[josephpmay]

We’ve actually had a similar issue in the US with some Electronic Initial Case Report documents (to be clear, we mostly rely on Electronic Lab Results-ELR rather than eICR in the US to count COVID numbers, so this hasn’t resulted in an under-count)

Rather than be a problem with the database having arbitrary file size limits, it actually was a problem with file size limits within network intermediaries. In most cases, the issue is less the limit, and more that the files themselves were too large because of how they were created. I don’t think this is the same issue as the UK (I don’t think they are using the eICR standard there yet), but it’s an example of how you could have a problem with file size limitations without storing data in Excel.