A Review of Infectious Disease Surveillance to Inform Public Health Action Against the Novel Coronavirus SARS-CoV-2

The SARS-CoV-2 pandemic exposed the inadequacy of infectious disease surveillance throughout the US and other countries. Isolation and contact tracing to identify all infected people are key public health interventions necessary to control infectious disease outbreaks. However, these activities are dependent upon the surveillance platform to identify infections quickly. A robust surveillance platform can also reinforce community adherence to behavioral interventions such as social distancing. In situations where contact tracing is feasible, all suspected cases and contacts of confirmed cases must be tested for a SARS-CoV-2 infection and effectively isolated. At the community level wastewater surveillance can identify areas where transmission is or is not occurring, and genetic sequencing of SARS-CoV-2 can help to elucidate the intensity of transmission independent of the number of known cases and hospitalizations. State and county public health departments should improve the infectious disease surveillance platform whilst the public is practicing social distancing. These enhanced surveillance activities are necessary to contain the epidemic once the curve has been sufficiently flattened in highly burdened areas, and to prevent escalation in areas where transmission is minimal.