Participatory, Virologic, and Wastewater Surveillance Data to Assess Underestimation of COVID-19 Incidence, Germany, 2020–2024

Abstract

Using participatory, virologic, and wastewater surveillance systems, we estimated when and to what extent reported data of adult COVID-19 cases underestimated COVID-19 incidence in Germany. We also examined how case underestimation evolved over time. Our findings highlight how community-based surveillance systems can complement official notification systems for respiratory disease dynamics.

Keywords

• COVID-19
• respiratory infections
• severe acute respiratory syndrome coronavirus 2
• SARS-CoV-2
• SARS
• coronavirus disease