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Published on: April 6, 2019
Scalable Strategies to Increase Efficiency and Augment Public Health Activities During Epidemic Peaks
Dana K Pasquale1, Whitney Welsh, Andrew Olson
1Department of Population Health Sciences (Dr Pasquale), Department of Sociology (Drs Pasquale and Moody), Social Science Research Institute (Dr Welsh), Duke AI Health, School of Medicine (Messrs Olson and McCall), Duke Population Research Institute (Mr Yacoub), Duke Network Analysis Center (Dr Moody), Duke Office of Clinical Research, School of Medicine (Ms Barajas Gomez), Samuel DuBois Cook Center on Social Equity (Dr Bentley-Edwards), Department of Biomedical Engineering, Pratt School of Engineering (Dr Dunn and Ms Singh), Department of Biostatistics & Bioinformatics (Drs Dunn and Huang), Department of Medicine, School of Medicine (Dr Woods), Duke Global Health Institute (Dr Woods), Center for Infectious Disease Diagnostics & Innovation (Drs Petzold and Bowie), and Department of Surgery (Dr Huang), Duke University, Durham, North Carolina; LUMA Consulting, Durham, North Carolina (Ms Solis-Guzman); and Verily Life Sciences, South San Francisco, California (Dr Huang).
Objective:
Scalable strategies to reduce the time burden and increase contact tracing efficiency are crucial during early waves and peaks of infectious transmission.
Design:
We enrolled a cohort of SARS-CoV-2-positive seed cases into a peer recruitment study testing social network methodology and a novel electronic platform to increase contact tracing efficiency.
Setting:
Index cases were recruited from an academic medical center and requested to recruit their local social contacts for enrollment and SARS-CoV-2 testing.
Participants:
A total of 509 adult participants enrolled over 19 months (384 seed cases and 125 social peers).
Intervention:
Participants completed a survey and were then eligible to recruit their social contacts with unique "coupons" for enrollment. Peer participants were eligible for SARS-CoV-2 and respiratory pathogen screening.
Main Outcome Measures:
The main outcome measures were the percentage of tests administered through the study that identified new SARS-CoV-2 cases, the feasibility of deploying the platform and the peer recruitment strategy, the perceived acceptability of the platform and the peer recruitment strategy, and the scalability of both during pandemic peaks.
Results:
After development and deployment, few human resources were needed to maintain the platform and enroll participants, regardless of peaks. Platform acceptability was high. Percent positivity tracked with other testing programs in the area.
Conclusions:
An electronic platform may be a suitable tool to augment public health contact tracing activities by allowing participants to select an online platform for contact tracing rather than sitting for an interview.
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