Use of SMS-linked electronic surveys for COVID-19 case investigation and contact tracing — Marin County, CA, USA

Importance: Evidence of the impact of COVID-19 Case Investigation and Contact Tracing (CICT) programs is lacking. Policymakers need this evidence to assess its value. Objective: Estimate COVID-19 cases and hospitalizations averted nationwide by US states' CICT programs. Design: We combined data from US CICT programs (e.g., proportion of cases interviewed, contacts notified or monitored, and days to case and contact notification) with incidence data to model CICT impacts over 60 days period (November 25, 2020 to January 23, 2021) during the height of the pandemic. We estimated a range of impacts by varying assumed compliance with isolation and quarantine recommendations. Setting: US States and Territories Participants: Fifty-nine state and territorial health departments that received federal funding supporting COVID-19 pandemic response activities were eligible for inclusion. Of these, 22 states and 1 territory reported all measures necessary for the analysis. These 23 jurisdictions covered 42.5% of the US population (140 million persons), spanned all 4 census regions, and reported data that reflected all 59 federally funded CICT programs. Intervention: Public health case investigation and contact tracing Main Outcomes and Measures: Cases and hospitalizations averted; percent of cases averted among cases not prevented by vaccination and other non-pharmaceutical interventions (other NPIs). Results: We estimated 1.11 million cases and 27,231 hospitalizations were averted by CICT programs under a scenario where 80% of interviewed cases and monitored contacts, and 30% of notified contacts fully complied with isolation and quarantine guidance, eliminating their contributions to future transmission. As many as 1.36 million cases and 33,527 hospitalizations could have been prevented if all interviewed cases and monitored contacts had entered into and fully complied with isolation and quarantine guidelines upon being interviewed or notified. Across all scenarios and jurisdictions, CICT averted a median of 21.2% (range: 1.3% - 65.8%) of the cases not prevented by vaccination and other NPIs. Conclusions and Relevance: CICT programs likely had a substantial role in curtailing the pandemic in most jurisdictions during the winter 2020-2021 peak. Differences in impact across jurisdictions indicate an opportunity to further improve CICT effectiveness. These estimates demonstrate the potential benefits from sustaining and improving these programs.

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COVID-19 Case Investigation and Contact Tracing in Central Washington State, June–July 2020

Journal of Community Health ◽

10.1007/s10900-021-00974-5 ◽

2021 ◽

Author(s):

James S. Miller ◽

Robert A. Bonacci ◽

R. Ryan Lash ◽

Patrick K. Moonan ◽

Peter Houck ◽

...

Keyword(s):

Washington State ◽

Contact Tracing ◽

Case Investigation ◽

June July

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California's COVID-19 Virtual Training Academy: Rapid Scale-Up of a Statewide Contact Tracing and Case Investigation Workforce Training Program

Frontiers in Public Health ◽

10.3389/fpubh.2021.706697 ◽

2021 ◽

Vol 9 ◽

Author(s):

Debbie B. Brickley ◽

Maeve Forster ◽

Amelia Alonis ◽

Elizabeth Antonyan ◽

Lisa Chen ◽

...

Keyword(s):

