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1.
J Public Health Manag Pract ; 28(1): E16-E22, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34016907

RESUMO

Disease investigation and contact tracing are long-standing public health strategies used to control the spread of infectious disease. Throughout the COVID-19 pandemic, health departments across the country have lacked the internal workforce capacity and technology needed to efficiently isolate positive cases and quarantine close contacts to slow the spread of SARS-CoV-2. This article describes an innovative disease investigation and contact tracing program developed through a formalized community partnership between a local county health department and local university. This innovative new program added 108 contact tracers to the county's public health workforce, as well as enabled these contact tracers to work remotely using a call center app and secure cloud-based platform to manage the county's caseload of cases and contacts. An overview of the requirements needed to develop this program (eg, hiring, health data security protocols, data source management), as well as lessons learned is discussed.


Assuntos
COVID-19 , Pandemias , Busca de Comunicante , Gerenciamento de Dados , Humanos , Pandemias/prevenção & controle , SARS-CoV-2
2.
J Public Health Manag Pract ; 28(1): 16-24, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34534993

RESUMO

CONTEXT: The implementation of case investigation and contact tracing (CICT) for controlling COVID-19 (caused by SARS-CoV-2 virus) has proven challenging due to varying levels of public acceptance and initially constrained resources, especially enough trained staff. Evaluating the impacts of CICT will aid efforts to improve such programs. OBJECTIVES: Estimate the number of COVID-19 cases and hospitalizations averted by CICT and identify CICT processes that could improve overall effectiveness. DESIGN: We used data on the proportion of cases interviewed, contacts notified or monitored, and days from testing to case and contact notification from 14 jurisdictions to model the impact of CICT on cumulative case counts and hospitalizations over a 60-day period. Using the Centers for Disease Control and Prevention's COVIDTracer Advanced tool, we estimated a range of impacts by assuming either contacts would quarantine only if monitored or would do so upon notification of potential exposure. We also varied the observed program metrics to assess their relative influence. RESULTS: Performance by jurisdictions varied widely. Jurisdictions isolated between 12% and 86% of cases (including contacts that became cases) within 6 to 10 days after infection. We estimated that CICT-related reductions in transmission ranged from 0.4% to 32%. For every 100 remaining cases after other nonpharmaceutical interventions were implemented, CICT averted between 4 and 97 additional cases. Reducing time to case isolation by 1 day increased averted case estimates by up to 15 percentage points. Increasing the proportion of cases interviewed or contacts notified by 20 percentage points each resulted in at most 3 or 6 percentage point improvements in averted cases. CONCLUSIONS: We estimated that CICT reduced the number of COVID-19 cases and hospitalizations among all jurisdictions studied. Reducing time to isolation produced the greatest improvements in impact of CICT.


Assuntos
COVID-19 , Busca de Comunicante , Hospitalização , Humanos , Quarentena , SARS-CoV-2 , Estados Unidos/epidemiologia
4.
J Public Health Manag Pract ; 28(1): 25-35, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-33938487

RESUMO

BACKGROUND: Schools are an integral part of the community; however, congregate settings facilitate transmission of SARS-CoV-2, presenting a challenge to school administrators to provide a safe, in-school environment for students and staff. METHODS: We adapted the Centers for Disease Control and Prevention's COVIDTracer Advanced tool to model the transmission of SARS-CoV-2 in a school of 596 individuals. We estimate possible reductions in cases and hospitalizations among this population using a scenario-based analysis that accounts for (a) the risk of importation of infection from the community; (b) adherence to key Centers for Disease Control and Prevention-recommended mitigation strategies: mask wearing, cleaning and disinfection, hand hygiene, and social distancing; and (c) the effectiveness of contact tracing interventions at limiting onward transmission. RESULTS: Low impact and effectiveness of mitigation strategies (net effectiveness: 27%) result in approximately 40% of exposed staff and students becoming COVID-19 cases. When the net effectiveness of mitigation strategies was 69% or greater, in-school transmission was mostly prevented, yet importation of cases from the surrounding community could result in nearly 20% of the school's population becoming infected within 180 days. The combined effects of mitigation strategies and contact tracing were able to prevent most onward transmission. Hospitalizations were low among children and adults (<0.5% of the school population) across all scenarios examined. CONCLUSIONS: Based on our model, layering mitigation strategies and contact tracing can limit the number of cases that may occur from transmission in schools. Schools in communities with substantial levels of community spread will need to be more vigilant to ensure adherence of mitigation strategies to minimize transmission. Our results show that for school administrators, teachers, and parents to provide the safest environment, it is important to utilize multiple mitigation strategies and contract tracing that reduce SARS CoV-2 transmission by at least 69%. This will require training, reinforcement, and vigilance to ensure that the highest level of adherence is maintained over the entire school term.


