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2.
BMC Med Res Methodol ; 23(1): 120, 2023 05 19.
Article in English | MEDLINE | ID: covidwho-2324512

ABSTRACT

BACKGROUND: A considerable amount of various types of data have been collected during the COVID-19 pandemic, the analysis and understanding of which have been indispensable for curbing the spread of the disease. As the pandemic moves to an endemic state, the data collected during the pandemic will continue to be rich sources for further studying and understanding the impacts of the pandemic on various aspects of our society. On the other hand, naïve release and sharing of the information can be associated with serious privacy concerns. METHODS: We use three common but distinct data types collected during the pandemic (case surveillance tabular data, case location data, and contact tracing networks) to illustrate the publication and sharing of granular information and individual-level pandemic data in a privacy-preserving manner. We leverage and build upon the concept of differential privacy to generate and release privacy-preserving data for each data type. We investigate the inferential utility of privacy-preserving information through simulation studies at different levels of privacy guarantees and demonstrate the approaches in real-life data. All the approaches employed in the study are straightforward to apply. RESULTS: The empirical studies in all three data cases suggest that privacy-preserving results based on the differentially privately sanitized data can be similar to the original results at a reasonably small privacy loss ([Formula: see text]). Statistical inferences based on sanitized data using the multiple synthesis technique also appear valid, with nominal coverage of 95% confidence intervals when there is no noticeable bias in point estimation. When [Formula: see text] and the sample size is not large enough, some privacy-preserving results are subject to bias, partially due to the bounding applied to sanitized data as a post-processing step to satisfy practical data constraints. CONCLUSIONS: Our study generates statistical evidence on the practical feasibility of sharing pandemic data with privacy guarantees and on how to balance the statistical utility of released information during this process.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Privacy , Pandemics , Computer Simulation , Contact Tracing/methods
3.
BMC Infect Dis ; 23(1): 335, 2023 May 18.
Article in English | MEDLINE | ID: covidwho-2321725

ABSTRACT

BACKGROUND: In Ghana, contact tracing received heightened attention in the fight against the COVID-19 pandemic during its peak period. Despite the successes achieved, numerous challenges continue to limit the efforts of contact tracing in completely curtailing the effect of the pandemic. Despite these challenges, there are still opportunities that could be harnessed from the COVID-19 contact tracing experience for future eventualities. This study thus identified the challenges and opportunities associated with COVID-19 contact tracing in the Bono Region of Ghana. METHODS: Using a focus group discussion (FGD) approach, an exploratory qualitative design was conducted in six selected districts of the Bono region of Ghana in this study. The purposeful sampling technique was employed to recruit 39 contact tracers who were grouped into six focus groups. A thematic content analysis approach via ATLAS ti version 9.0 software was used to analyse the data and presented under two broad themes. RESULTS: The discussants reported twelve (12) challenges that hindered effective contact tracing in the Bono region. These include inadequate personal protective equipment, harassment by contacts, politicisation of the discourse around the disease, stigmatization, delays in processing test results, poor remuneration and lack of insurance package, inadequate staffing, difficulty in locating contacts, poor quarantine practices, poor education on COVID-19, language barrier and transportation challenges. Opportunities for improving contact tracing include cooperation, awareness creation, leveraging on knowledge gained in contact tracing, and effective emergency plans for future pandemics. CONCLUSION: There is a need for health authorities, particularly in the region, and the state as a whole to address contact tracing-related challenges while simultaneously harnessing the recommended opportunities for improved contact tracing in the future for effective pandemic control.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Contact Tracing/methods , SARS-CoV-2 , Pandemics/prevention & control , Ghana/epidemiology
4.
Health Secur ; 21(3): 222-232, 2023.
Article in English | MEDLINE | ID: covidwho-2320476

ABSTRACT

During the COVID-19 pandemic, the Mashpee Wampanoag Tribe of southeastern Massachusetts requested US federal government assistance. The tribe collaborated successfully with many partners in response to the COVID-19 pandemic. In this case study, the authors describe the tribe's collaboration with a team from the Centers for Disease Control and Prevention who assisted with epidemiology, case investigation and contact tracing, infection prevention and control, community prevention measures, and vaccination. Collaborative efforts resulted in over 200 public service announcements and videos produced, 55 tribal staff trained, 222 people followed up for contact tracing, 80% of tribal members vaccinated, and 5 COVID-19 response plans written. Deployment response teams learned elements essential to partnering with a Native American tribe. This successful partnership during a rapidly evolving pandemic suggests the US federal government and tribal nations can work together effectively to build response capacity for future infectious disease threats.


