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Table 3 Role of syndromic surveillance and other factors in supporting public health decisions a

From: The use of syndromic surveillance for decision-making during the H1N1 pandemic: A qualitative study

Public health decision Syndromic data Other factors supporting decision-making for SSUs Factors supporting decision-making for NSUs
Useful for:
Operation of influenza assessment centres, e.g. opening/closing, location ED data particularly used to support opening and in some instances, the location Consultations with health care providers about pressure on the health care system Consultations with health care providers about pressure on the health care system
Assessment centre activity Hospital decision
Recommendations/communications to the public Overall, provided picture of virus activity in the community and burden on the health care system to inform the timing and content of communications Inclusion of standard infection prevention and control recommendations Inclusion of standard infection prevention and control recommendations
Releasing communications regularly was made part of regular practice Guidance from the MOHLTC and provincial teleconferences
Overall, provided credibility in knowing the situation to help support and reinforce messages To be proactive Significant event, e.g. the first lab confirmed case or death
Laboratory data were used to provide updates about community activity levels Releasing communications regularly was made part of regular and collaborative practice with media
Response to media requests
Use of surveillance bulletins Overall, used to communicate and provide updates on virus activity levels in the community internally and externally Providing/updating bulletins was made part of regular practice. Providing/updating bulletins was made part of regular practice.
Laboratory data were included Laboratory data were included
Minimal impact on:
Operation of immunization clinics, e.g. opening/closing, location As a reflection of community activity, all data generally reinforced urgency of clinics and supported timing of closures Vaccine supply Vaccine supply
Demand for vaccine MOHLTC guidance
MOHLTC guidance Experiences with previous seasonal influenza campaigns
Geographic distribution of population; physical adequacy of space to accommodate equipment, car parking and line-ups Geographic distribution of population; physical adequacy of space to accommodate equipment, car parking and line-ups
Closing schools Overall, data showed community-wide spread and thus, would not be helpful at preventing transmission Understanding of the potential usefulness based on the research literature and societal impact if closed. Understanding of the potential usefulness based on the research literature and societal impact if closed.
For some local health departments, school absenteeism data did not suggest need to close. MOHLTC guidance MOHLTC guidance
Sending information letters home with school children School absenteeism data identified schools for targeted communication about infection prevention and control measures First lab confirmed case or death of a child Vaccine availability for school-aged children
Start of the school year First lab confirmed case or death of a child
New information available from the MOHLTC New information available from the MOHLTC
Requests by schools or school boards
Recommendations/messages to health care providers Overall, data was used to update stakeholders regularly about H1N1 activity in the community and support communications with health care partners Guidance from the MOHLTC and provincial teleconferences Guidance from the MOHLTC and provincial teleconferences
    To maintain regular communications with health care partners
  1. aMOHLTC, Ontario Ministry of Health and Long-Term Care.