Assuntos
COVID-19 , Adulto , Criança , Busca de Comunicante , Humanos , SARS-CoV-2 , Instituições Acadêmicas , Estudantes , Estados Unidos
5.
Philos Trans A Math Phys Eng Sci ; 380(2214): 20210127, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34802267

RESUMO

During the COVID-19 pandemic, more than ever, data science has become a powerful weapon in combating an infectious disease epidemic and arguably any future infectious disease epidemic. Computer scientists, data scientists, physicists and mathematicians have joined public health professionals and virologists to confront the largest pandemic in the century by capitalizing on the large-scale 'big data' generated and harnessed for combating the COVID-19 pandemic. In this paper, we review the newly born data science approaches to confronting COVID-19, including the estimation of epidemiological parameters, digital contact tracing, diagnosis, policy-making, resource allocation, risk assessment, mental health surveillance, social media analytics, drug repurposing and drug development. We compare the new approaches with conventional epidemiological studies, discuss lessons we learned from the COVID-19 pandemic, and highlight opportunities and challenges of data science approaches to confronting future infectious disease epidemics. This article is part of the theme issue 'Data science approaches to infectious disease surveillance'.


Assuntos
COVID-19 , Pandemias , Busca de Comunicante , Ciência de Dados , Humanos , Pandemias/prevenção & controle , SARS-CoV-2
6.
J Theor Biol ; 532: 110919, 2022 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-34592263

RESUMO

The COVID-19 pandemic has led to widespread attention given to the notions of "flattening the curve" during lockdowns, and successful contact tracing programs suppressing outbreaks. However a more nuanced picture of these interventions' effects on epidemic trajectories is necessary. By mathematical modeling each as reactive quarantine measures, dependent on current infection rates, with different mechanisms of action, we analytically derive distinct nonlinear effects of these interventions on final and peak outbreak size. We simultaneously fit the model to provincial reported case and aggregated quarantined contact data from China. Lockdowns compressed the outbreak in China inversely proportional to population quarantine rates, revealing their critical dependence on timing. Contact tracing had significantly less impact on final outbreak size, but did lead to peak size reduction. Our analysis suggests that altering the cumulative cases in a rapidly spreading outbreak requires sustained interventions that decrease the reproduction number close to one, otherwise some type of swift lockdown measure may be needed.


Assuntos
COVID-19 , Busca de Comunicante , China/epidemiologia , Controle de Doenças Transmissíveis , Surtos de Doenças/prevenção & controle , Humanos , Pandemias , Quarentena , SARS-CoV-2
7.
PLoS One ; 16(11): e0259969, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34793526

RESUMO

Comprehensive testing schemes, followed by adequate contact tracing and isolation, represent the best public health interventions we can employ to reduce the impact of an ongoing epidemic when no or limited vaccine supplies are available and the implications of a full lockdown are to be avoided. However, the process of tracing can prove feckless for highly-contagious viruses such as SARS-CoV-2. The interview-based approaches often miss contacts and involve significant delays, while digital solutions can suffer from insufficient adoption rates or inadequate usage patterns. Here we present a novel way of modelling different contact tracing strategies, using a generalized multi-site mean-field model, which can naturally assess the impact of manual and digital approaches alike. Our methodology can readily be applied to any compartmental formulation, thus enabling the study of more complex pathogen dynamics. We use this technique to simulate a newly-defined epidemiological model, SEIR-T, and show that, given the right conditions, tracing in a COVID-19 epidemic can be effective even when digital uptakes are sub-optimal or interviewers miss a fair proportion of the contacts.