Subject(s)
COVID-19 , United States , Humans , COVID-19/epidemiology , Pandemics/prevention & control , Contact Tracing/methods , Centers for Disease Control and Prevention, U.S.
5.
PLoS One ; 18(5): e0285752, 2023.
Article in English | MEDLINE | ID: covidwho-2316739

ABSTRACT

COVID-19 exposed and exacerbated health disparities, and a core challenge has been how to adapt pandemic response and public health in light of these disproportionate health burdens. Responding to this challenge, the County of Santa Clara Public Health Department designed a model of "high-touch" contact tracing that integrated social services with disease investigation, providing continued support and resource linkage for clients from structurally vulnerable communities. We report results from a cluster randomized trial of 5,430 cases from February to May 2021 to assess the ability of high-touch contact tracing to aid with isolation and quarantine. Using individual-level data on resource referral and uptake outcomes, we find that the intervention, randomized assignment to the high-touch program, increased the referral rate to social services by 8.4% (95% confidence interval, 0.8%-15.9%) and the uptake rate by 4.9% (-0.2%-10.0%), with the most pronounced increases in referrals and uptake of food assistance. These findings demonstrate that social services can be effectively combined with contact tracing to better promote health equity, demonstrating a novel path for the future of public health.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Contact Tracing/methods , Touch , Health Promotion , SARS-CoV-2 , Social Work
6.
J Theor Biol ; 557: 111331, 2023 01 21.
Article in English | MEDLINE | ID: covidwho-2315357

ABSTRACT

The emergence of SARS-CoV-2 saw severe detriments to public health being inflicted by COVID-19 disease throughout 2020. In the lead up to Christmas 2020, the UK Government sought an easement of social restrictions that would permit spending time with others over the Christmas period, whilst limiting the risk of spreading SARS-CoV-2. In November 2020, plans were published to allow individuals to socialise within 'Christmas bubbles' with friends and family. This policy involved a planned easing of restrictions in England between 23-27 December 2020, with Christmas bubbles allowing people from up to three households to meet throughout the holiday period. We estimated the epidemiological impact of both this and alternative bubble strategies that allowed extending contacts beyond the immediate household. We used a stochastic individual-based model for a synthetic population of 100,000 households, with demographic and SARS-CoV-2 epidemiological characteristics comparable to England as of November 2020. We evaluated five Christmas bubble scenarios for the period 23-27 December 2020, assuming our populations of households did not have symptomatic infection present and were not in isolation as the eased social restrictions began. Assessment comprised incidence and cumulative infection metrics. We tested the sensitivity of the results to a situation where it was possible for households to be in isolation at the beginning of the Christmas bubble period and also when there was lower adherence to testing, contact tracing and isolation interventions. We found that visiting family and friends over the holiday period for a shorter duration and in smaller groups was less risky than spending the entire five days together. The increases in infection from greater amounts of social mixing disproportionately impacted the eldest. We provide this account as an illustration of a real-time contribution of modelling insights to a scientific advisory group, the Scientific Pandemic Influenza Group on Modelling, Operational sub-group (SPI-M-O) for the Scientific Advisory Group for Emergencies (SAGE) in the UK, during the COVID-19 pandemic. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Pandemics , COVID-19/epidemiology , Contact Tracing/methods , Family Characteristics
7.
Swiss Med Wkly ; 150: w20457, 2020 12 14.
Article in English | MEDLINE | ID: covidwho-2270793

ABSTRACT

In the wake of the pandemic of coronavirus disease 2019 (COVID-19), contact tracing has become a key element of strategies to control the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Given the rapid and intense spread of SARS-CoV-2, digital contact tracing has emerged as a potential complementary tool to support containment and mitigation efforts. Early modelling studies highlighted the potential of digital contact tracing to break transmission chains, and Google and Apple subsequently developed the Exposure Notification (EN) framework, making it available to the vast majority of smartphones. A growing number of governments have launched or announced EN-based contact tracing apps, but their effectiveness remains unknown. Here, we report early findings of the digital contact tracing app deployment in Switzerland. We demonstrate proof-of-principle that digital contact tracing reaches exposed contacts, who then test positive for SARS-CoV-2. This indicates that digital contact tracing is an effective complementary tool for controlling the spread of SARS-CoV-2. Continued technical improvement and international compatibility can further increase the efficacy, particularly also across country borders.


