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Community-Driven, Text Message-Based COVID-19 Surveillance System, Los Angeles County, California, USA, 2020-2024.

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    Angelenos in Action (AiA), a text-based surveillance system, effectively monitored respiratory illness trends during COVID-19. The system showed strong correlations with COVID-19 case counts and wastewater data.

    Keywords:
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    Area of Science:

    • Public Health
    • Epidemiology
    • Digital Health

    Background:

    • Respiratory virus surveillance faced challenges during the COVID-19 pandemic due to limited testing and guidance for mild cases.
    • Traditional surveillance methods proved unreliable at the pandemic's outset.

    Purpose of the Study:

    • To develop and assess the performance of a text message-based community syndromic surveillance system, Angelenos in Action (AiA).
    • To monitor respiratory illness trends in Los Angeles County.

    Main Methods:

    • The Angelenos in Action (AiA) system utilized text messages for community-based syndromic surveillance.
    • Performance was evaluated by correlating AiA data with COVID-19 case counts, SARS-CoV-2 laboratory test positivity rates, and wastewater SARS-CoV-2 concentrations.
    • Approximately 17,000 unique participants provided responses, with 43% maintaining regular engagement.

    Main Results:

    • AiA demonstrated a strong correlation with reported COVID-19 case counts (coefficient = 0.975).
    • The system showed significant correlations with sentinel laboratory SARS-CoV-2 test positivity (0.762) and wastewater SARS-CoV-2 concentrations (0.861).
    • A moderate correlation was observed between AiA data and influenza test positivity rates.

    Conclusions:

    • Angelenos in Action (AiA) proved to be a robust tool for respiratory illness surveillance, performing well against established methods.
    • The system's strong correlation with COVID-19 indicators suggests its utility in tracking pandemics.
    • AiA shows potential for broader application in monitoring various respiratory illnesses beyond COVID-19.