Assuntos
COVID-19 , Busca de Comunicante/métodos , Surtos de Doenças/prevenção & controle , Modelos Estatísticos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos
9.
BMJ Open ; 11(11): e051491, 2021 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-34740930

RESUMO

OBJECTIVE: To describe the characteristics of contacts of patients with COVID-19 case in terms of time, place and person, to calculate the secondary attack rate (SAR) and factors associated with COVID-19 infection among contacts. DESIGN: A retrospective cohort study SETTING AND PARTICIPANTS: Contacts of cases identified by the health department from 14 March 2020to 30 May 2020, in 9 of 38 administrative districts of Tamil Nadu. Significant proportion of cases attended a religious congregation. OUTCOME MEASURE: Attack rate among the contacts and factors associated with COVID-19 positivity. RESULTS: We listed 15 702 contacts of 931 primary cases. Of the contacts, 89% (n: 14 002) were tested for COVID-19. The overall SAR was 4% (599/14 002), with higher among the household contacts (13%) than the community contacts (1%). SAR among the contacts of primary cases with congregation exposure were 5 times higher than the contacts of non-congregation primary cases (10% vs 2%). Being a household contact of a primary case with congregation exposure had a fourfold increased risk of getting COVID-19 (relative risk (RR): 16.4; 95% CI: 13 to 20) than contact of primary case without congregation exposure. Among the symptomatic primary cases, household contacts of congregation primaries had higher RR than household contacts of other cases ((RR: 25.3; 95% CI: 10.2 to 63) vs (RR: 14.6; 95% CI: 5.7 to 37.7)). Among asymptomatic primary case, RR was increased among household contacts (RR: 16.5; 95% CI: 13.2 to 20.7) of congregation primaries compared with others. CONCLUSION: Our study showed an increase in disease transmission among household contacts than community contacts. Also, symptomatic primary cases and primary cases with exposure to the congregation had more secondary cases than others.


Assuntos
COVID-19 , Busca de Comunicante , Humanos , Incidência , Índia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
10.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(10): 1757-1762, 2021 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814608

RESUMO

Objective: To analyze the epidemiological characteristics of close contacts of COVID-19 cases and infection-related risk factors in Beijing and provide evidences for COVID-19 prevention and control. Methods: A total of 20 681 close contacts of COVID-19 cases, who had exposures during January 6, 2020 to February 15, 2021, were traced in Beijing. The information about their demographic characteristics, exposure history, and quarantine outcomes were collected and analyzed with descriptive statistics. The logistic regression analysis was used to identify the risk factors for COVID-19. Results: The infection rate SARS-CoV-2 in close contacts was 2.16% (447/20 681). The age M(P25, P75) was 35 (27, 49) years. The majority of the close contacts were aged 20-59 years, accounting for 81.77% (16 912/20 681). Centralized isolation was the major type of medical observation, accounting for 82.15% (16 989/20 681). Among the exposure types, working and studying in the same room (16.06%, 3 322/20 681), sharing same transport vehicle (12.88%, 2 664/20 681), performing diagnosis and treatment nursing (7.80%,1 612/20 681), and living together (7.23%,1 495/20 681), accounting for 43.96% (9 093/20 681). The index cases included staff (19.34%, 3 999/20 681), the unemployed (17.34%, 3 586/20 681), people engaged in business service (13.85%, 2 864/20 681), people engaged in food service (10.77%, 2 228/20 681), their close contacts accounted for 61.30% (12 677/20 681). Multivariate logistic regression analysis showed that compared with other types of exposure, the risk factors for infection were having meal together (OR=3.96, 95%CI: 2.30-6.83) and living together (OR=6.41, 95%CI:4.48-9.17); Compared with the other occupations, the index case being engaged in food service (OR=3.06, 95%CI:1.29-7.25) and teacher (OR=4.94, 95%CI:1.43-17.08) were risk factors for the infection. Conclusions: The main environmental exposure types of SARS-CoV-2 infection in close contacts were having meal together and living together. Contact with the index case being engaged in food service and teacher increased the risk for COVID-19. Comprehensive prevention and control measures such as centralized isolation and vaccination should be continued.