Subject(s)
COVID-19/transmission , Contact Tracing/methods , Disease Notification/methods , Mobile Applications , Smartphone , COVID-19/epidemiology , COVID-19/prevention & control , Confidentiality , Humans , SARS-CoV-2 , Switzerland/epidemiology , Wireless Technology
8.
Nat Commun ; 14(1): 858, 2023 02 22.
Article in English | MEDLINE | ID: covidwho-2265965

ABSTRACT

The NHS COVID-19 app was launched in England and Wales in September 2020, with a Bluetooth-based contact tracing functionality designed to reduce transmission of SARS-CoV-2. We show that user engagement and the app's epidemiological impacts varied according to changing social and epidemic characteristics throughout the app's first year. We describe the interaction and complementarity of manual and digital contact tracing approaches. Results of our statistical analyses of anonymised, aggregated app data include that app users who were recently notified were more likely to test positive than app users who were not recently notified, by a factor that varied considerably over time. We estimate that the app's contact tracing function alone averted about 1 million cases (sensitivity analysis 450,000-1,400,000) during its first year, corresponding to 44,000 hospital cases (SA 20,000-60,000) and 9,600 deaths (SA 4600-13,000).


Subject(s)
COVID-19 , Mobile Applications , Humans , SARS-CoV-2 , State Medicine , Wales , Contact Tracing/methods , England
9.
PLoS One ; 18(3): e0283081, 2023.
Article in English | MEDLINE | ID: covidwho-2277733

ABSTRACT

With countries across the world facing repeated epidemic waves, it becomes critical to monitor, mitigate and prevent subsequent waves. Common indicators like active case numbers may not be sensitive enough in the presence of systemic inefficiencies like insufficient testing or contact tracing. Test positivity rates are sensitive to testing strategies and cannot estimate the extent of undetected cases. Reproductive numbers estimated from logarithms of new incidences are inaccurate in dynamic scenarios and not sensitive enough to capture changes in efficiencies. Systemic fatigue results in lower testing, inefficient tracing and quarantining thereby precipitating the onset of the epidemic wave. We propose a novel indicator for detecting the slippage of test-trace efficiency based on the number of deaths/hospitalizations resulting from known and hitherto unknown infections. This can also be used to forecast an epidemic wave that is advanced or exacerbated due to a drop in efficiency in situations where the testing has come down drastically and contact tracing is virtually nil as is prevalent currently. Using a modified SEIRD epidemic simulator we show that (i) Ratio of deaths/hospitalizations from an undetected infection to total deaths converges to a measure of systemic test-trace inefficiency. (ii) This index forecasts the slippage in efficiency earlier than other known metrics. (iii) Mitigation triggered by this index helps reduce peak active caseload and eventual deaths. Deaths/hospitalizations accurately track the systemic inefficiencies and detect latent cases. Based on these results we make a strong case that administrations use this metric in the ensemble of indicators. Further, hospitals may need to be mandated to distinctly register deaths/hospitalizations due to previously undetected infections. Thus the proposed metric is an ideal indicator of an epidemic wave that poses the least socio-economic cost while keeping the surveillance robust during periods of pandemic fatigue.


Subject(s)
COVID-19 , Humans , COVID-19/diagnosis , COVID-19/epidemiology , SARS-CoV-2 , Pandemics/prevention & control , Quarantine , Contact Tracing/methods
10.
Eur J Epidemiol ; 38(3): 243-266, 2023 Mar.
Article in English | MEDLINE | ID: covidwho-2276861