Public Health ◽

Los Angeles ◽

Training Program ◽

San Francisco ◽

Curriculum Design ◽

Scale Up ◽

Contact Tracing ◽

Infectious Period ◽

Training Experience ◽

Case Investigation

Case investigation (CI) and contact tracing (CT) are key to containing the COVID-19 pandemic. Widespread community transmission necessitates a large, diverse workforce with specialized knowledge and skills. The University of California, San Francisco and Los Angeles partnered with the California Department of Public Health to rapidly mobilize and train a CI/CT workforce. In April through August 2020, a team of public health practitioners and health educators constructed a training program to enable learners from diverse backgrounds to quickly acquire the competencies necessary to function effectively as CIs and CTs. Between April 27 and May 5, the team undertook a curriculum design sprint by performing a needs assessment, determining relevant goals and objectives, and developing content. The initial four-day curriculum consisted of 13 hours of synchronous live web meetings and 7 hours of asynchronous, self-directed study. Educational content emphasized the principles of COVID-19 exposure, infectious period, isolation and quarantine guidelines and the importance of prevention and control interventions. A priority was equipping learners with skills in rapport building and health coaching through facilitated web-based small group skill development sessions. The training was piloted among 31 learners and subsequently expanded to an average weekly audience of 520 persons statewide starting May 7, reaching 7,499 unique enrollees by August 31. Capacity to scale and sustain the training program was afforded by the UCLA Extension Canvas learning management system. Repeated iteration of content and format was undertaken based on feedback from learners, facilitators, and public health and community-based partners. It is feasible to rapidly train and deploy a large workforce to perform CI and CT. Interactive skills-based training with opportunity for practice and feedback are essential to develop independent, high-performing CIs and CTs. Rigorous evaluation will continue to monitor quality measures to improve the training experience and outcomes.

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Measuring the unknown: an estimator and simulation study for assessing case reporting during epidemics

10.1101/2021.02.17.431606 ◽

2021 ◽

Author(s):

Christopher I Jarvis ◽

Amy Gimma ◽

Flavio Finger ◽

Tim P Morris ◽

Jennifer A Thompson ◽

...

Keyword(s):

Democratic Republic ◽

Performance Indicator ◽

Contact Tracing ◽

Essential Factor ◽

Outbreak Response ◽

Case Investigation ◽

True Value ◽

Main Driver ◽

Republic Of The Congo ◽

Close Range

AbstractThe fraction of cases reported, known as ‘reporting’, is a key performance indicator in an outbreak response, and an essential factor to consider when modelling epidemics and assessing their impact on populations. Unfortunately, its estimation is inherently difficult, as it relates to the part of an epidemic which is, by definition, not observed.We introduce a simple statistical method for estimating reporting, initially developed for the response to Ebola in Eastern Democratic Republic of the Congo (DRC), 2018-2020. This approach uses transmission chain data typically gathered through case investigation and contact tracing, and uses the proportion of investigated cases with a known, reported infector as a proxy for reporting. Using simulated epidemics, we study how this method performs for different outbreak sizes and reporting levels. Results suggest that our method has low bias, reasonable precision, and despite sub-optimal coverage, usually provides estimates within close range (5-10%) of the true value.Being fast and simple, this method could be useful for estimating reporting in real-time in settings where person-to-person transmission is the main driver of the epidemic, and where case investigation is routinely performed as part of surveillance and contact tracing activities.Author summaryWhen responding to epidemics of infectious diseases, it is essential to estimate how many cases are not being reported. Unfortunately reporting, the proportion of cases actually observed, is difficult to estimate during an outbreak, as it typically requires large surveys to be conducted on the affected populations. Here, we introduce a method for estimating reporting from case investigation data, using the proportion of cases with a known, reported infector. We used simulations to test the performance of our approach by mimicking features of a recent Ebola epidemic in the Democratic Republic of the Congo. We found that despite some uncertainty in smaller outbreaks, our approach can be used to obtain informative ballpark estimates of reporting under most settings. This method is simple and computationally inexpensive, and can be used to inform the response to any epidemic in which transmission events can be uncovered by case investigation.

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Meeting case investigation and contact tracing needs during COVID-19 in Alberta: the development and implementation of the Alberta Health Services Pod Partnership Model

Can J Public Health ◽

10.17269/s41997-021-00604-6 ◽

2022 ◽

Author(s):

J. Cyne Johnston ◽

Keri-Lynn Strain ◽

Cindy Dribnenki ◽

Maureen Devolin

Keyword(s):

Health Services ◽

Contact Tracing ◽

Case Investigation ◽

Partnership Model ◽

Alberta Health

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Contact tracing indicators for COVID-19: rapid scoping review and conceptual framework

10.1101/2021.05.13.21257067 ◽

2021 ◽

Author(s):

Florian Vogt ◽

Karishma Kurup ◽

Paul Mussleman ◽

Caroline Habrun ◽

Madeleine Crowe ◽

...

