COVID-19 testing and infection surveillance: Is a combined digital contact-tracing and mass-testing solution feasible in the United States?

The role of Contact-Tracing Mobile Apps in pandemic prevention: A multidisciplinary perspective on health beliefs, social, and technological factors

During the recent COVID-19 pandemic, governments implemented mobile applications for contact tracing as a rapid and effective solution to mitigate the spread of the virus. However, these seemingly straightforward solutions did not achieve their intended objectives. In line with previous research, this paper aims to investigate the factors that influence the acceptance and usage of contact-tracing mobile apps (CTMAs) in the context of disease control. The research model in this paper integrates the Unified Theory of Acceptance and Use of Technology and the Health Belief Model (HBM). The present study involved a diverse sample of 770 French participants of all genders, ages, occupations, and regions. Critical elements from the Health Belief Model, technological factors related to the app, and social factors, including the centrality of religiosity, were assessed using well-established measurement scales. The research's findings demonstrate that several factors, such as perceived benefits and perceived severity, social influence, health motivation, and centrality of religiosity, significantly impact the intention to use a CTMA. These findings suggest that CTMAs hold promise as valuable tools for managing future epidemics. However, addressing challenges, revising implementation strategies, and potentially collaborating with specialized industry partners under regulatory frameworks are crucial. This practical insight can guide policymakers and public health officials in their decision-making.

Short- and Long-Term Predicted and Witnessed Consequences of Digital Surveillance During the COVID-19 Pandemic: Scoping Review

BACKGROUND

The COVID-19 pandemic has prompted the deployment of digital technologies for public health surveillance globally. The rapid development and use of these technologies have curtailed opportunities to fully consider their potential impacts (eg, for human rights, civil liberties, privacy, and marginalization of vulnerable groups).

OBJECTIVE

We conducted a scoping review of peer-reviewed and gray literature to identify the types and applications of digital technologies used for surveillance during the COVID-19 pandemic and the predicted and witnessed consequences of digital surveillance.

METHODS

Our methodology was informed by the 5-stage methodological framework to guide scoping reviews: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarizing, and reporting the findings. We conducted a search of peer-reviewed and gray literature published between December 1, 2019, and December 31, 2020. We focused on the first year of the pandemic to provide a snapshot of the questions, concerns, findings, and discussions emerging from peer-reviewed and gray literature during this pivotal first year of the pandemic. Our review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guidelines.

RESULTS

We reviewed a total of 147 peer-reviewed and 79 gray literature publications. Based on our analysis of these publications, we identified a total of 90 countries and regions where digital technologies were used for public health surveillance during the COVID-19 pandemic. Some of the most frequently used technologies included mobile phone apps, location-tracking technologies, drones, temperature-scanning technologies, and wearable devices. We also found that the literature raised concerns regarding the implications of digital surveillance in relation to data security and privacy, function creep and mission creep, private sector involvement in surveillance, human rights, civil liberties, and impacts on marginalized groups. Finally, we identified recommendations for ethical digital technology design and use, including proportionality, transparency, purpose limitation, protecting privacy and security, and accountability.

CONCLUSIONS

A wide range of digital technologies was used worldwide to support public health surveillance during the COVID-19 pandemic. The findings of our analysis highlight the importance of considering short- and long-term consequences of digital surveillance not only during the COVID-19 pandemic but also for future public health crises. These findings also demonstrate the ways in which digital surveillance has rendered visible the shifting and blurred boundaries between public health surveillance and other forms of surveillance, particularly given the ubiquitous nature of digital surveillance.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-https://doi.org/10.1136/bmjopen-2021-053962.

Employee investigation and contact tracing program in a pediatric cancer hospital to mitigate the spread of COVID-19 among the workforce, patients, and caregivers

Background

Case investigations and contact tracing are essential disease control measures used by health departments. Early in the pandemic, they were seen as a key strategy to stop COVID-19 spread. The CDC urged rapid action to scale up and train a large workforce and collaborate across public and private agencies to halt COVID-19 transmission.

Methods

We developed a program for case investigation and contact tracing that followed CDC and local health guidelines, compliant with the Occupational Safety and Health Administration (OSHA) regulations and tailored to the needs and resources of our institution. Program staff were trained and assessed for competency before joining the program.

