scholarly journals Challenges for Nontechnical Implementation of Digital Proximity Tracing During the COVID-19 Pandemic: Media Analysis of the SwissCovid App

10.2196/25345 ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. e25345
Author(s):  
Viktor von Wyl
Keyword(s):  
Health System ◽  
Resource Competition ◽  
Digital Health ◽  
Intervention Development ◽  
Media Analysis ◽  
Mitigation Measures ◽  
Contact Tracing ◽  
Implementation Challenges ◽  
User Coverage ◽  
Media Reports

Background Several countries have released digital proximity tracing (DPT) apps to complement manual contact tracing for combatting the SARS-CoV-2 pandemic. DPT aims to notify app users about proximity exposures to persons infected with SARS-CoV-2 so that they can self-quarantine. The success of DPT apps depends on user acceptance and the embedding of DPT into the pandemic mitigation strategy. Objective By searching for media articles published during the first 3 months after DPT launch, the implementation of DPT in Switzerland was evaluated to inform similar undertakings in other countries. The second aim of the study was to create a link between reported DPT implementation challenges and normalization process theory for planning and optimizing complex digital health interventions, which can provide useful guidance for decision-making in DPT design and implementation. Methods A Swiss media database was searched for articles on the Swiss DPT app (SwissCovid) published in German or French between July 4 and October 3, 2020. In a structured process, topics were extracted and clustered manually from articles that were deemed pertinent. Extracted topics were mapped to four NPT constructs, which reflected the flow of intervention development from planning, stakeholder onboarding, and execution to critical appraisal. Coherence constructs describe sense-making by stakeholders, cognitive participation constructs reflect participants’ efforts to create engagement with the intervention, collective actions refer to intervention execution and joint stakeholder efforts to make the intervention work, and reflexive monitoring refers to collective risk-benefit appraisals to create improvements. Results Out of 94 articles deemed pertinent and selected for closer inspection, 38 provided unique information on implementation challenges. Five challenge areas were identified: communication challenges, challenges for DPT to interface with other processes, fear of resource competition with established pandemic mitigation measures, unclear DPT effectiveness, and obstacles to greater user coverage and compliance. Specifically, several articles mentioned unclear DPT benefits to affect commitment and to raise fears among different health system actors regarding resource competition. Moreover, media reports indicated process interface challenges such as delays or unclear responsibilities in the notification cascade, as well as misunderstandings and unmet communication needs from health system actors. Finally, reports suggested misaligned incentives, not only for app usage by the public but also for process engagement by other actors in the app notification cascade. NPT provided a well-fitting framework to contextualize the different DPT implementation challenges and to highlight improvement strategies, namely a better alignment of stakeholder incentives, or stakeholder-specific communication to address their concerns about DPT. Conclusions Early experiences from one of the first adopters of DPT indicate that nontechnical implementation challenges may affect the effectiveness of DPT. The NPT analysis provides a novel perspective on DPT implementation and stresses the need for stakeholder inclusion in development and operationalization.

scholarly journals Challenges for non-technical implementation of digital proximity tracing: early experiences from Switzerland (Preprint)

2020 ◽  
Author(s):  
Viktor von Wyl
Keyword(s):  
Health System ◽  
Resource Competition ◽  
Digital Health ◽  
Mitigation Measures ◽  
Contact Tracing ◽  
Implementation Challenges ◽  
Early Experiences ◽  
Multiple Challenges ◽  
Media Reports ◽  
Communication Needs

