Innovative strategies for early detection of acute respiratory infections: A systematic review and co-design of a tailored surveillance system with primary care providers and emergency department physicians in Canada

Benita Hosseini, Temerty Faculty of Medicine; Andrew Pinto, Temerty Faculty of Medicine; Aaron Orkin, Temerty Faculty of Medicine

The COVID-19 pandemic emphasized the importance of global preparedness and effective surveillance systems for infectious diseases. Early Warning Systems (EWSs) can mitigate the impact of such diseases through information exchange, monitoring, and early detection. This study aims to evaluate the effectiveness of EWSs and co-design an early threat detection system for respiratory infections in collaboration with Canadian primary care providers and ED physicians. The study involves a systematic literature review on EWS strategies and efficacy, as well as the co-design of a surveillance system tailored for outpatient settings across Canada's five zones. A comprehensive search will be performed, and two independent reviewers will assess articles describing and evaluating EWSs. Following data extraction, the quality of the studies will be assessed, and the findings will be synthesized to provide a comprehensive summary. The co-design process involves stakeholder identification, needs assessment through semi-structured interviews (5 per zone) and focus groups (1 per zone) and co-design workshops (1 per zone) to actively engage stakeholders from each zone in the co-design process. The workshops will focus on understanding the specific needs of the participants and identifying feasible implementation strategies tailored to each zone's unique regional characteristics. A thematic analysis approach will be employed to identify key themes and recommendations for the co-designed system. The findings from this study serve as a basis for obtaining further funding and refining the surveillance system for nationwide implementation. Moreover, we will leverage existing funds from other similar studies to provide additional financial support for this project if needed.