Results

From March 2020 to May 2021, we performed 838 COVID-19 case investigations, which led to 136 contacts. Most employees reported a known SARS-CoV-2 exposure from the community (n = 435) or household (n = 343). Only seven (5.1%) employees were determined as more likely than not to have SARS-CoV-2 infection related to workplace exposure, and when so, lapses in following the masking recommendations were identified. Between June 2021-February 2022, our program adjusted to the demand of the different waves, particularly omicron, by significantly reducing the amount of data collected. No transmission from employees to patients or caregivers was observed during this period.

Conclusion

Prompt implementation of case investigation and contact tracing is possible, and it effectively reduces workplace exposures. This approach can be adapted to suit the specific needs and requirements of various healthcare settings, particularly those serving the most vulnerable patient populations.

Evaluating the Added Value of Digital Contact Tracing Support Tools for Citizens: Framework Development

BACKGROUND

The COVID-19 pandemic revealed that with high infection rates, health services conducting contact tracing (CT) could become overburdened, leading to limited or incomplete CT. Digital CT support (DCTS) tools are designed to mimic traditional CT, by transferring a part of or all the tasks of CT into the hands of citizens. Besides saving time for health services, these tools may help to increase the number of contacts retrieved during the contact identification process, quantity and quality of contact details, and speed of the contact notification process. The added value of DCTS tools for CT is currently unknown.

OBJECTIVE

To help determine whether DCTS tools could improve the effectiveness of CT, this study aims to develop a framework for the comprehensive assessment of these tools.

METHODS

A framework containing evaluation topics, research questions, accompanying study designs, and methods was developed based on consultations with CT experts from municipal public health services and national public health authorities, complemented with scientific literature.

RESULTS

These efforts resulted in a framework aiming to assist with the assessment of the following aspects of CT: speed; comprehensiveness; effectiveness with regard to contact notification; positive case detection; potential workload reduction of public health professionals; demographics related to adoption and reach; and user experiences of public health professionals, index cases, and contacts.

CONCLUSIONS

This framework provides guidance for researchers and policy makers in designing their own evaluation studies, the findings of which can help determine how and the extent to which DCTS tools should be implemented as a CT strategy for future infectious disease outbreaks.

Health disparity in the spread of COVID-19: Evidence from social distancing, risk of interactions, and access to testing

OBJECTIVE

- To identify and assess whether three major risk factors that due to differential access to flexible resources might help explain disparities in the spread of COVID-19 across communities with different socioeconomic status, including socioeconomic inequalities in social distancing, the potential risk of interpersonal interactions, and access to testing.

METHODS

Analysis uses ZIP code level weekly COVID-19 new cases, weekly population movement flows, weekly close-contact index, and weekly COVID-19 testing sites in Southern California from March 2020 to April 2021, merged with the U.S. census data to measure ZIP code level socioeconomic status and cofounders. This study first develops the measures for social distancing, the potential risk of interactions, and access to testing. Then we employ a spatial lag regression model to quantify the contributions of those factors to weekly COVID-19 case growth.

RESULTS

Results identify that, during the first COVID-19 wave, new case growth of the low-income group is two times higher than that of the high-income group. The COVID-19 case disparity widens to four times in the second COVID-19 wave. We also observed significant disparities in social distancing, the potential risk of interactions, and access to testing among communities with different socioeconomic status. In addition, all of them contribute to the disparities of COVID-19 incidences. Among them, the potential risk of interactions is the most important contributor, whereas testing accessibility contributes least. We also found that close-contact is a more effective measure of social distancing than population movements in examining the spread of COVID-19.

CONCLUSION

- This study answers critically unaddressed questions about health disparities in the spread of COVID-19 by assessing factors that might explain why the spread is different in different groups.

Use of digital technologies for public health surveillance during the COVID-19 pandemic: A scoping review

Throughout the COVID-19 pandemic, a variety of digital technologies have been leveraged for public health surveillance worldwide. However, concerns remain around the rapid development and deployment of digital technologies, how these technologies have been used, and their efficacy in supporting public health goals. Following the five-stage scoping review framework, we conducted a scoping review of the peer-reviewed and grey literature to identify the types and nature of digital technologies used for surveillance during the COVID-19 pandemic and the success of these measures. We conducted a search of the peer-reviewed and grey literature published between 1 December 2019 and 31 December 2020 to provide a snapshot of questions, concerns, discussions, and findings emerging at this pivotal time. A total of 147 peer-reviewed and 79 grey literature publications reporting on digital technology use for surveillance across 90 countries and regions were retained for analysis. The most frequently used technologies included mobile phone devices and applications, location tracking technologies, drones, temperature scanning technologies, and wearable devices. The utility of digital technologies for public health surveillance was impacted by factors including uptake of digital technologies across targeted populations, technological capacity and errors, scope, validity and accuracy of data, guiding legal frameworks, and infrastructure to support technology use. Our findings raise important questions around the value of digital surveillance for public health and how to ensure successful use of technologies while mitigating potential harms not only in the context of the COVID-19 pandemic, but also during other infectious disease outbreaks, epidemics, and pandemics.