BACKGROUND Several countries have released digital proximity tracing (DPT) apps in addition to manual contact tracing (MCT) to combat the Sars-CoV-2 pandemic. The goal of DPT is to notify app users about proximity exposures to persons infected with Sars-CoV-2 so that they can self-quarantine. However, early press reports from Switzerland suggest multiple challenges for non-technical DPT implementation. OBJECTIVE Using media articles published during the first three months after the DPT app launch to describe non-technical implementation challenges reported by different stakeholders and to map these reports to the four constructs of normalization process theory (NPT), a framework to develop and evaluate complex digital health interventions. METHODS A Swiss media database was searched for articles on the Swiss DPT app (SwissCovid) published in German or French between 04.07.2020 and 03.10.2020. Topics were extracted manually from articles that were deemed pertinent in a structured process. Extracted topics were mapped to NPT constructs. RESULTS Out of 94 articles deemed pertinent and selected for closer inspection, 38 provided unique information on implementation challenges. These challenges included unclear DPT benefits, which affected commitment and raised fears among different health system actors regarding resource competition with established pandemic mitigation measures. Moreover, media reports indicated process interface challenges such as delays or unclear responsibilities in the notification cascade, as well as misunderstandings and unmet communication needs from certain health system actors. Finally, some reports suggested misaligned incentives, not only for app usage by the public but also for process engagement by other actors in the app notification cascade. These challenges mapped well to the four constructs of NPT. CONCLUSIONS Early experiences from one of the first adopters of DPT indicate that non-technical implementation challenges warrant attention. The detected implementation challenges fit well into the framework of NPT, which seems well suited to guide the development and evaluation of complex DPT interventions.

scholarly journals Challenges for non-technical implementation of digital proximity tracing: early experiences from Switzerland

2020 ◽  
Author(s):  
Viktor von Wyl
Keyword(s):  
Health System ◽  
Resource Competition ◽  
Digital Health ◽  
Mitigation Measures ◽  
Contact Tracing ◽  
Implementation Challenges ◽  
Early Experiences ◽  
Multiple Challenges ◽  
Media Reports ◽  
Communication Needs

AbstractBackgroundSeveral countries have released digital proximity tracing (DPT) apps in addition to manual contact tracing (MCT) to combat the Sars-CoV-2 pandemic. The goal of DPT is to notify app users about proximity exposures to persons infected with Sars-CoV-2 so that they can self-quarantine. However, early press reports from Switzerland suggest multiple challenges for non-technical DPT implementation.ObjectiveUsing media articles published during the first three months after the DPT app launch to describe non-technical implementation challenges reported by different stakeholders and to map these reports to the four constructs of normalization process theory (NPT), a framework to develop and evaluate complex digital health interventions.MethodsA Swiss media database was searched for articles on the Swiss DPT app (SwissCovid) published in German or French between 04.07.2020 and 03.10.2020. Topics were extracted manually from articles that were deemed pertinent in a structured process. Extracted topics were mapped to NPT constructs.ResultsOut of 94 articles deemed pertinent and selected for closer inspection, 38 provided unique information on implementation challenges. These challenges included unclear DPT benefits, which affected commitment and raised fears among different health system actors regarding resource competition with established pandemic mitigation measures. Moreover, media reports indicated process interface challenges such as delays or unclear responsibilities in the notification cascade, as well as misunderstandings and unmet communication needs from certain health system actors. Finally, some reports suggested misaligned incentives, not only for app usage by the public but also for process engagement by other actors in the app notification cascade. These challenges mapped well to the four constructs of NPT.ConclusionsEarly experiences from one of the earliest adopters of DPT indicate that non-technical implementation challenges warrant attention. The detected implementation challenges fit well into the framework of NPT, which seems well suited to guide the development and evaluation of complex DPT interventions.

“PHONE-CONNECT” - A Pilot Program Prescribing Phones to Address Digital Health Equity Needs in the COVID-19 Era (Preprint)

2020 ◽  
Author(s):  
Gill Kazevman ◽  
Marck Mercado ◽  
Jennifer Hulme ◽  
Andrea Somers
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Services ◽  
Access To Health Care ◽  
Health Care Services ◽  
Point Of Care ◽  
Digital Health ◽  
Contact Tracing ◽  
Health Care Intervention ◽  
Care Intervention

UNSTRUCTURED Vulnerable populations have been identified as having higher infection rates and poorer COVID-19 related outcomes, likely due to their inability to readily access primary care, follow public health directives and adhere to self-isolation guidelines. As a response to the COVID-19 pandemic, many health care services have adopted new digital solutions, relying on phone and internet connectivity. Yet, persons who are digitally inaccessible, such as those struggling with poverty or homelessness, are often unable to utilize these services. In response to this newly highlighted social disparity known as “digital health inequity”, emergency physicians at the University Health Network, Toronto, initiated a program called “PHONE CONNECT”. This novel approach attempts to improve patients’ access to health care, information and social services, as well as improve their ability to adhere to public health directives (social isolation and contact tracing). While similar programs addressing the same emerging issues have been recently described in the media, this is the first time phones are provided as a health care intervention in an emergency department. This innovative ED point-of-care intervention may have a significant impact on improving the health outcomes for vulnerable people during the COVID-19 pandemic, and even beyond it.

