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hospitalisation or ICU admission rates and impact on how hospitals are coping with the burden of COVID-19 infections. The assessment of the impact on hospitals should be based on bed occupancy levels in hospitals and intensive care units, and the capacity for ventilation, and could use simple indicators such as ‘capacity sufficient’ or ‘overwhelmed’. These indicators would inform decisions on social distancing and quarantine measures which would need to be taken in the context of large pressures on public health services. The indicators should be collated at national level and reported at EU level. Excess mortality surveillance: Monitoring of all-cause or specific excess mortality is essential at this stage in order to assess the impact of the epidemic in addition to monitoring deaths among confirmed cases. Dissemination of surveillance data: Results from surveillance activities should be reported regularly to stakeholders and policy makers in order to inform control strategies. During the initial phase, extremely high demand for information from the public, stakeholders and policy makers will mean that daily reports or regularly updated dashboards are required. Weekly surveillance reports should also be developed collating data from multiple surveillance sources, including ARI/ILI sentinel surveillance, SARI surveillance, virological surveillance, case-based surveillance (as long as this is implemented), mortality data and qualitative indicators on the burden in hospitals and intensive care units. At the EU level, similar reports will be produced only a weekly basis and published on the ECDC website. Limited resources: in general, surveillance data should continue to be collected at the most detailed level possible as long as capacity allows, in order to provide the best evidence for control interventions. When resources are limited, countries should move to more limited datasets as described above and eventually to aggregate reporting where this reduces burden. A number of countries have reported shortages of laboratory reagents and resources for COVID-19 testing. Such shortages could become more acute in the context of large increases in cases. In circumstances with shortages, testing capacity should be reserved for more severe cases and hospital use and SARI cases. If there is no capacity for testing of samples from sentinel clinics, sentinel syndromic surveillance for ARI/ILI through sentinel general practices and/or telephone helplines should be used to assess the intensity and spread of infection. This might be challenging if influenza and/or other respiratory pathogens are co-circulating. If testing capacity remains in hospitals or intensive care units, then SARI/ICU surveillance should be used for surveillance purposes. In the event that no testing capacity remains at all in hospitals, the qualitative indicators described above could be used. Contact tracing ECDC has published a technical report and algorithm on public health management of persons having had contact with probable and confirmed cases of COVID-19 infection [90]. ECDC have also produced a technical report for EU/EEA countries public health authorities with an estimation of resources required – including staff needs and coordination – for contact tracing, quarantine and monitoring activities [79]. The steps and resources needed are outlined in more detail in these documents. The purpose of tracing COVID-19 case contacts is to identify symptomatic contacts as early as possible for testing, isolation and treatment. For contact tracing purposes, a contact is defined as a person who has or may have been in contact with a COVID-19 case in the period from 24 hours before the onset of symptoms until the time of diagnosis and isolation of the case. The classification of contacts according to high or low-risk exposure is based on the associated risk of infection that in turn determines the type of monitoring as defined in the ECDC technical document [90]. Data on contact tracing investigations should be collated and analysed at local and/or national level in order to learn from investigations and inform guidance. In scenario 2, contact tracing, quarantining and monitoring is still a valuable part of a range of public health measures and should be intensified if possible. As the number of cases and their contacts increase as the country moves towards scenario 3, resources may be stretched, but there is still value in tracing contacts even if not all contacts of each case are traced. This will help slow the spread of infection but should be applied together with other measures, such as social distancing, as these different strategies can have synergistic effects [91-93]. The ECDC technical report outlines some ways to save resources such as using well-trained non-technical staff, and switching to self-monitoring [79]. If resources are limited, contact tracing and follow-up can be prioritised, first to the high-risk exposure contacts of each case (close contacts), contacts that are healthcare workers or work with vulnerable populations, followed by as many as possible of the low-risk exposure contacts [79]. In scenarios 3 and 4 contact tracing, where possible, could still contribute to delaying the spread and reducing the pressure on the healthcare system, and may be prioritised according to the principles outlined above. According to the WHO-China joint