Digitalization impacts the COVID-19 pandemic and the stringency of government measures

COVID-19 poses a significant burden to populations worldwide. Although the pandemic has accelerated digital transformation, little is known about the influence of digitalization on pandemic developments. Therefore, this country-level study aims to explore the impact of pre-pandemic digital adoption on COVID-19 outcomes and government measures. Using the Digital Adoption Index (DAI), we examined the association between countries' digital preparedness levels and COVID-19 cases, deaths, and stringency indices (SI) of government measures until March 2021. Gradient Tree Boosting based algorithm pinpointed essential features related to COVID-19 trends, such as digital adoption, populations' smoker fraction, age, and poverty. Subsequently, regression analyses indicated that higher DAI was associated with significant declines in new cases (β = - 362.25/pm; p < 0.001) and attributed deaths (β = - 5.53/pm; p < 0.001) months after the peak. When plotting DAI against the SI normalized for the starting day, countries with higher DAI adopted slightly more stringent government measures (β = 4.86; p < 0.01). Finally, a scoping review identified 70 publications providing valuable arguments for our findings. Countries with higher DAI before the pandemic show a positive trend in handling the pandemic and facilitate the implementation of more decisive governmental measures. Further distribution of digital adoption may have the potential to attenuate the impact of COVID-19 cases and deaths.

Barriers to SARS-CoV-2 Testing among U.S. Employers in the COVID-19 Pandemic: A Qualitative Analysis Conducted January through April 2021

During the first year of the COVID-19 pandemic, U.S. companies were seeking ways to support their employees to return to the workplace. Nonetheless, the development of strategies to support the access, use, and interpretation of SARS-CoV-2 testing was challenging. In the present study, we explore, from the perspective of owners and company leadership, the barriers to SARS-CoV-2 testing among U.S. companies. Key informant interviews with company representatives were conducted during January-April 2021 about SARS-CoV-2 testing. A pre-interview survey assessed respondent socio-demographic and organizational characteristics. Interview sessions were transcribed, coded, and analyzed using MaxQDA. A total of twenty interviews were completed with at least two interviews conducted in each major U.S. industry sector. Ninety percent of participants represented companies in business >10 years, comprising both small and large workforces. Using a grounded theory approach, six themes emerged: (1) access to and knowledge of SARS-CoV-2 tests; (2) strategies for symptomatic and asymptomatic testing of workers; (3) type/availability of personal protective equipment to mitigate coronavirus exposures; (4) return-to-work policies; (5) guidance and communication of SARS-CoV-2 Testing; and (6) use of contact tracing and SARS-CoV-2 vaccination. Various modifiable and non-modifiable challenges for SARS-CoV-2 testing among U.S. companies were identified and can inform work-related SARS-CoV-2 testing strategies.

The Korean 3T Practice: New Biosurveillance Model Utilizing New Information Technology and Digital Tools

In South Korea, COVID-19 pandemic responses, namely the 3T (testing, tracing, and treating) strategy, emerged as a new biosurveillance regime actively using new information technology (IT) and digital tools. The foundation of the Korean 3T system is epidemiological investigation efforts and clinical practices exploiting the use of new digital and IT tools. Due to these unique features, the Korean 3T system can be referred to as a “contact-based biosurveillance system,” which is an advanced version of the traditional biosurveillance models (indicator-based or event-based models). This article illustrates how the contact-based biosurveillance system originated from the experience with the 2015 Middle East Respiratory Syndrome (MERS) outbreak. The post-MERS Korean biosurveillance regime actively adopted the utility of new digital and IT tools to strengthen not only the ex-ante epidemic intelligence capabilities (by traditional models) but also the ex-post response and recovery capabilities (digital contact tracing and digital health intervention). However, critics claim that the Korean 3T system may violate individuals’ privacy and human rights by addressing the fact that the Korean biosurveillance system would strengthen social surveillance and population control by the government as a “digital big brother” in the cyber age. Nevertheless, 3T biosurveillance promises a positive future direction for digital health practice in the current biosurveillance regimes.