scholarly journals Spatiotemporal tracing of pandemic spread from infection data

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Satyaki Roy ◽  
Preetom Biswas ◽  
Preetam Ghosh
Keyword(s):  
New York ◽  
Network Inference ◽  
Spatial Interaction ◽  
Time Windows ◽  
New York State ◽  
Mitigation Measures ◽  
Contact Tracing ◽  
Long Distance ◽  
Spatiotemporal Models ◽  
Spread Of Infection

AbstractCOVID-19, a global pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 virus, has claimed millions of lives worldwide. Amid soaring contagion due to newer strains of the virus, it is imperative to design dynamic, spatiotemporal models to contain the spread of infection during future outbreaks of the same or variants of the virus. The reliance on existing prediction and contact tracing approaches on prior knowledge of inter- or intra-zone mobility renders them impracticable. We present a spatiotemporal approach that employs a network inference approach with sliding time windows solely on the date and number of daily infection numbers of zones within a geographical region to generate temporal networks capturing the influence of each zone on another. It helps analyze the spatial interaction among the hotspot or spreader zones and highly affected zones based on the flow of network contagion traffic. We apply the proposed approach to the daily infection counts of New York State as well as the states of USA to show that it effectively measures the phase shifts in the pandemic timeline. It identifies the spreaders and affected zones at different time points and helps infer the trajectory of the pandemic spread across the country. A small set of zones periodically exhibit a very high outflow of contagion traffic over time, suggesting that they act as the key spreaders of infection. Moreover, the strong influence between the majority of non-neighbor regions suggests that the overall spread of infection is a result of the unavoidable long-distance trips by a large number of people as opposed to the shorter trips at a county level, thereby informing future mitigation measures and public policies.

The global refugee crisis and the career ecosystem

2019 ◽  
Vol 25 (1) ◽  
pp. 1-13
Author(s):  
Julia Richardson ◽  
Charlotte M. Karam ◽  
Fida Afiouni
Keyword(s):  
Media Coverage ◽  
Community Dynamics ◽  
Media Analysis ◽  
Host Community ◽  
Refugee Crisis ◽  
Content Type ◽  
Relevant Stakeholder ◽  
Media Reports ◽  
The Impact ◽  
Business Media

Purpose The purpose of this paper is to introduce this special issue about the “Impact of the Global Refugee Crisis on the Career Ecosystem” and summarise the key contributions of the included practitioner and scholarly papers which examine refugee business and labour market experiences. The paper also examines the impact of media reports to provide a broader understanding of the context within which the current refugee crisis is evolving. Design/methodology/approach The authors begin with a delineation of the concept of a career ecosystem in the context of refugee crises. The authors then employ this framing as a backdrop to engage in a basic analysis of business media coverage of the most recent Syrian refugee crisis, and a summary of the practitioner and scholarly papers. Findings The findings of the media analysis suggest major coverage differences between different groups of countries in the number of documents identified, the proposed aim of business engagement with refugees, and substance of the extracted statements generally. Research limitations/implications The analysis of business media coverage is rudimentary and intended only as a prompt for further conversations about how contemporary media commentary impacts on career opportunities for refugees and relevant stakeholder practices. Practical implications This paper demonstrates the importance of including broader considerations of refugee careers that explore the interaction and intersection with transnational and local ecosystem of labour markets while paying attention to the sociocultural and political refugee-host community dynamics. Originality/value This paper presents a more systems-oriented perspective and provides both practice and scholarly perspectives on the composite and dynamic nature of the refugee crisis on career ecosystems more broadly.

scholarly journals Moving Faster than the COVID-19 Pandemic: The Rapid, Digital Transformation of a Public Health System

2021 ◽  
Vol 12 (02) ◽  
pp. 229-236
Author(s):  
Clair Sullivan ◽  
Ides Wong ◽  
Emily Adams ◽  
Magid Fahim ◽  
Jon Fraser ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Digital Transformation ◽  
Contact Tracing ◽  
Programming Approach ◽  
Data Governance ◽  
Application Development ◽  
Containment Strategy

