Global influenza preparedness relies on a functioning Global Influenza Surveillance and Response System (GISRS), but the ongoing response to the coronavirus disease (COVID-19) pandemic challenges the system’s ability to work effectively. WHO is working with countries to address the challenges and ensure the threat of influenza is not neglected.

Even in the midst of the COVID-19 pandemic, influenza remains a top public health priority. Seasonal influenza causes up to five million hospitalizations and 650,000 deaths every year. Transmission this year may be reduced by the wide measures taken to contain COVID-19, but it will likely increase again once those measures are lifted. In many countries, the co-circulation of influenza and COVID-19 could worsen the impact on health systems that are already overwhelmed. And in all nations the threat of pandemic influenza, which could emerge any moment anywhere, remains real. 

GISRS has long served as the backbone to global influenza preparedness and response; and it has also been successfully leveraged to support the COVID-19 response ever since the novel virus emerged. But many countries face significant challenges in maintaining the routine influenza surveillance that drives GISRS during the COVID-19 pandemic. This is because, for example, they have shortages of laboratory materials or staff or because of changes to sentinel sites and systems. The result has been a sharp decline in influenza virus and data sharing through WHO and other global and regional platforms, with potentially severe impacts for countries. In many cases, short- and long-term capacities to detect and report influenza activity may be compromised. At a global level, the lack of data could lead to suboptimal recommendations for influenza vaccine composition. At a national level, it could similarly weaken public health decision-making on influenza, including on vaccination programmes. 

WHO urges all countries to recognize the ongoing threat of influenza and to strengthen or maintain their national influenza programmes to the best of their ability, even during COVID-19. In particular, we recommend strategically maintaining sentinel surveillance and continuing, where feasible, vaccination programmes and campaigns. We are supporting countries in this effort by:  

• Providing guidance on preparing for the upcoming influenza season against a backdrop of potential co-circulation of coronavirus and influenza viruses.
• Hosting a teleconsultation to identify the obstacles facing GISRS National Influenza Centres, Collaborating Centres, and Essential Regulatory Laboratories and develop strategies to address them. 
• Hosting a teleconsultation for national influenza surveillance officers to discuss how to maintain a functioning sentinel system in the face of COVID-19.
• Providing guidance on how to maintain essential health services, including immunization.
• Communicating with policymakers and the media about the key disruptors of routine influenza surveillance and their impacts to garner public and political will for maintaining influenza capacities.