Assuntos
COVID-19 , Pequim , Busca de Comunicante , Humanos , Fatores de Risco , SARS-CoV-2
11.
BMC Nephrol ; 22(1): 384, 2021 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789170

RESUMO

BACKGROUND: Hemodialysis patients are among high-risk groups for COVID-19. Africa is the continent with the lowest number of cases in the general population but we have little information about the disease burden in dialysis patients. OBJECTIVES: This study aimed to describe the seroprevalence of SARS-CoV-2 antibodies in the hemodialysis population of Senegal. PATIENTS AND METHODS: We conducted a multicenter cross-sectional survey, between June and September 2020 involving 10 public dialysis units randomly selected in eight regions of Senegal. After seeking their consent, we included 303 patients aged ≥ 18 years and hemodialysis for ≥ 3 months. Clinical symptoms and biological parameters were collected from medical records. Patients' blood samples were tested with Abbott SARS-CoV-2 Ig G assay using an Architect system. Statistical tests were performed with STATA 12.0. RESULTS: Seroprevalence of SARS-CoV-2 antibodies was 21.1% (95% CI = 16.7-26.1%). We noticed a wide variability in SARS-CoV-2 seroprevalence between regions ranging from 5.6 to 51.7%. Among the 38 patients who underwent nasal swab testing, only six had a PCR-confirmed infection and all of them did seroconvert. Suggestive clinical symptoms were reported by 28.1% of seropositive patients and the majority of them presented asymptomatic disease. After multivariate analysis, a previous contact with a confirmed case and living in a high population density region were associated with the presence of SARS-CoV-2 antibodies. CONCLUSION: This study presents to our knowledge the first seroprevalence data in African hemodialysis patients. Compared to data from other continents, we found a higher proportion of patients with SARS-CoV-2 antibodies but a lower lethality rate.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/epidemiologia , Diálise Renal , SARS-CoV-2/imunologia , Adolescente , Adulto , Idoso , COVID-19/sangue , COVID-19/complicações , Busca de Comunicante , Estudos Transversais , Escolaridade , Feminino , Geografia Médica , Inquéritos Epidemiológicos , Humanos , Imunoglobulina G/sangue , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Densidade Demográfica , Prevalência , Senegal/epidemiologia , Estudos Soroepidemiológicos , Avaliação de Sintomas , Adulto Jovem
12.
Emerg Infect Dis ; 27(12): 3063-3072, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34808076

RESUMO

Despite its critical role in containing outbreaks, the efficacy of contact tracing, measured as the sensitivity of case detection, remains an elusive metric. We estimated the sensitivity of contact tracing by applying unilist capture-recapture methods on data from the 2018-2020 outbreak of Ebola virus disease in the Democratic Republic of the Congo. To compute sensitivity, we applied different distributional assumptions to the zero-truncated count data to estimate the number of unobserved case-patients with any contacts and infected contacts. Geometric distributions were the best-fitting models. Our results indicate that contact tracing efforts identified almost all (n = 792, 99%) of case-patients with any contacts but only half (n = 207, 48%) of case-patients with infected contacts, suggesting that contact tracing efforts performed well at identifying contacts during the listing stage but performed poorly during the contact follow-up stage. We discuss extensions to our work and potential applications for the ongoing coronavirus pandemic.


Assuntos
Ebolavirus , Doença pelo Vírus Ebola , Busca de Comunicante , República Democrática do Congo/epidemiologia , Surtos de Doenças , Doença pelo Vírus Ebola/epidemiologia , Humanos
13.
PLoS One ; 16(11): e0258945, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34723981

RESUMO

Exposure notification apps have been developed to assist in notifying individuals of recent exposures to SARS-CoV-2. However, in several countries, such apps have had limited uptake. We assessed whether strategies to increase downloads of exposure notification apps should emphasize improving the accuracy of the apps in recording contacts and exposures, strengthening privacy protections and/or offering financial incentives to potential users. In a discrete choice experiment with potential app users in the US, financial incentives were more than twice as important in decision-making about app downloads, than privacy protections, and app accuracy. The probability that a potential user would download an exposure notification app increased by 40% when offered a $100 reward to download (relative to a reference scenario in which the app is free). Financial incentives might help exposure notification apps reach uptake levels that improve the effectiveness of contact tracing programs and ultimately enhance efforts to control SARS-CoV-2. Rapid, pragmatic trials of financial incentives for app downloads in real-life settings are warranted.