Keyword(s):

Conceptual Framework ◽

Scoping Review ◽

Grey Literature ◽

Contact Tracing ◽

Financial Resources ◽

Process Indicators ◽

Case Investigation ◽

Transmission Chain ◽

The Impact ◽

Output Indicators

Background: Contact tracing is one of the key interventions in response to the COVID-19 pandemic but its implementation varies widely across countries. There is little guidance on how to monitor contact tracing performance, and no systematic overview of indicators to assess contact tracing systems or conceptual framework for such indicators exists to date. Methods: We conducted a rapid scoping review using a systematic literature search strategy in the peer-reviewed and grey literature as well as open source online documents. We developed a conceptual framework to map indicators by type (input, process, output, outcome, impact) and thematic area (human resources, financial resources, case investigation, contact identification, contact testing, contact follow up, case isolation, contact quarantine, transmission chain interruption, incidence reduction). Results: We identified a total of 153 contact tracing indicators from 1,555 peer-reviewed studies, 894 studies from grey literature sources, and 15 sources from internet searches. Two-thirds of indicators were process indicators (102; 67%), while 48 (31%) indicators were output indicators. Only three (2%) indicators were input indicators. Indicators covered seven out of ten conceptualized thematic areas, with more than half being related to either case investigation (37; 24%) or contact identification (44; 29%). There were no indicators for the input area 'financial resources', the outcome area 'transmission chain interruption', and the impact area 'incidence reduction'. Conclusions: Almost all identified indicators were either process or output indicators focusing on case investigation, contact identification, case isolation or contact quarantine. We identified important gaps in input, outcome and impact indicators, which constrains evidence-based assessment of contact tracing systems. A universally agreed set of indicators is needed to allow for cross-system comparisons and to improve the performance of contact tracing systems.

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Estimates of Cases and Hospitalizations Averted by COVID-19 Case Investigation and Contact Tracing in 14 Health Jurisdictions in the United States

Journal of Public Health Management and Practice ◽

10.1097/phh.0000000000001420 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Seonghye Jeon ◽

Gabriel Rainisch ◽

R. Ryan Lash ◽

Patrick K. Moonan ◽

John E. Oeltmann ◽

...

Keyword(s):

United States ◽

The United States ◽

Contact Tracing ◽

Case Investigation

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COVID-19 Case Investigation and Contact Tracing in the US, 2020

JAMA Network Open ◽

10.1001/jamanetworkopen.2021.15850 ◽

2021 ◽

Vol 4 (6) ◽

pp. e2115850

Author(s):

R. Ryan Lash ◽

Patrick K. Moonan ◽

Brittany L. Byers ◽

Robert A. Bonacci ◽

Kimberly E. Bonner ◽

...

Keyword(s):

Contact Tracing ◽

Case Investigation ◽

The Us

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Estimates of cases and hospitalizations averted by COVID-19 case investigation and contact tracing in 14 health jurisdictions in the United States

10.1101/2021.05.27.21257931 ◽

2021 ◽

Author(s):

Seonghye Jeon ◽

Gabriel Rainisch ◽

Ryan Lash ◽

Patrick K Moonan ◽

John E Oeltmann ◽

...

Keyword(s):

The United States ◽

Contact Tracing ◽

Case Investigation ◽

Percentage Points ◽

Control And Prevention ◽

Trained Staff ◽

Nonpharmaceutical Interventions ◽

The Impact ◽

Overall Effectiveness ◽

Do So

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 proportion of cases interviewed, contacts notified or monitored, and days from testing to contact notification from 14 jurisdictions to model the impact of CICT on cumulative cases counts and hospitalizations over a 60-day period. Using the Centers for Disease Control and Prevention (CDC)'s COVIDTracer 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 which became cases) within 6 to 10 days after exposure-and-infection. We estimated that CICT-related reductions in transmission ranged from 0.4% to 32%. For every 100 cases prevented by nonpharmaceutical interventions, CICT averted between 4 and 97 additional cases. Reducing time to case isolation by one 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 case investigation and contact tracing 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.

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