ABSTRACT
Background Contact tracing is a public health intervention implemented in synergy with other measures, such as testing, physical distancing, and vaccination, to curb the COVID-19 pandemic. Digital solutions have been developed worldwide to enhance the contact tracing process. The aim of the study was to evaluate the effectiveness and impact of tracking COVID-19 patients using digital tools. Methods A systematic literature review was performed on eight online databases to identify observational studies on digital contact tracing, published 2020-2021, in English. Studies identified through the ‘Population Health Information Research Infrastructure’ project were also included. An ad hoc form has been deployed for data extraction of relevant information. Quality assessment of the included studies will be performed using validated tools. Results Over 8000 records were identified, of which 27 met the inclusion criteria: 16 modelling and 11 population-based studies. A study was based on GPS technology, four were Bluetooth-based, and others used digital technologies and manual tracing. The uptake rate of the tools ranged 19-100% across the studies. Most studies compared digital contact tracing with other strategies (e.g., no intervention, lockdown). Digital contact tracing was associated with improved identification of contact persons (9 studies), reduction of the effective reproduction number or covid-19 infections (8 studies), and increased effectiveness in combination with other containment measures (9 studies). Security and privacy issues were considered in 8 studies. Conclusions Digital contact tracing contributes in reducing further transmission, especially with sufficient population uptake of the applications and in combination with other public health measures. However, its deployment has been limited by security and privacy issues. Further studies are required to investigate the combined impact of digital and conventional contact tracing and enhance privacy and security.
ABSTRACT
Background Innovative solutions are used to monitor the spread of COVID-19, to research and develop vaccines, and to ensure online privacy and security. The aim of the study is to investigate which innovative methods, including algorithms and digital tools (e.g., social media, artificial intelligence, contact tracing applications) are used to monitor health issues related to COVID-19 in Europe, and who is using them. Methods A questionnaire was developed and administered online to European countries’ representatives and stakeholders of the project Population Health Information Research Infrastructure (PHIRI). The survey investigated the use of innovative solutions and digital tools in Europe to monitor COVID-19 and vaccination programs, to research and develop diagnostics and teleconsultations, and to fight online disinformation. Legislative and ethical aspects were also considered. A descriptive data analysis was performed. Results 19 responses were collected from 14 countries. Digital tools are used to monitor COVID-19 (13/14 countries), vaccination programs (12/14), for telemedicine (7/14), and to fight disinformation (10/14). Specific algorithms to detect the patterns of the pandemic spread are available in five countries. The main target groups of the tools are the general population, healthcare providers, patients and epidemiologists. The uptake rate of the tools ranged 5-100% across countries. Measures to evaluate the impact of digital tools (e.g., user surveys, reviews, evaluation teams) have been adopted in seven countries. Information on legislative and ethical aspects related to the use of digital solutions are available in 10 countries. Conclusions The development and use of innovative methods for population health monitoring and research purposes have been the key to mitigate the COVID-19 pandemic. Improving the uptake rate, impact assessment of digital tools and fight against disinformation could enhance countries’ preparedness for future pandemics. Key messages • Given that digital solutions are deployed in population health monitoring, research, and for online privacy and security, they have a key role in mitigating the COVID-19 pandemic. • Enhancement of the uptake rate and assessment of digital tools, and fight against disinformation could strengthen countries’ preparedness for future pandemics.
ABSTRACT
Background The COVID-19 pandemic caused an overabundance of valid and invalid information rapidly spread via traditional media, by internet and digital communication. Health Literacy (HL), as the ability to access, understand, appraise, apply health information, is fundamental for finding, interpreting, correctly using COVID-19 information. Methods In 2021, in the framework of the participation to the WHO M-POHL (Measuring Population and Organizational Health Literacy) network, a survey was conducted in a representative sample of the Italian general population aged 18+ years (N = 3,500). The validated HL questionnaire included coronavirus-related HL (HL-COVID, 16-items), general HL, sociodemographic characteristics, risk factors, lifestyles sections. For the HL-items, a 4-point Likert scale was applied: very easy, easy, difficult, very difficult. HL-COVID levels were defined as Good: very easy+easy>81.3% (more than 12 of 16 answers);Sufficient: 50.0%<very easy+easy < =81.3% (9-12 of 16 answers);Limited: very easy+easy < =50.0% (fewer than 9 of 16 answers). Elderly were responders aged 65+ years, the remaining ones were defined as adults. Ordinal Logistic Regression analysis was performed to assess the association of HL-COVID with sociodemographic characteristics (sex, age-group, educational level, financial deprivation). Results Good HL-COVID prevalence was lower in elderly than in adults (44.8% vs. 51.0%, p-value=0.001);the opposite for both sufficient (22.8% vs. 19.9%) and limited (32.5% vs. 29.1%) levels, but not statistically significant. The odds of a low HL-COVID (sufficient/limited) increased by 31% in the elderly and by 50%, 92%, and almost triple in persons with a low, considerable, and severe financial deprivation level, respectively. Conclusions The COVID-19 pandemic highlighted the need to improve HL and to prepare the general population for future emergency and non-emergency situations, confirming that HL can be considered a social vaccine. Key messages Low coronavirus-related HL level is mostly associated to elderly and to increasing deprivation level. The COVID-19 pandemic confirmed that Health Literacy can be considered a social vaccine.
ABSTRACT
Background The COVID-19 pandemic has had an unprecedented impact on Europe. Health systems came under strain, with non-urgent treatments postponed and resources reserved for treatment of COVID-19 patients. Delayed care seeking has been reported, for fear of infection with SARS-CoV2. Yet, the scale of this impact remains under researched. This study aims to compare indirect effects of the pandemic in a European cross-country study aiming to highlight the potential of Population Health Information Research Infrastructures (www.phiri.eu). Methods Focusing on (i) major vascular events (MVE) and (ii) elective surgery for joint replacements (ESJR) as well as (iii) serious trauma this study analyses individual level hospital data in a standardised harmonised data model. We compared pre-pandemic incidence rates (2018-2019) with rates for 2020 and 2021. Analyses are systematically contrasted with SARS CoV2 incidence rates, and policy measures taken based on the OxCGRT index. Results A drop in hospital discharge rates was observed during the pandemic in all countries but differing by condition and month. Socio-economic differences also varied by condition. Our evidence suggests that periods of more severe policy measures also correlated with more dramatic drops in regular hospital activities. Conclusions Our findings provide new insights on the dramatic level of de-prioritisation of essential services faced by non-COVID-19 patients in Europe. From a public health perspective, hospital escalation plans should be developed early on to avoid negative mid and long-term health and financial consequences of indirect effects. The study demonstrates the tremendous potential in exploiting health information systems in a systematic way across countries and the value of the PHIRI system. Further research should investigate policy trade-offs involved in severe lockdown measures during a pandemic and variations in health service resilience for future pandemic preparedness.