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An Ignored Warning: Why Passive Surveillance May Miss Major Outbreaks?
Public health surveillance is one of the key tools to identify and respond to health crises. However, as technology advances, many people worry that traditional passive surveillance systems may not be able to catch warnings of major outbreaks in time.
According to the definition of the World Health Organization, "Public health surveillance is the process of systematically collecting, analyzing and interpreting health-related data."
Monitoring systems can be divided into passive monitoring and active monitoring. Passive surveillance relies on regular reporting of disease by health care providers, while active surveillance requires professionals to collect data directly, which includes visits to clinics and examination of records. Although active monitoring can provide more comprehensive information, it is usually more time-consuming and costly.
Reports by medical institutions are often not comprehensive due to limited resources, resulting in information on certain diseases being underestimated or underreported.
Of the two, passive monitoring is widely used because of its convenience, but it can also come with risks. For example, during an ongoing flu season, if patients are relied upon to proactively report their conditions, many cases who are unable to travel to a medical facility will not be recorded, thus affecting the overall understanding of the epidemic.
Especially when facing public health emergencies such as COVID-19, this monitoring method cannot reflect the full picture of the epidemic in an instant. Because of social distancing or lockdown measures, patients may not be attending their clinics in the usual way, meaning a lot of important data will be missed. Active surveillance can reduce such intelligence leakage and become a policy tool critical for immediate response.
In the early stages of an epidemic, timely identification and response to symptoms can significantly reduce the number of infections and mortality.
However, improved monitoring systems rely on more than just the investment of human resources. The growing use of digital technologies in public health surveillance includes analyzing social media data, search engine trends and data from mobile apps. These emerging surveillance methods are believed to be able to catch signs of outbreaks in time, even before professional medical reports.
For example, according to Google Flu Trends, when flu activity rises, so does the number of related searches. Such data can serve as early warning indicators to help public health managers prepare for potential outbreaks.
“An effective surveillance system must not only report data in a timely manner, but must also have the ability to predict potential health crises.”
However, over-reliance on high-tech monitoring methods may also present its own problems. Social media data can be influenced by misinformation, causing confusion, and not everyone reports health conditions on social media, especially underlying medical conditions. Therefore, these data need to be analyzed carefully to avoid missing the true situation of the epidemic.
For public health experts, building an effective surveillance system is not just about traditional medical reporting, but also about finding data from a variety of sources and ensuring that the information has an opportunity to be collected and analyzed. The purpose of this is to respond well at the early stage of the epidemic and avoid another large-scale outbreak such as SARS or COVID-19.
"Data diversity and accuracy are keys to a successful monitoring system."
In conclusion, the current status of public health surveillance faces multiple challenges. Although passive monitoring systems are practical when resources are limited, their potential risk of data loss cannot be ignored. How to integrate multiple data sources to improve the effectiveness of the surveillance system is not only a scientific issue, but also an urgent issue that public health policymakers need to face. Perhaps we should think about: How can we ensure that every important health warning is not ignored in future epidemics?
