Evolving Global and National Criteria for Identifying a Suspected Case of COVID-19

Abstract Background: The outbreak of coronavirus disease 2019 (COVID-19) began in December 2019 and is spreading rapidly. Rapid and accurate identification of suspected cases is critical in suppressing viral spread. We aimed to highlight the discrepancies in the varying criteria used by international agencies and highly impacted individual countries worldwide. Methods: The criteria from two international agencies and ten countries across Asia, Europe, and North America were reviewed. Each included information on the clinical causes of illness and epidemiology risk factors. Non-English language guidelines were translated into English by one of the co-authors who was fluent in that language. Results: Although the majority of criteria are modified from the World Health Organization recommendations, the specific clinical features and epidemiological risks for triggering evaluation of COVID-19 in suspected patients differed widely among nations. The rationale for these differences may be linked to each individual country’s resources, politics, experience with previous outbreaks or pandemics, health insurance systems, severity of the COVID-19 situation, and other undetermined factors. Conclusion: There was no consensus on the single best criteria for identifying a suspected case of COVID-19.