Why Covid and Co. must continue to be monitored

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The government’s announcement to phase out all Corona measures by the end of June is understandable for virologist Andreas Bergthaler – even if questions about protecting vulnerable groups and Long Covid have not yet been sufficiently resolved. The announcement that monitoring will nevertheless be continued is positive.

“In the case of PCR samples, Austria will carry out at least 1,500 whole-genome sequencings per week in the future, thus fulfilling the recommendation of the European authorities,” the health ministry said Wednesday. “That would be a lot and also internationally herzeigbar,” the researcher from the Medical University of Vienna and the Research Center for Molecular Medicine (CeMM) of the Academy of Sciences (ÖAW) told APA. Details, however, are still pending. If the genetic analyses were evaluated promptly after the samples were taken, this would be positive for the epidemiological overview, the virologist said.

The team’s contract around Ulrich Elling of the Institute of Molecular Biotechnology (IMBA) of the Austrian Academy of Sciences for the partial sequencing of samples of confirmed individual cases with the AGES expires at the end of March. This monitoring line will, therefore, soon be discontinued.

The wastewater monitoring system remains
The wastewater monitoring system, in which 48 wastewater treatment plants across Austria are sampled weekly, will continue to run independently of the planned sequencing of PCR samples. “This covers just under 60 percent of the population,” says Bergthaler. What is analyzed here is, on the one hand, the viral load in the wastewater, which allows conclusions to be drawn about the number of cases and, on the other hand, which variants of the SARS-CoV-2 pathogen are present in it. The system has been running in the current network for about a year, and the contract is scheduled for four years. These logistics were created during the pandemic and resulted from strong scientific networking.

Bergthaler and his team have been involved here for a long time, doing the sequencing. Scientifically, researchers focus heavily on what other pathogen traces can be robustly detected in wastewater samples and how this information can benefit the healthcare system.

Discussions are underway on possible extensions of the content of case- and wastewater-based “surveillance systems,” he said. Ideally, according to the recommendations of the EU health authority ECDC, such an approach would also include influenza viruses and other pathogens of respiratory diseases. The virologist said it would be desirable if Austria were among the first countries to introduce something like this.

Monitoring other pathogens
SARS-CoV-2 would be included here, but it would not be the only focus. In recent months, in particular, other diseases have caused high hospital occupancy rates; Bergthaler points out: “The big thing that should come is that you don’t set up this surveillance for SARS-CoV-2 specifically, but for many respiratory infectious agents.”

If such a system is implemented, the consequences should also be clarified, for example, if it becomes clear that a massive influenza wave is building up. The key challenge here, he said, is how to identify and mitigate waves of infection at an early stage in terms of primary prevention “instead of just looking back to see what happened.”

That’s exactly what the Corona advisory body Gecko aims to do in the period leading up to the expiration of its mandate at the end of June, among other things. The findings from the critical recap of the turbulent period will be used to inform future thinking on evidence-based policy advice, says Gecko member Bergthaler. That, too, would be a way to learn from the pandemic in the longer term.