Background: Influenza viruses can cause mild to severe illnesses. The burden of disease varies widely depending on multiple factors, including the type and subtype of circulating viruses, timing of the season, flu vaccine efficacy and vaccination rates. Influenza viruses are also highly prone to genetic change and rapid spread due to modern human movement patterns, making influenza surveillance vital for public health awareness, guidance, policy, disease mitigation, and annual recommendations on vaccine composition.

Methods: A network of three National Influenza Reference Centers (NIRCs) was established in the United States more than 10 years ago to support the Centers for Disease Control and Prevention´s (CDC) Influenza Division with its national influenza surveillance efforts. Located in California, New York, and Wisconsin, they are funded by CDC via a collaborative agreement with the Association of Public Health Laboratories (APHL). The role of the NIRCs is critical to national and global influenza surveillance, providing rapid information on circulating influenza strains from three arms of laboratory testing: (1) the virus isolation project (VIP), (2) next-generation sequencing (NGS), and (3) anti-viral drug resistance testing.

Results: Here, we review the data generated in the VIP lab of the New York State (NYS) NIRC before, during, and after the COVID-19 pandemic and discuss its utility in an understanding of disease dynamics and viral evolution, as well as public health policy and decision making during this historic period in health care.

Conclusion: Continued preparedness and surveillance are critical to mitigating the impact of evolving influenza viruses.