Rapid implementation of mobile technology for real-time epidemiology of COVID-19

Drew, David A.; Nguyen, Long H.; Steves, Claire J.; Menni, Cristina; Фрейдин, Максим Борисович; Varsavsky, Thomas; Sudre, Carole H.; Cardoso, M. Jorge; Ourselin, Sébastien; Wolf, Jonathan; Spector, Tim D.; Chan, Andrew T.

doi:10.1126/science.abc0473

Cited by 338 publications

(263 citation statements)

References 21 publications

(26 reference statements)

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“…parents with muscle pain more likely report muscle pain in their children). Consistently with a study from the UK, 9,17 our ndings suggest that monitoring the prevalence of COVID-19-like symptoms in adults, but not in children, may serve as an alert of changes in disease activity and may inform about local disease clusters.…”

Section: Discussionsupporting

confidence: 88%

“…Thus they are prone to selection bias when aiming to estimate the population prevalence, as individuals with speci c symptoms, or who experienced those symptoms in the recent past, may be more or less likely to volunteer than asymptomatic individuals. Also, some ad-hoc webbased cohorts have been established, in which participants volunteer to report their symptoms on a regular basis [9]. This design is less affected by selection bias as participants may be enrolled before the onset of the symptoms.…”

Section: Introductionmentioning

confidence: 99%

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COVID-19-like symptoms and their relation to SARS-CoV-2 epidemic in children and adults of an Italian birth cohort

Popović

Moccia

Isaevska

et al. 2020

Preprint

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Background Emerging COVID-19 pandemic caused extensive lockdowns in a number of countries, but yet unknown number of cases positive to SARS-CoV-2 escapes surveillance systems. Methods Mothers participating in an Italian NINFEA birth cohort were invited to complete an online questionnaire on COVID-19-like symptoms in the household. We estimated the population prevalence of COVID-19-like symptoms in children and adults, assessed their geographical correlation with the cumulative number of COVID-19 cases by province, analysed their clustering within families, and estimated their sensitivity, positive (PPV) and negative predictive values (NPV) for COVID-19 diagnosis in individuals tested for SARS-CoV-2.Results Information was collected on 3184 households, 6133 adults, and 5751 children. There was a strong geographical correlation between the population cumulative incidence of COVID-19 and the prevalence of muscle pain, fatigue, low-grade fever, and breathing difficulties in adults (Spearman’s rho ≥0.70). Having at least one family member with a COVID-19 diagnosis, compared with none tested for SARS-CoV-2, was associated with an increased prevalence ratio of almost all COVID-19-like symptoms in adults, and only of low-grade fever (37-37.5oC; prevalence ratio 5.27; 95% confidence intervals: 2.37 to 11.74) and anosmia/dysgeusia in children. Among adults with COVID-19, fatigue, muscle pain, and fever had a sensitivity ≥70%. In individuals tested for SARS-CoV-2, with a 16.6% prevalence of COVID-19, breathing difficulties and nausea/vomiting had the highest PPVs, with point estimates close to 60%, and with NPVs close to 90%. Among tested Piedmont residents, with a COVID-19 prevalence of 18.5%, breathing difficulties and anosmia/disguesia reached PPVs above 80%.Conclusion Geographical prevalence of COVID-19-like symptoms in adults may inform on local disease clusters, while certain symptoms in family members of confirmed COVID-19 cases could help identification of the intra-familial spread of the virus and its further propagation in the community. Low-grade fever is frequent in children with at least one household member with COVID-19 and possibly indicates child infection.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

COVID-19-like symptoms and their relation to SARS-CoV-2 epidemic in children and adults of an Italian birth cohort

Popović

Moccia

Isaevska

et al. 2020

Preprint

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“…Also, longterm effects of the disease, and the impact of the COVID-19 epidemic on social relations, mental health, and financial outcome can be evaluated with this tool. Machine learning could also reveal new disease manifestations of the epidemic (Drew et al, 2020).…”

Section: Mobile Phone Technologymentioning

confidence: 99%

COVID‐19: test, trace and isolate‐new epidemiological data

Brüssow

2020

Environmental Microbiology

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Summary In the absence of an efficient drug treatment or a vaccine, the control of the COVID‐19 pandemic relies on classic infection control measures. Since these means are socially disruptive and come with substantial economic loss for societies, a better knowledge of the epidemiology of the new coronavirus epidemic is crucial to achieve control at a sustainable cost and within tolerable restrictions of civil rights.