ABSTRACT

Contact tracing is a non-pharmaceutical intervention (NPI) widely used in the control of the COVID-19 pandemic. Its effectiveness may depend on a number of factors including the proportion of contacts traced, delays in tracing, the mode of contact tracing (e.g. forward, backward or bidirectional contact training), the types of contacts who are traced (e.g. contacts of index cases or contacts of contacts of index cases), or the setting where contacts are traced (e.g. the household or the workplace). We performed a systematic review of the evidence regarding the comparative effectiveness of contact tracing interventions. 78 studies were included in the review, 12 observational (ten ecological studies, one retrospective cohort study and one pre-post study with two patient cohorts) and 66 mathematical modelling studies. Based on the results from six of the 12 observational studies, contact tracing can be effective at controlling COVID-19. Two high quality ecological studies showed the incremental effectiveness of adding digital contact tracing to manual contact tracing. One ecological study of intermediate quality showed that increases in contact tracing were associated with a drop in COVID-19 mortality, and a pre-post study of acceptable quality showed that prompt contact tracing of contacts of COVID-19 case clusters / symptomatic individuals led to a reduction in the reproduction number R. Within the seven observational studies exploring the effectiveness of contact tracing in the context of the implementation of other non-pharmaceutical interventions, contact tracing was found to have an effect on COVID-19 epidemic control in two studies and not in the remaining five studies. However, a limitation in many of these studies is the lack of description of the extent of implementation of contact tracing interventions. Based on the results from the mathematical modelling studies, we identified the following highly effective policies: (1) manual contact tracing with high tracing coverage and either medium-term immunity, highly efficacious isolation/quarantine and/ or physical distancing (2) hybrid manual and digital contact tracing with high app adoption with highly effective isolation/ quarantine and social distancing, (3) secondary contact tracing, (4) eliminating contact tracing delays, (5) bidirectional contact tracing, (6) contact tracing with high coverage in reopening educational institutions. We also highlighted the role of social distancing to enhance the effectiveness of some of these interventions in the context of 2020 lockdown reopening. While limited, the evidence from observational studies shows a role for manual and digital contact tracing in controlling the COVID-19 epidemic. More empirical studies accounting for the extent of contact tracing implementation are required.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Contact Tracing/methods , Pandemics/prevention & control , Retrospective Studies , Communicable Disease Control/methods , SARS-CoV-2
11.
J Sch Health ; 93(5): 353-359, 2023 05.
Article in English | MEDLINE | ID: covidwho-2285679

ABSTRACT

BACKGROUND: Case investigation and contact tracing (CI/CT) are important public health tools to interrupt COVID-19 transmission. Our study aims to understand how parents and school staff perceive COVID-19 CI/CT. METHODS: Using a mixed methods approach, we distributed a community survey and conducted 15 focus group discussions (FGDs) in English and Spanish between December 2020 and March 2021 with 20 parents and 22 staff from schools in San Diego County ZIP Codes with COVID-19 rates in the top quintile as of August 2020. RESULTS: One in 4 survey respondents reported that they would be reluctant to participate in CI/CT. FGDs revealed themes of mistrust in government authorities, overburdened institutions, unfamiliarity with CI/CT, and uncertainty about its reliability. School community members emphasized that parents trust schools to be involved in CI/CT efforts, but schools are overwhelmed with this added responsibility. CONCLUSIONS: Investing in schools as community hubs is necessary so they can become important partners in prevention and mitigation in public health.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Contact Tracing/methods , Reproducibility of Results , Public Health , Focus Groups
12.
J Med Syst ; 47(1): 24, 2023 Feb 14.
Article in English | MEDLINE | ID: covidwho-2245008

ABSTRACT

Singapore, like many other nations globally, had to contend with significant caseloads arising from the Coronavirus disease (COVID-19) pandemic. This paper focuses on using technology as an intervention for pandemic management. With scant scientific evidence on effective medications and vaccinations (i.e., pharmaceutical interventions) initially, disease containment strategies predominated during the early phases. Non-pharmaceutical interventions were critical in slowing disease transmission and preventing public healthcare institutions from being overwhelmed. Such interventions could be broadly divided into case-based interventions (e.g., contact tracing and quarantining of close contacts) and population-based measures (e.g., mask use and social distancing). The paper describes Singapore's experience in the operational implementation of contact-based interventions, and illustrates how harnessing the digital edge enabled fast, accurate, resource-efficient, and flexible execution of ground operations. Singapore applied digital technology and developed an integrated system to facilitate issuance and acknowledgement of quarantine orders, submission of COVID-19 test results, and collection of antigen rapid test kits at the population level. Data was obtained from this proprietary centralised, automated platform. The paper demonstrates how such simple, yet elegant systems could have a direct impact on disease transmission in an outbreak setting and on population health. Moving forward, it is recommended that technology and digital solutions feature prominently in work process designs beyond COVID-19 such as in the management of emerging infectious diseases and non-communicable diseases.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Quarantine , Contact Tracing/methods , SARS-CoV-2 , Disease Outbreaks/prevention & control
14.
BMC Public Health ; 23(1): 146, 2023 01 21.
Article in English | MEDLINE | ID: covidwho-2219358