Data privacy during pandemics: a systematic literature review of COVID-19 smartphone applications

BACKGROUND

On January 8, 2020, the Centers for Disease Control and Prevention officially announced a new virus in Wuhan, China. The first novel coronavirus (COVID-19) case was discovered on December 1, 2019, implying that the disease was spreading quietly and quickly in the community before reaching the rest of the world. To deal with the virus' wide spread, countries have deployed contact tracing mobile applications to control viral transmission. Such applications collect users' information and inform them if they were in contact with an individual diagnosed with COVID-19. However, these applications might have affected human rights by breaching users' privacy.

METHODOLOGY

This systematic literature review followed a comprehensive methodology to highlight current research discussing such privacy issues. First, it used a search strategy to obtain 808 relevant papers published in 2020 from well-established digital libraries. Second, inclusion/exclusion criteria and the snowballing technique were applied to produce more comprehensive results. Finally, by the application of a quality assessment procedure, 40 studies were chosen.

RESULTS

This review highlights privacy issues, discusses centralized and decentralized models and the different technologies affecting users' privacy, and identifies solutions to improve data privacy from three perspectives: public, law, and health considerations.

CONCLUSIONS

Governments need to address the privacy issues related to contact tracing apps. This can be done through enforcing special policies to guarantee users privacy. Additionally, it is important to be transparent and let users know what data is being collected and how it is being used.

A Large-Scale Screening Responding Sporadic Epidemic of COVID-19 in China by an Integrated Health-Care System

Introduction

In the post-pandemic period of COVID-19, the majority of cities in China try to balance the normalization of epidemic prevention and social-economic development. However, the appearance of asymptomatic infected patients poses threats to public health, which might be infectious without clinical symptoms and only be detected by testing approaches.

Methods

Along with the appearance of one symptomatic case, a regional large-scale screening program was carried out in Shenzhen City charged by a regionally integrated healthcare system. After describing the screening program, a retrospective cross-sectional study for the screening outcome and efficacy was conducted.

Discussion

According to the screening results, the asymptomatic case was infectious and their close contacts should be quarantined cautiously as the close contacts of symptomatic cases. Besides, after integrating medical resources in Luohu district of Shenzhen, the medical capability of Luohu district improved greatly which could be demonstrated in inspection and organization abilities in this screening program.

Conclusion

The large-scale screening contributed to preventing epidemic transmission. In the post-pandemic period, regular surveillance of asymptomatic cases and rapid response capability for emergent screening program are both crucial for the prevention and control of COVID-19 epidemic. The integrated healthcare system coordinating regional medical institutions and optimizing regional medical recourse has advantages to address public health emergencies.

Survey on COVID-19-related mortality associated with occupational infection during the first phase of the pandemic: A systematic review

According to the Centre for Disease Control and Prevention in 2020, a cluster of pneumonia cases of unknown etiology caused by the severe acute respiratory syndrome (SARS)-coronavirus 2 was reported in Wuhan, China. The present review examined the literature to reveal the incidence of novel coronavirus-2019 disease (COVID-19) infections, underlying comorbidities, workplace infections and case fatality rates. A review was performed to identify the relevant publications available up to May 15, 2020. Since the early stages of the COVID-19 outbreak, the case fatality rate among healthcare workers (HCWs) has stood at 0.69% worldwide and 0.4% in Italy. Based on the current information, most patients have exhibited good prognoses in terms of after-effects or sequelae and low mortality rate. Patients that became critically ill were primarily in the elderly population or had chronic underlying diseases, including diabetes and hypertension. Among all working sectors, HCWs, since they are front-line caregivers for patients with COVID-19, are considered to be in the high-risk population. Increased age and a number of comorbidity factors have been associated with increased risk of mortality in patients with COVID-19. The most frequent complications of COVID-19 reported that can cause fatality in patients were SARS, cardiac arrest, secondary infections and septic shock, in addition to acute kidney failure and liver failure. Overcoming the COVID-19 pandemic is an ongoing challenge, which poses a threat to global health that requires close surveillance and prompt diagnosis, in coordination with research efforts to understand this pathogen and develop effective countermeasures.

