Outliers in the number of cases of influenza-like illness (ILI) that tested negative for influenza were present in global influenza surveillance networks early in the COVID-19 pandemic, an average of 13.3 weeks before the first reported COVID-19 peaks in 16 of the 28 countries included in a new study publishing July 19th in PLOS Medicine by Natalie Cobb of University of Washington, US, and colleagues.