Title Comparison of longitudinal trends in self-reported symptoms and COVID-19 case activity in Ontario, Canada.
Author Maharaj, Arjuna S; Parker, Jennifer; Hopkins, Jessica P; Gournis, Effie; Bogoch, Isaac I; Rader, Benjamin; Astley, Christina M; Ivers, Noah M; Hawkins, Jared B; Lee, Liza; Tuite, Ashleigh R; Fisman, David N; Brownstein, John S; Lapointe-Shaw, Lauren
Journal PLoS One Publication Year/Month 2022
PMID 35015778 PMCID PMC8754059
Affiliation + expend 1.Doctor of Medicine Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.

BACKGROUND: Limitations in laboratory diagnostic capacity impact population surveillance of COVID-19. It is currently unknown whether participatory surveillance tools for COVID-19 correspond to government-reported case trends longitudinally and if it can be used as an adjunct to laboratory testing. The primary objective of this study was to determine whether self-reported COVID-19-like illness reflected laboratory-confirmed COVID-19 case trends in Ontario Canada. METHODS: We retrospectively analyzed longitudinal self-reported symptoms data collected using an online tool-Outbreaks Near Me (ONM)-from April 20th, 2020, to March 7th, 2021 in Ontario, Canada. We measured the correlation between COVID-like illness among respondents and the weekly number of PCR-confirmed COVID-19 cases and provincial test positivity. We explored contemporaneous changes in other respiratory viruses, as well as the demographic characteristics of respondents to provide context for our findings. RESULTS: Between 3,849-11,185 individuals responded to the symptom survey each week. No correlations were seen been self-reported CLI and either cases or test positivity. Strong positive correlations were seen between CLI and both cases and test positivity before a previously documented rise in rhinovirus/enterovirus in fall 2020. Compared to participatory surveillance respondents, a higher proportion of COVID-19 cases in Ontario consistently came from low-income, racialized and immigrant areas of the province- these groups were less well represented among survey respondents. INTERPRETATION: Although digital surveillance systems are low-cost tools that have been useful to signal the onset of viral outbreaks, in this longitudinal comparison of self-reported COVID-like illness to Ontario COVID-19 case data we did not find this to be the case. Seasonal respiratory virus transmission and population coverage may explain this discrepancy.

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