Assuntos
COVID-19 , Aplicativos Móveis , SARS-CoV-2/patogenicidade , Adulto , Idoso , Tomada de Decisão Clínica , Busca de Comunicante/métodos , Notificação de Doenças , Humanos , Pessoa de Meia-Idade , Adulto Jovem
14.
Comput Math Methods Med ; 2021: 5384481, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34777563

RESUMO

In this study we propose a Coronavirus Disease 2019 (COVID-19) mathematical model that stratifies infectious subpopulations into: infectious asymptomatic individuals, symptomatic infectious individuals who manifest mild symptoms and symptomatic individuals with severe symptoms. In light of the recent revelation that reinfection by COVID-19 is possible, the proposed model attempt to investigate how reinfection with COVID-19 will alter the future dynamics of the recent unfolding pandemic. Fitting the mathematical model on the Kenya COVID-19 dataset, model parameter values were obtained and used to conduct numerical simulations. Numerical results suggest that reinfection of recovered individuals who have lost their protective immunity will create a large pool of asymptomatic infectious individuals which will ultimately increase symptomatic individuals with mild symptoms and symptomatic individuals with severe symptoms (critically ill) needing urgent medical attention. The model suggests that reinfection with COVID-19 will lead to an increase in cumulative reported deaths. Comparison of the impact of non pharmaceutical interventions on curbing COVID19 proliferation suggests that wearing face masks profoundly reduce COVID-19 prevalence than maintaining social/physical distance. Further, numerical findings reveal that increasing detection rate of asymptomatic cases via contact tracing, testing and isolating them can drastically reduce COVID-19 surge, in particular individuals who are critically ill and require admission into intensive care.


Assuntos
COVID-19/transmissão , Modelos Biológicos , Pandemias , SARS-CoV-2 , Infecções Assintomáticas/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Biologia Computacional , Simulação por Computador , Busca de Comunicante , Bases de Dados Factuais , Suscetibilidade a Doenças , Humanos , Quênia/epidemiologia , Máscaras , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Distanciamento Físico , Reinfecção/epidemiologia , Reinfecção/transmissão , SARS-CoV-2/imunologia
15.
Rev Med Suisse ; 17(759): 2010-2013, 2021 Nov 17.
Artigo em Francês | MEDLINE | ID: mdl-34787976

RESUMO

The rapid evolution of the SARS-CoV-2 epidemic required the implementation of contact tracing at an unprecedented scale in the Swiss cantons. Hundreds of contact tracers with different professions, most without medical background, had to be recruited and educated for tasks that usually are carried out by small teams of experts in communicable diseases. Teaching materials and courses about contact tracing, especially in French, were scarce. Thus, the learning team at the contact tracing centre of the canton of Vaud supported by clinicians and epidemiologists developed a method to dynamically create and apply a series of teaching modules. We describe this process and its results. The teaching materials are freely available upon contact with the authors.


Assuntos
COVID-19 , SARS-CoV-2 , Busca de Comunicante , Humanos , Pandemias , Suíça/epidemiologia
16.
Sensors (Basel) ; 21(21)2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34770431

RESUMO

The COVID-19 pandemic has significantly threatened the health and well-being of humanity. Contact tracing (CT) as an important non-pharmaceutical intervention is essential to containing the spread of such an infectious disease. However, current CT solutions are fragmented with limited use of sensing and computing technologies in a scalable framework. These issues can be well addressed with the use of the Internet of Things (IoT) technologies. Therefore, we need to overview the principle, motivation, and architecture for a generic IoT-based CT system (IoT-CTS). A novel architecture for IoT-CTS solutions is proposed with the consideration of peer-to-peer and object-to-peer contact events, as well as the discussion on key topics, such as an overview of applicable sensors for CT needs arising from the COVID-19 transmission methods. The proposed IoT-CTS architecture aims to holistically utilize essential sensing mechanisms with the analysis of widely adopted privacy-preserving techniques. With the use of generic peer-to-peer and object-to-peer sensors based on proximity and environment sensing mechanisms, the infectious cases with self-directed strategies can be effectively reduced. Some open research directions are presented in the end.


