definitions include upper respiratory tract infections (URTIs), and lower respiratory tract infections (LRTIs). See Annex 1.
  • Severe Acute Respiratory Illnesses include either URTI or LRTIs, which are hospitalized. This category is not included in the case definitions. See Annex 1.
  • The Alert Thresholds for URTI and LRTI occurs when reported cases are 1.5 times the average for the previous 3 weeks. These trends should be monitored on a weekly basis to determine if the incidence rate is beyond the alert threshold. However, in the context of a COVID-19 outbreak, use the information from the line list to monitor daily trends of cases and death over time (Epi-curve).
  • Suspected COVID-19 case definitions (See Annex 1) should be used for event-based surveillance at both health facility and community level. This is a NOTIFIABLE DISEASE and must be reported immediately to UNHCR/Partner Health Coordinator and Local Ministry of Health (MOH) Focal Points.