ABSTRACT

BACKGROUND: Data about the effectiveness of digital contact tracing are based on studies conducted in countries with predominantly high- or middle-income settings. Up to now, little research is done to identify specific problems for the implementation of such technique in low-income countries. METHODS: A Bluetooth-assisted GPS location-based digital contact tracing (DCT) app was tested by 141 participants during 14 days in a hospital in Monrovia, Liberia in February 2020. The DCT app was compared to a paper-based reference system. Hits between participants and 10 designated infected participants were recorded simultaneously by both methods. Additional data about GPS and Bluetooth adherence were gathered and surveys to estimate battery consumption and app adherence were conducted. DCT apps accuracy was evaluated in different settings. RESULTS: GPS coordinates from 101/141 (71.6%) participants were received. The number of hours recorded by the participants during the study period, true Hours Recorded (tHR), was 496.3 h (1.1% of maximum Hours recordable) during the study period. With the paper-based method 1075 hits and with the DCT app five hits of designated infected participants with other participants have been listed. Differences between true and maximum recording times were due to failed permission settings (45%), data transmission issues (11.3%), of the participants 10.1% switched off GPS and 32.5% experienced other technical or compliance problems. In buildings, use of Bluetooth increased the accuracy of the DCT app (GPS + BT 22.9 m ± 21.6 SD vs. GPS 60.9 m ± 34.7 SD; p = 0.004). GPS accuracy in public transportation was 10.3 m ± 10.05 SD with a significant (p = 0.007) correlation between precision and phone brand. GPS resolution outdoors was 10.4 m ± 4.2 SD. CONCLUSION: In our study several limitations of the DCT together with the impairment of GPS accuracy in urban settings impede the solely use of a DCT app. It could be feasible as a supplement to traditional manual contact tracing. DKRS, DRKS00029327 . Registered 20 June 2020 - Retrospectively registered.


Subject(s)
Mobile Applications , Humans , Contact Tracing/methods , Pilot Projects , Feasibility Studies , Poverty
15.
J Public Health Manag Pract ; 29(4): 556-562, 2023.
Article in English | MEDLINE | ID: covidwho-2222930

ABSTRACT

CONTEXT: Research and policy studies alike have enumerated population and community health benefits of system integration between medical, public health, and social entities. The emergence of the COVID-19 pandemic revealed the necessity of a well-trained and adequately staffed public health and medical workforce in order to process SARS-CoV-2 cases and prevent subsequent transmission. Higher education systems, in particular, represented defined populations of exposure and transmission. Opportunities existed for collaboration and task sharing between institutions of higher education and local public health departments to limit spread and impacts. PROGRAM: This article describes the Pandemic Response Officer (PRO) program at Cornell University, a team of staff and students created during the intensity of the pandemic to benefit the Tompkins County and Cornell University communities. IMPLEMENTATION: The PRO program was formed in January 2021, with an original team of 8 individuals, working iteratively to investigate and support employee cases and exposures. Implementation was motivated by Cornell University's dual responsibility as a large employer that also possessed SARS-CoV-2 test results of employees. PROs loaded case information into a shared HIPPA-compliant electronic record that collected information for case notification, case investigation, isolation support, contact tracing, contact notification, and quarantine support. Over time, the PROs grew to a team of 25, gaining responsibilities as university and public health systems shared roles to maximize resources. EVALUATION: From January 1 to December 31, 2021, PROs managed 773 employee and 2943 student cases. During the Omicron surge (November 28-December 31, 2021), PROs saved the public health department an estimated 2797 hours of effort, equating to more than 10 professionals working full-time, evenings and weekends, to process cases and contacts during this interval. DISCUSSION: By integrating efforts between a university and public health agency, this intervention minimized SARS-CoV-2 transmission via expedient case support and alleviated strain on public health systems by expanding the public health workforce.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Public Health , SARS-CoV-2 , Pandemics/prevention & control , Contact Tracing/methods
16.
mSphere ; 8(1): e0054422, 2023 02 21.
Article in English | MEDLINE | ID: covidwho-2213888