Assuntos
COVID-19 , Internet das Coisas , Busca de Comunicante , Humanos , Pandemias , SARS-CoV-2
17.
J Math Biol ; 83(5): 46, 2021 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-34599662

RESUMO

In this study, we analyze the effectiveness of measures aimed at finding and isolating infected individuals to contain epidemics like COVID-19, as the suppression induced over the effective reproduction number. We develop a mathematical model to compute the relative suppression of the effective reproduction number of an epidemic that such measures produce. This outcome is expressed as a function of a small set of parameters that describe the main features of the epidemic and summarize the effectiveness of the isolation measures. In particular, we focus on the impact when a fraction of the population uses a mobile application for epidemic control. Finally, we apply the model to COVID-19, providing several computations as examples, and a link to a public repository to run custom calculations. These computations display in a quantitative manner the importance of recognizing infected individuals from symptoms and contact-tracing information, and isolating them as early as possible. The computations also assess the impact of each variable on the mitigation of the epidemic.


Assuntos
COVID-19 , Epidemias , Aplicativos Móveis , Busca de Comunicante , Humanos , SARS-CoV-2
18.
JMIR Public Health Surveill ; 7(11): e30462, 2021 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-34623956

RESUMO

BACKGROUND: In 2020, the Singapore government rolled out the TraceTogether program, a digital system to facilitate contact tracing efforts in response to the COVID-19 pandemic. This system is available as a smartphone app and Bluetooth-enabled token to help identify close contacts. As of February 1, 2021, more than 80% of the population has either downloaded the mobile app or received the token in Singapore. Despite the high adoption rate of the TraceTogether mobile app and token (ie, device), it is crucial to understand the role of social and normative perceptions in uptake and usage by the public, given the collective efforts for contact tracing. OBJECTIVE: This study aimed to examine normative influences (descriptive and injunctive norms) on TraceTogether device use for contact tracing purposes, informed by the theory of normative social behavior, a theoretical framework to explain how perceived social norms are related to behaviors. METHODS: From January to February 2021, cross-sectional data were collected by a local research company through emailing their panel members who were (1) Singapore citizens or permanent residents aged 21 years or above; (2) able to read English; and (3) internet users with access to a personal email account. The study sample (n=1137) was restricted to those who had either downloaded the TraceTogether mobile app or received the token. RESULTS: Multivariate (linear and ordinal logistic) regression analyses were carried out to assess the relationships of the behavioral outcome variables (TraceTogether device usage and intention of TraceTogether device usage) with potential correlates, including perceived social norms, perceived community, and interpersonal communication. Multivariate regression analyses indicated that descriptive norms (unstandardized regression coefficient ß=0.31, SE=0.05; P<.001) and injunctive norms (unstandardized regression coefficient ß=0.16, SE=0.04; P<.001) were significantly positively associated with the intention to use the TraceTogether device. It was also found that descriptive norms were a significant correlate of TraceTogether device use frequency (adjusted odds ratio [aOR] 2.08, 95% CI 1.66-2.61; P<.001). Though not significantly related to TraceTogether device use frequency, injunctive norms moderated the relationship between descriptive norms and the outcome variable (aOR 1.12, 95% CI 1.03-1.21; P=.005). CONCLUSIONS: This study provides useful implications for the design of effective intervention strategies to promote the uptake and usage of digital methods for contact tracing in a multiethnic Asian population. Our findings highlight that influence from social networks plays an important role in developing normative perceptions in relation to TraceTogether device use for contact tracing. To promote the uptake of the TraceTogether device and other preventive behaviors for COVID-19, it would be useful to devise norm-based interventions that address these normative perceptions by presenting high prevalence and approval of important social referents, such as family and close friends.


