FluCov: Influenza-COVID-19, understanding and communicating the co-circulation of influenza and COVID-19.

Duration: Mar 2021 - Dec 2025

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Background

On 1 January 2020, the World Health Organisation (WHO) requested information on a reported cluster of atypical pneumonia cases in Wuhan from the Chinese authorities. On 1 March 2020, WHO made the assessment that SARS-CoV-2 could be characterized as a pandemic. The emergence of this new virus has had a major impact on the global circulation of respiratory viruses, including influenza and RSV. The end of the pandemic was announced on 4 May 2023, with SARS-CoV-2 being an established virus which continues to circulate globally.

Participating countries

A number of 25 contextual and geographical representative countries have been selected:

Africa (2): Egypt, South Africa
America (6): Argentina, Brazil, Canada, Chili, Mexico, USA
Europe (8): France, Germany, Israel, Italy, Netherlands, Poland, Spain, United Kingdom
South Asia (4): India, Philippines, Thailand, Vietnam
Pacific (6): Australia, China, Japan, New Zealand, South Korea, Taiwan

Aim

The FluCov project aims to provide a situation analysis of influenza and SARS-CoV-2 co-circulation in relation to other respiratory pathogens, when relevant. This information is critical for the assessment and development of public health implications for influenza vaccine composition, coverage, and policies in the coming years.

Project design

The research project consists of six components:

Developing an integrated Bulletin for acute respiratory pathogens using data from WHO FluNet and other key sources with a primary focus on influenza and SARS-CoV-2
Further maintaining the existing FluCov Dashboard on the Nivel website and exploring ways to extend the project, notably to new pathogens e.g. RSV
Assessing how the FluCov Dashboard on the Nivel website can be further enhanced by adding new Bulletins and possibly also new sources of surveillance data (influenza and RSV)
Assessing the possible extinction of the B-Yamagata influenza virus
Assessing the impact of the SARS-CoV-2 pandemic on influenza vaccine coverage rates around the world
Writing a manuscript to describe and present the FluCov multi-pathogen surveillance website/ platform and results

Results

We share our research and findings by providing access to the FluCov Bulletins, posters, and survey results:

A dashboard which allows visitors to query the influenza and Sars-Cov-2 data themselves
Regular publications:
- the FluCov Bulletins of the epidemiological assessment on the impact of SARS-CoV-2 on influenza activity
- influenza activity reports: weekly short publication of influenza activity in the Northern Hemisphere
Scientific publications:
- abstracts
1. regarding the epidemiological impact of the SARS-CoV-2 pandemic on influenza activity, which was submitted to ESCAIDE (European Scientific Conference on Applied Infectious Disease Epidemiology) in November 2021
2. regarding results of three years the FluCov project, submitted to OPTIONS XII in September 2024
- conference contributions:
1. two posters which were presented at Options XI: 1) the NIC survey results and 2) the modelling study/strategy (by EHESP)
2. poster presented at ESCMID Global 2024: quantitative analysis of influena B/Yamagata surveillance data
3. oral presentation online at the 7th ESWI influenza conference: influenza vaccine coverage rate
- research article: Probable extinction of influenza B/Yamagata and its public health implications: a systematic literature review and assessment of global surveillance databases (The Lancet Microbe)
- letter to the editor: influenza vaccine coverage rate during the COVID-19 pandemic (Eurosurveillance)
- short communication: modelling the susceptible population for the 2022/23 influenza season (Influenza and Other Respiratory Viruses)
- report: landscape analysis of modelling activities regarding the impact of SARS-CoV-2 on influenza activity
- survey: among National Influenza Centers about the impact of the SARS-CoV-2 pandemic on influenza surveillance (Influenza and Other Respiratory Viruses)

Result 1: FluCov Dashboard, the impact of SARS-CoV-2 on influenza

The emergence of SARS-CoV-2 in 2019 had a major impact on the global circulation of respiratory viruses, including influenza (see https://www.nature.com/articles/s41467-022-29402-5). In order to understand the impact of SARS-CoV-2 on influenza activity worldwide, and more recently their co-circulation, the FluCov Dashboard offers users a clear view of the current and past circulation of both viruses (since 2019), in a wide range of countries all over the world. Real-time weekly surveillance weekly data are downloaded and presented in the Dashboard.

Results 2 en 3: FluCov Bulletins, scientific publications, survey results, posters

FluCov Influenza Activity Reports - (weekly update), starting 22 Nov 2023

FluCov-Bulletins (monthly) starting in June 2021)

InFluNews (Newsletter Global Influenza Initiative GII)

Infographic InFlunews, issue 7, November 2022

InFluNews, issue 1 - February 2022

Posters

FluCov NIC Survey, presented at OPTIONS XI, 26-29 September 2022
EU5 Modelling to produce influenza activity scenarios, presented at OPTIONS XI, 26-29 September 2022
FluCov EpiBulletin, presented at WHO-ISIRV conference "COVID-19, Influenza and RSV: Surveillance-Informed Prevention and Treatment, 19-21 October 2021

Scientific publications

2023 | The impact of the SARS-CoV-2 pandemic on global influenza surveillance: insights from 18 National Influenza Centers based on a survey conducted between November 2021 and March 2022. Staadegaard, L., Del Riccio, M., Wiegersma, S., El Guerche-Séblain, C., Dueger, E., Akçay, M., Casalegno, J.S., Dückers, M., Caini, S., Paget, J. 2023
2023 | Landscape analysis of modelling activities around the world regarding the impact of SARS-CoV-2 on influenza activity. Wiegersma, S., Del Riccio, M., Staadegaard, L., Paget, J. Utrecht: Nivel, 2023
2023 | Preparing for the upcoming 2022/23 influenza season: A modelling study of the susceptible population in Australia, France, Germany, Italy, Spain and the United Kingdom. Boudewijns, B., Paget, J. Del Riccio, M., Coudeville, L., Crépey, P. Influenza Other Respi Viruses. 2023
2021 | Letter to the editor: Increase of influenza vaccination coverage rates during the COVID-19 pandemic and implications for the upcoming influenza season in northern hemisphere countries and Australia. Del Riccio M, Lina B, Caini S, Staadegaard L, Wiegersma S, Kynčl J, Combadière B, MacIntyre CR, Paget J. Euro Surveill. 2021

Presentations

GII-MENA-RAISE Survey – Results

Nivel project team

Participating Nivel researchers are:

Bronke Boudewijns, junior researcher
Susanne Heemskerk, junior researcher
Marco Del Riccio, MD, guest researcher
Saverio Caini MD, PhD, guest researcher
Caroline Schneeberger, PhD, senior researcher

Project partners

Project partners are:

The Global Influenza Initiative (GII)
Funding
The research project is funded by Sanofi. The current research grant runs until December 2025.

Want to know more?

For more information on this project, please feel free to get in touch with the Nivel expert(s) involved. You will find them on the right, together with the (future) Nivel deliverables (publications) and other relevant content.

Funding

Sanofi Pasteur

Project partners

The Global Influenza Initiative (GII) consists of the Middle East, Eurasia and Africa Influenza Stakeholders Network (MENA); Raise Awareness of Influenza Strategies in Europe (RAISE); Pan-European Committee on Influenza