Innovation in Coping with the COVID-19 Pandemic: The Best Practices from Five Smart Cities in Indonesia

In relation to innovations which help to cope with the COVID-19 pandemic, the best practices of several smart cities become an important input to organize and create strategies for future cities. This research aims to identify the responses of cities to the COVID-19 pandemic; analyze their innovation in tackling the COVID-19 pandemic; and create strategies and planning for the future of the cities. This study analyzes aspects such as the use of information and communication technology (ICT), smart city implementation, the biological disaster of the COVID-19 pandemic, the environment, and spatial plans. This research was carried out in five smart cities using a case study. The results indicated that each case had innovations for coping with the COVID-19 pandemic. They showed a uniqueness and local innovations adapted to the problems faced in the five case areas. The innovations were demonstrated by the use of ICT-based applications in several public services as part of smart city implementation. The concept of a smart city, which addresses the biological disaster of the COVID-19 pandemic through the existence of ship-based isolation centers and sociotechnical innovations, was then adapted in various cities throughout Indonesia. In terms of the smart environment concept, this is translated through technological and social innovation approaches to improve medical and domestic waste management, public service systems, and the socialization of environmental protection programs in cities during the pandemic. The COVID-19 pandemic is allegedly accelerating the implementation of the smart city concept in spatial planning. There is a tendency for the use of public space in the city center to shift to local-scale service centers. Additionally, other activities are increasingly occupying the digital space so that it affects the arrangement of spatial organization and increases the need for ICT infrastructure. The efficient and flexible use of applications for supporting the implementation of smart cities needs to be broadened for the public services provided by both the government and private sectors. Meanwhile, in relation to the dimensions of a smart environment, it is necessary to take into account the waste management as a result of COVID-19. The same case is the aspect of spatial planning in which it is necessary to redesign open spaces for public use. City planning in the future also needs to be capable of the smart mitigation of non-physical disasters, such as the COVID-19 pandemic.

Assessing the Impact of Policy Measures in Reducing the COVID-19 Pandemic: A Case Study of South Asia

The COVID-19 pandemic is considered to be the world’s most urgent health disaster and the greatest challenge humanity has faced since World War II. One of the most significant concerns is the effectiveness of the extraordinary efforts undertaken around the world to prevent the spread of the coronavirus. This study applied the Westerlund cointegration test and the Pooled Mean Group–Autoregressive Distributed Lag (PMG-ARDL) model to investigate the effectiveness of government policy measures in reducing the COVID-19 pandemic using weekly data for the period 1 January 2020 to 31 May 2021. The results of the Westerlund cointegration test validate the presence of a cointegration relationship between government policy measures and the COVID-19 pandemic. In addition, results of PMG-ARDL show that economic support, stringency, and health and containment measures play a significant role in reducing the COVID-19 pandemic. Therefore, this study concluded that pharmaceutical and non-pharmaceutical measures have a substantial impact on mitigating the COVID-19 pandemic in South Asia. Policy implications such as government financial support for poor families, stringency, and health and containment measures must be adopted during the pandemic to curb/reduce the spread of COVID-19. Furthermore, it is also recommended to provide vaccines free of charge to developing countries and a stimulus package to support health research to expand the capacity for rapid vaccine in this region.

Proposed Framework for Considering SARS-CoV-2 Antigen Testing of Unexposed Asymptomatic Workers in Selected Workplaces

OBJECTIVES

To propose a framework for considering SARS-CoV-2 antigen testing of unexposed asymptomatic workers in selected workplaces.

METHODS

This is a commentary based on established occupational safety and health principles, published articles, and other pertinent literature, including non-peer-reviewed preprints in medrixiv.org prior to April 16, 2021.

RESULTS

Not applicable to this commentary/viewpoint article.

CONCLUSION

Antigen testing is a rapidly evolving and useful public health tool that can be used to guide measures to reduce spread of SARS-CoV-2 in the community and in selected workplaces. This commentary provides a proposed framework for occupational safety and health practitioners and employers for considering antigen testing as a method to screen asymptomatic workers in selected non-healthcare settings. When applied selectively, antigen testing can be a useful, effective part of a comprehensive workplace program for COVID-19 prevention and control.