Assuntos
COVID-19 , Busca de Comunicante , Estudos Transversais , Humanos , Pandemias , Percepção , SARS-CoV-2
19.
JMIR Public Health Surveill ; 7(10): e32468, 2021 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-34612841

RESUMO

BACKGROUND: Contact tracing in association with quarantine and isolation is an important public health tool to control outbreaks of infectious diseases. This strategy has been widely implemented during the current COVID-19 pandemic. The effectiveness of this nonpharmaceutical intervention is largely dependent on social interactions within the population and its combination with other interventions. Given the high transmissibility of SARS-CoV-2, short serial intervals, and asymptomatic transmission patterns, the effectiveness of contact tracing for this novel viral agent is largely unknown. OBJECTIVE: This study aims to identify and synthesize evidence regarding the effectiveness of contact tracing on infectious viral disease outcomes based on prior scientific literature. METHODS: An evidence-based review was conducted to identify studies from the PubMed database, including preprint medRxiv server content, related to the effectiveness of contact tracing in viral outbreaks. The search dates were from database inception to July 24, 2020. Outcomes of interest included measures of incidence, transmission, hospitalization, and mortality. RESULTS: Out of 159 unique records retrieved, 45 (28.3%) records were reviewed at the full-text level, and 24 (15.1%) records met all inclusion criteria. The studies included utilized mathematical modeling (n=14), observational (n=8), and systematic review (n=2) approaches. Only 2 studies considered digital contact tracing. Contact tracing was mostly evaluated in combination with other nonpharmaceutical interventions and/or pharmaceutical interventions. Although some degree of effectiveness in decreasing viral disease incidence, transmission, and resulting hospitalizations and mortality was observed, these results were highly dependent on epidemic severity (R0 value), number of contacts traced (including presymptomatic and asymptomatic cases), timeliness, duration, and compliance with combined interventions (eg, isolation, quarantine, and treatment). Contact tracing effectiveness was particularly limited by logistical challenges associated with increased outbreak size and speed of infection spread. CONCLUSIONS: Timely deployment of contact tracing strategically layered with other nonpharmaceutical interventions could be an effective public health tool for mitigating and suppressing infectious outbreaks by decreasing viral disease incidence, transmission, and resulting hospitalizations and mortality.


Assuntos
Controle de Doenças Transmissíveis/métodos , Busca de Comunicante , Viroses/prevenção & controle , COVID-19/prevenção & controle , Humanos
20.
PLoS One ; 16(10): e0259037, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34710158

RESUMO

Epidemiological simulations as a method are used to better understand and predict the spreading of infectious diseases, for example of COVID-19. This paper presents an approach that combines a well-established approach from transportation modelling that uses person-centric data-driven human mobility modelling with a mechanistic infection model and a person-centric disease progression model. The model includes the consequences of different room sizes, air exchange rates, disease import, changed activity participation rates over time (coming from mobility data), masks, indoors vs. outdoors leisure activities, and of contact tracing. It is validated against the infection dynamics in Berlin (Germany). The model can be used to understand the contributions of different activity types to the infection dynamics over time. It predicts the effects of contact reductions, school closures/vacations, masks, or the effect of moving leisure activities from outdoors to indoors in fall, and is thus able to quantitatively predict the consequences of interventions. It is shown that these effects are best given as additive changes of the reproduction number R. The model also explains why contact reductions have decreasing marginal returns, i.e. the first 50% of contact reductions have considerably more effect than the second 50%. Our work shows that is is possible to build detailed epidemiological simulations from microscopic mobility models relatively quickly. They can be used to investigate mechanical aspects of the dynamics, such as the transmission from political decisions via human behavior to infections, consequences of different lockdown measures, or consequences of wearing masks in certain situations. The results can be used to inform political decisions.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Busca de Comunicante/métodos , Berlim , COVID-19/metabolismo , Telefone Celular/tendências , Simulação por Computador , Alemanha , Desinfecção das Mãos/tendências , Humanos , Máscaras/tendências , Modelos Teóricos , Distanciamento Físico , Dinâmica Populacional/tendências , SARS-CoV-2/patogenicidade , Análise de Sistemas
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