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“…As part of COVID-19-specific surveillance, countries are innovating approaches for passive and active case detection. [12][13][14] For the latter, rapid assessment systems (RAS) have been introduced as a means for self-determination of risk and then communication of guidance so that individuals can seek care and undertake personal protective measures to prevent transmission. [13,15] With increasing specificity and sensitivity of symptom-based case definitions for COVID-19, [16,17] such tools hold potential for effectively and efficiently signaling deployment of testing and contact tracing teams.…”

Section: Introductionmentioning

confidence: 99%

Coordinated support for local action: A modeling study of strategies to facilitate behavior adoption in urban poor communities of Liberia for sustained COVID-19 suppression

Skrip

Fallah

Bedson

et al. 2020

Preprint

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Background: Long-term suppression of SARS-CoV-2 transmission will require context-specific strategies that recognize the heterogeneous capacity of communities to undertake public health recommendations, particularly due to limited access to food, sanitation facilities, and physical space required for self-quarantine or isolation. We highlight the epidemiological impact of barriers to adoption of public health recommendations by urban slum populations in low- and middle-income countries (LMICs) and the potential role of community-based initiatives to coordinate efforts that support cases and high-risk contacts. Methods: Daily case updates published by the National Public Health Institute of Liberia were used to inform a stratified stochastic compartmental model representing transmission of SARS-CoV-2 in two subpopulations (urban poor versus less socioeconomically vulnerable) of Montserrado County, Liberia. Differential transmission was considered at levels of the subpopulation, household versus community, and events (i.e., funerals). Adoption of home-isolation behavior was assumed to be related to the proportion of each subpopulation residing in housing units with multiple rooms, access to sanitation facilities, and access to basic goods like water and food. Percentage reductions in cumulative infection counts, cumulative counts of severe cases, and maximum daily infection counts for each subpopulation were evaluated across intervention scenarios that included symptom-triggered, community-driven efforts to support high-risk contacts and confirmed cases in self-isolation following the scheduled lifting of the state of emergency. Results: Modeled outbreaks for the status quo scenario differed between the two subpopulations, with increased overall infection burden but decreased numbers of severe cases in the urban poor subpopulation relative to the less socioeconomically vulnerable population after 180 days post-introduction into Liberia. With more proactive self-isolation by mildly symptomatic individuals after lifting of the public health emergency, median reductions in cumulative infections, severe cases, and maximum daily incidence were 7.6% (IQR: 2.2%-20.9%), 7.0% (2.0%-18.5%), and 9.9% (2.5%-31.4%) for cumulative infections, severe cases, and maximum daily incidence, respectively, across epidemiological curve simulations in the urban poor subpopulation and 16.8% (5.5%-29.3%), 15.0% (5.0%-26.4%), and 28.1% (IQR: 9.3%-47.8%) in the less socioeconomically vulnerable population. An increase in the maximum attainable percentage of behavior adoption by the urban slum subpopulation, with the provision of support to facilitate self-isolation or quarantine, was associated with median reductions in cumulative infections, severe cases, and maximum daily incidence were 19.2% (IQR: 10.1%-34.0%), 21.1% (IQR: 13.3%-34.2%), and 26.0% (IQR: 11.5%-48.9%), respectively, relative to the status quo scenario. Conclusions: Broadly supported post-lockdown recommendations that prioritize proactively monitoring symptoms, seeking testing and isolating at home by confirmed cases are limited by resource constraints in urban poor communities. Investing in community-based initiatives that determine needs and coordinate needs-based support for self-identified cases and their contacts could provide a more effective, longer-term strategy for suppressing transmission of COVID-19 in settings with prevalent distrust and socioeconomic vulnerabilities.

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Rapid implementation of mobile technology for real-time epidemiology of COVID-19

Cited by 338 publications

References 21 publications

COVID-19-like symptoms and their relation to SARS-CoV-2 epidemic in children and adults of an Italian birth cohort

COVID-19-like symptoms and their relation to SARS-CoV-2 epidemic in children and adults of an Italian birth cohort

COVID‐19: test, trace and isolate‐new epidemiological data

Coordinated support for local action: A modeling study of strategies to facilitate behavior adoption in urban poor communities of Liberia for sustained COVID-19 suppression

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