Digital contact tracing, community uptake, and proximity awareness technology to fight COVID-19: a systematic review

Digital contact tracing provides an expeditious and comprehensive way to collect and analyze data on people's proximity, location, movement, and health status. However, this technique raises concerns about data privacy and its overall effectiveness. This paper contributes to this debate as it provides a systematic review of digital contact tracing studies between January 1, 2020, and March 31, 2021. Following the PRISMA protocol for systematic reviews and the CHEERS statement for quality assessment, 580 papers were initially screened, and 19 papers were included in a qualitative synthesis. We add to the current literature in three ways. First, we evaluate whether digital contact tracing can mitigate COVID-19 by either reducing the effective reproductive number or the infected cases. Second, we study whether digital is more effective than manual contact tracing. Third, we analyze how proximity/location awareness technologies affect data privacy and population participation. We also discuss proximity/location accuracy problems arising when these technologies are applied in different built environments (i.e., home, transport, mall, park). This review provides a strong rationale for using digital contact tracing under specific requirements. Outcomes may inform current digital contact tracing implementation efforts worldwide regarding the potential benefits, technical limitations, and trade-offs between effectiveness and privacy.

Contact Tracing Apps: Lessons Learned on Privacy, Autonomy, and the Need for Detailed and Thoughtful Implementation

The global and national response to the COVID-19 pandemic has been inadequate due to a collective lack of preparation and a shortage of available tools for responding to a large-scale pandemic. By applying lessons learned to create better preventative methods and speedier interventions, the harm of a future pandemic may be dramatically reduced. One potential measure is the widespread use of contact tracing apps. While such apps were designed to combat the COVID-19 pandemic, the time scale in which these apps were deployed proved a significant barrier to efficacy. Many companies and governments sprinted to deploy contact tracing apps that were not properly vetted for performance, privacy, or security issues. The hasty development of incomplete contact tracing apps undermined public trust and negatively influenced perceptions of app efficacy. As a result, many of these apps had poor voluntary public uptake, which greatly decreased the apps' efficacy. Now, with lessons learned from this pandemic, groups can better design and test apps in preparation for the future. In this viewpoint, we outline common strategies employed for contact tracing apps, detail the successes and shortcomings of several prominent apps, and describe lessons learned that may be used to shape effective contact tracing apps for the present and future. Future app designers can keep these lessons in mind to create a version that is suitable for their local culture, especially with regard to local attitudes toward privacy-utility tradeoffs during public health crises.

Impact of Mass Workplace COVID-19 Rapid Testing on Health and Healthcare Resource Savings

Background: The epidemiological situation generated by COVID-19 has cast into sharp relief the delicate balance between public health priorities and the economy, with businesses obliged to toe the line between employee health and continued production. In an effort to detect as many cases as possible, isolate contacts, cut transmission chains, and limit the spread of the virus in the workplace, mass testing strategies have been implemented in both public health and industrial contexts to minimize the risk of disruption in activity. Objective: To evaluate the economic impact of the mass workplace testing strategy as carried out by a large automotive company in Catalonia in terms of health and healthcare resource savings. Methodology: Analysis of health costs and impacts based on the estimation of the mortality and morbidity avoided because of screening, and the resulting savings in healthcare costs. Results: The economic impact of the mass workplace testing strategies (using both PCR and RAT tests) was approximately €10.44 per test performed or €5575.49 per positive detected; 38% of this figure corresponds to savings derived from better use of health resources (hospital beds, ICU beds, and follow-up of infected cases), while the remaining 62% corresponds to improved health rates due to the avoided morbidity and mortality. In scenarios with higher positivity rates and a greater impact of the infection on health and the use of health resources, these results could be up to ten times higher (€130.24 per test performed or €69,565.59 per positive detected). Conclusion: In the context of COVID-19, preventive actions carried out by the private sector to safeguard industrial production also have concomitant public benefits in the form of savings in healthcare costs. Thus, governmental bodies need to recognize the value of implementing such strategies in private settings and facilitate them through, for example, subsidies.