ABSTRACT

Tracking the spread of infection amongst individuals within and between communities has been a major challenge during viral outbreaks. With the unprecedented scale of viral sequence data collection during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the possibility of using phylogenetics to reconstruct past transmission events has been explored as a more rigorous alternative to traditional contact tracing; however, the reliability of sequence-based inference of transmission networks has yet to be directly evaluated. E. E. Bendall, G. Paz-Bailey, G. A. Santiago, C. A. Porucznik, et al. (mSphere 7:e00400-22, 2022, https://doi.org/10.1128/mSphere.00400-22) evaluate the potential of this technique by applying best practices sequence comparison methods to three geographically distinct cohorts that include known transmission pairs and demonstrate that linked pairs are often indistinguishable from unrelated samples. This study clearly establishes how low viral diversity limits the utility of genomic methods of epidemiological inference for SARS-CoV-2.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , SARS-CoV-2/genetics , Reproducibility of Results , Contact Tracing/methods , Disease Outbreaks
17.
JMIR Public Health Surveill ; 7(6): e27189, 2021 06 03.
Article in English | MEDLINE | ID: covidwho-2197904

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, swab tests proved to be effective in containing the infection and served as a means for early diagnosis and contact tracing. However, little evidence exists regarding the correct timing for the execution of the swab test, especially for asymptomatic individuals and health care workers. OBJECTIVE: The objective of this study was to analyze changes in the positive findings over time in individual SARS-CoV-2 swab tests during a health surveillance program. METHODS: The study was conducted with 2071 health care workers at the University Hospital of Verona, with a known date of close contact with a patient with COVID-19, between February 29 and April 17, 2020. The health care workers underwent a health surveillance program with repeated swab tests to track their virological status. A generalized additive mixed model was used to investigate how the probability of a positive test result changes over time since the last known date of close contact, in an overall sample of individuals who tested positive for COVID-19 and in a subset of individuals with an initial negative swab test finding before being proven positive, to assess different surveillance time intervals. RESULTS: Among the 2071 health care workers in this study, 191 (9.2%) tested positive for COVID-19, and 103 (54%) were asymptomatic with no differences based on sex or age. Among 49 (25.7%) cases, the initial swab test yielded negative findings after close contact with a patient with COVID-19. Sex, age, symptoms, and the time of sampling were not different between individuals with an initial negative swab test finding and those who initially tested positive after close contact. In the overall sample, the estimated probability of testing positive was 0.74 on day 1 after close contact, which increased to 0.77 between days 5 and 8. In the 3 different scenarios for scheduled repeated testing intervals (3, 5, and 7 days) in the subgroup of individuals with an initially negative swab test finding, the probability peaked on the sixth, ninth and tenth, and 13th and 14th days, respectively. CONCLUSIONS: Swab tests can initially yield false-negative outcomes. The probability of testing positive increases from day 1, peaking between days 5 and 8 after close contact with a patient with COVID-19. Early testing, especially in this final time window, is recommended together with a health surveillance program scheduled in close intervals.


Subject(s)
COVID-19 Nucleic Acid Testing/statistics & numerical data , COVID-19/diagnosis , Health Personnel/statistics & numerical data , Adult , COVID-19/epidemiology , COVID-19/transmission , Contact Tracing/methods , False Negative Reactions , Female , Humans , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Italy/epidemiology , Male , Middle Aged , Pandemics , SARS-CoV-2 , Time Factors
18.
JMIR Public Health Surveill ; 7(3): e25859, 2021 03 26.
Article in English | MEDLINE | ID: covidwho-2197891