Abstract Background Queensland, Australia has been successful in containing the COVID-19 pandemic. Underpinning that response has been a highly effective virus containment strategy which relies on identification, isolation, and contact tracing of cases. The dramatic emergence of the COVID-19 pandemic rendered traditional paper-based systems for managing contact tracing no longer fit for purpose. A rapid digital transformation of the public health contact tracing system occurred to support this effort. Objectives The objectives of the digital transformation were to shift legacy systems (paper or standalone electronic systems) to a digitally enabled public health system, where data are centered around the consumer rather than isolated databases. The objective of this paper is to outline this case study and detail the lessons learnt to inform and give confidence to others contemplating digitization of public health systems in response to the COVID-19 pandemic. Methods This case study is set in Queensland, Australia. Universal health care is available. A multidisciplinary team was established consisting of clinical informaticians, developers, data strategists, and health information managers. An agile “pair-programming” approach was undertaken to application development and extensive change efforts were made to maximize adoption of the new digital workflows. Data governance and flows were changed to support rapid management of the pandemic. Results The digital coronavirus application (DCOVA) is a web-based application that securely captures information about people required to quarantine and creates a multiagency secure database to support a successful containment strategy. Conclusion Most of the literature surrounding digital transformation allows time for significant consultation, which was simply not possible under crisis conditions. Our observation is that staff was willing to adopt new digital systems because the reason for change (the COVID-19 pandemic) was clearly pressing. This case study highlights just how critical a unified purpose, is to successful, rapid digital transformation.

scholarly journals Modeling the impact of school reopening and contact tracing strategies on Covid-19 dynamics in different epidemiologic settings in Brazil

2021 ◽  
Author(s):  
Marcelo Eduardo Borges ◽  
Leonardo Souto Ferreira ◽  
Silas Poloni ◽  
Ângela Maria Bagattini ◽  
Caroline Franco ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Transmission Rate ◽  
Disease Incidence ◽  
Demographic Data ◽  
School Closure ◽  
Mitigation Measures ◽  
Contact Tracing ◽  
School Closures ◽  
Infection Transmission ◽  
The Impact

Among the various non–pharmaceutical interventions implemented in response to the Covid–19 pandemic during 2020, school closures have been in place in several countries to reduce infection transmission. Nonetheless, the significant short and long–term impacts of prolonged suspension of in–person classes is a major concern. There is still considerable debate around the best timing for school closure and reopening, its impact on the dynamics of disease transmission, and its effectiveness when considered in association with other mitigation measures. Despite the erratic implementation of mitigation measures in Brazil, school closures were among the first measures taken early in the pandemic in most of the 27 states in the country. Further, Brazil delayed the reopening of schools and stands among the countries in which schools remained closed for the most prolonged period in 2020. To assess the impact of school reopening and the effect of contact tracing strategies in rates of Covid–19 cases and deaths, we model the epidemiological dynamics of disease transmission in 3 large urban centers in Brazil under different epidemiological contexts. We implement an extended SEIR model stratified by age and considering contact networks in different settings – school, home, work, and elsewhere, in which the infection transmission rate is affected by various intervention measures. After fitting epidemiological and demographic data, we simulate scenarios with increasing school transmission due to school reopening. Our model shows that reopening schools results in a non–linear increase of reported Covid-19 cases and deaths, which is highly dependent on infection and disease incidence at the time of reopening. While low rates of within[&ndash]school transmission resulted in small effects on disease incidence (cases/100,000 pop), intermediate or high rates can severely impact disease trends resulting in escalating rates of new cases even if other interventions remain unchanged. When contact tracing and quarantining are restricted to school and home settings, a large number of daily tests is required to produce significant effects of reducing the total number of hospitalizations and deaths. Our results suggest that policymakers should carefully consider the epidemiological context and timing regarding the implementation of school closure and return of in-person school activities. Also, although contact tracing strategies are essential to prevent new infections and outbreaks within school environments, our data suggest that they are alone not sufficient to avoid significant impacts on community transmission in the context of school reopening in settings with high and sustained transmission rates.

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