WLAN-log-based superspreader detection in the COVID-19 pandemic

Identifying “superspreaders” of disease is a pressing concern for society during pandemics such as COVID-19. Superspreaders represent a group of people who have much more social contacts than others. The widespread deployment of WLAN infrastructure enables non-invasive contact tracing via people’s ubiquitous mobile devices. This technology offers promise for detecting superspreaders. In this paper, we propose a general framework for WLAN-log-based superspreader detection. In our framework, we first use WLAN logs to construct contact graphs by jointly considering human symmetric and asymmetric interactions. Next, we adopt three vertex centrality measurements over the contact graphs to generate three groups of superspreader candidates. Finally, we leverage SEIR simulation to determine groups of superspreaders among these candidates, who are the most critical individuals for the spread of disease based on the simulation results. We have implemented our framework and evaluate it over a WLAN dataset with 41 million log entries from a large-scale university. Our evaluation shows superspreaders exist on university campuses. They change over the first few weeks of a semester, but stabilize throughout the rest of the term. The data also demonstrate that both symmetric and asymmetric contact tracing can discover superspreaders, but the latter performs better with daily contact graphs. Further, the evaluation shows no consistent differences among three vertex centrality measures for long-term (i.e., weekly) contact graphs, which necessitates the inclusion of SEIR simulation in our framework. We believe our proposed framework and these results can provide timely guidance for public health administrators regarding effective testing, intervention, and vaccination policies.

ReCognizing SUspect and PredictiNg ThE SpRead of Contagion Based on Mobile Phone LoCation DaTa (COUNTERACT): A system of identifying COVID-19 infectious and hazardous sites, detecting disease outbreaks based on the internet of things, edge computing, and artificial intelligence

Human movement is a significant factor in extensive spatial-transmission models of contagious viruses. The proposed COUNTERACT system recognizes infectious sites by retrieving location data from a mobile phone device linked with a particular infected subject. The proposed approach is computing an incubation phase for the subject's infection, backpropagation through the subjects' location data to investigate a location where the subject has been during the incubation period. Classifying to each such site as a contagious site, informing exposed suspects who have been to the contagious location, and seeking near real-time or real-time feedback from suspects to affirm, discard, or improve the recognition of the infectious site. This technique is based on the contraption to gather confirmed infected subject and possibly carrier suspect area location, correlating location for the incubation days. Security and privacy are a specific thing in the present research, and the system is used only through authentication and authorization. The proposed approach is for healthcare officials primarily. It is different from other existing systems where all the subjects have to install the application. The cell phone associated with the global positioning system (GPS) location data is collected from the COVID-19 subjects.

Mass Testing With Contact Tracing Compared to Test and Trace for the Effective Suppression of COVID-19 in the United Kingdom: Systematic Review

BACKGROUND

Making testing available to everyone and tracing contacts might be the gold standard to control COVID-19. Many countries including the United Kingdom have relied on the symptom-based test and trace strategy in bringing the COVID-19 pandemic under control. The effectiveness of a test and trace strategy based on symptoms has been questionable and has failed to meet testing and tracing needs. This is further exacerbated by it not being delivered at the point of care, leading to rising cases and deaths. Increases in COVID-19 cases and deaths in the United Kingdom despite performing the highest number of tests in Europe suggest that symptom-based testing and contact tracing might not be effective as a control strategy. An alternative strategy is making testing available to all.

OBJECTIVE

The primary objective of this review was to compare mass testing and contact tracing with the conventional test and trace method in the suppression of SARS-CoV-2 infections. The secondary objective was to determine the proportion of asymptomatic COVID-19 cases reported during mass testing interventions.

METHODS

Literature in English was searched from September through December 2020 in Google Scholar, ScienceDirect, Mendeley, and PubMed. Search terms included "mass testing," "test and trace," "contact tracing," "COVID-19," "SARS-CoV-2," "effectiveness," "asymptomatic," "symptomatic," "community screening," "UK," and "2020." Search results were synthesized without meta-analysis using the direction of effect as the standardized metric and vote counting as the synthesis metric. A statistical synthesis was performed using Stata 14.2. Tabular and graphical methods were used to present findings.

RESULTS

The literature search yielded 286 articles from Google Scholar, 20 from ScienceDirect, 14 from Mendeley, 27 from PubMed, and 15 through manual search. A total of 35 articles were included in the review, with a sample size of nearly 1 million participants. We found a 76.9% (10/13, 95% CI 46.2%-95.0%; P=.09) majority vote in favor of the intervention under the primary objective. The overall proportion of asymptomatic cases among those who tested positive and in the tested sample populations under the secondary objective was 40.7% (1084/2661, 95% CI 38.9%-42.6%) and 0.0% (1084/9,942,878, 95% CI 0.0%-0.0%), respectively.

CONCLUSIONS

There was low-level but promising evidence that mass testing and contact tracing could be more effective in bringing the virus under control and even more effective if combined with social distancing and face coverings. The conventional test and trace method should be superseded by decentralized and regular mass rapid testing and contact tracing, championed by general practitioner surgeries and low-cost community services.