ABSTRACT

BACKGROUND: The COVID-19 pandemic has drastically changed life in the United States, as the country has recorded over 23 million cases and 383,000 deaths to date. In the leadup to widespread vaccine deployment, testing and surveillance are critical for detecting and stopping possible routes of transmission. Contact tracing has become an important surveillance measure to control COVID-19 in the United States, and mobile health interventions have found increased prominence in this space. OBJECTIVE: The aim of this study was to investigate the use and usability of MyCOVIDKey, a mobile-based web app to assist COVID-19 contact tracing efforts, during the 6-week pilot period. METHODS: A 6-week study was conducted on the Vanderbilt University campus in Nashville, Tennessee. The study participants, consisting primarily of graduate students, postdoctoral researchers, and faculty in the Chemistry Department at Vanderbilt University, were asked to use the MyCOVIDKey web app during the course of the study period. Paradata were collected as users engaged with the MyCOVIDKey web app. At the end of the study, all participants were asked to report on their user experience in a survey, and the results were analyzed in the context of the user paradata. RESULTS: During the pilot period, 45 users enrolled in MyCOVIDKey. An analysis of their enrollment suggests that initial recruiting efforts were effective; however, participant recruitment and engagement efforts at the midpoint of the study were less effective. App use paralleled the number of users, indicating that incentives were useful for recruiting new users to sign up but did not result in users attempting to artificially inflate their use as a result of prize offers. Times to completion of key tasks were low, indicating that the main features of the app could be used quickly. Of the 45 users, 30 provided feedback through a postpilot survey, with 26 (58%) completing it in its entirety. The MyCOVIDKey app as a whole was rated 70.0 on the System Usability Scale, indicating that it performed above the accepted threshold for usability. When the key-in and self-assessment features were examined on their own, it was found that they individually crossed the same thresholds for acceptable usability but that the key-in feature had a higher margin for improvement. CONCLUSIONS: The MyCOVIDKey app was found overall to be a useful tool for COVID-19 contact tracing in a university setting. Most users suggested simple-to-implement improvements, such as replacing the web app framework with a native app format or changing the placement of the scanner within the app workflow. After these updates, this tool could be readily deployed and easily adapted to other settings across the country. The need for digital contact tracing tools is becoming increasingly apparent, particularly as COVID-19 case numbers continue to increase while more businesses begin to reopen.


Subject(s)
COVID-19/prevention & control , Contact Tracing/methods , Mobile Applications , Adult , COVID-19/epidemiology , Data Analysis , Female , Humans , Male , Middle Aged , Pilot Projects , Surveys and Questionnaires , United States/epidemiology , Young Adult
19.
J Biol Dyn ; 16(1): 859-879, 2022 12.
Article in English | MEDLINE | ID: covidwho-2187651

ABSTRACT

Contact tracing is an important intervention measure to control infectious diseases. We present a new approach that borrows the edge dynamics idea from network models to track contacts included in a compartmental SIR model for an epidemic spreading in a randomly mixed population. Unlike network models, our approach does not require statistical information of the contact network, data that are usually not readily available. The model resulting from this new approach allows us to study the effect of contact tracing and isolation of diagnosed patients on the control reproduction number and number of infected individuals. We estimate the effects of tracing coverage and capacity on the effectiveness of contact tracing. Our approach can be extended to more realistic models that incorporate latent and asymptomatic compartments.


Subject(s)
Communicable Diseases , Epidemics , Humans , Contact Tracing/methods , Epidemiological Models , Models, Biological , Communicable Diseases/epidemiology
20.
Sci Rep ; 12(1): 22582, 2022 12 30.
Article in English | MEDLINE | ID: covidwho-2186054

ABSTRACT

As the COVID-19 pandemic has demonstrated, identifying the origin of a pandemic remains a challenging task. The search for patient zero may benefit from the widely-used and well-established toolkit of contact tracing methods, although this possibility has not been explored to date. We fill this gap by investigating the prospect of performing the source detection task as part of the contact tracing process, i.e., the possibility of tuning the parameters of the process in order to pinpoint the origin of the infection. To this end, we perform simulations on temporal networks using a recent diffusion model that recreates the dynamics of the COVID-19 pandemic. We find that increasing the budget for contact tracing beyond a certain threshold can significantly improve the identification of infected individuals but has diminishing returns in terms of source detection. Moreover, disease variants of higher infectivity make it easier to find the source but harder to identify infected individuals. Finally, we unravel a seemingly-intrinsic trade-off between the use of contact tracing to either identify infected nodes or detect the source of infection. This trade-off suggests that focusing on the identification of patient zero may come at the expense of identifying infected individuals.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Contact Tracing/methods , Pandemics , Budgets
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