COVID-19 Contact Research Articles

The Extreme Right as a Defender of Human Rights? Parliamentary Debates on COVID-19 Emergency Legislation in Slovakia

During the COVID-19 pandemic, the protection of public health became a political priority worldwide. Slovakia’s COVID-19 response was initially praised as a global success. However, major rights restrictions were introduced in spring 2020, with some of these endorsed by the parliament. This article uses Rossiter’s and Schmitt’s concepts of the exception and Agamben’s distinction between life and survival to highlight the risks pertaining to the framing of the protection of public health as contradictory to human rights guarantees. It investigates how human rights were discussed by Slovak parliamentarians in relation to key legislation, that introduced a COVID-19 contact tracing app and allowed repeated prolongation of health emergencies by the executive with parliamentary approval. The findings indicate that democratic parliamentarians prioritized public health considerations framed in terms of security and effectiveness rather than rights, dissociating biological survival from political life. In contrast, extreme political actors became outspoken critics of emergencies, referring to human rights. As such, the deliberations represent a missed opportunity by democratic legislators to justify public health protection via a human rights lens and risk undermining democracy in Slovakia.

Factors impacting the use of the NZ COVID Tracer application in New Zealand".

The COVID-19 pandemic has clearly created devastating damage on world economics and public health. This project identifies key concerns of end-users toward the NZ COVID-19 contact tracing app in New Zealand. The key research objective in this study is to understand the usage behaviour towards the mobile application NZ COVID-19 Tracer used for contact tracing purposes. Secondly, the study explores the reasons for using the contact tracing app. Thirdly, it examines the relationship between usage behaviour of the NZ-COVID Tracer app with age, the user's perceived health, attitude towards COVID-19, whether family or friends are infected by COVID-19, trust in maintaining social distancing, trust in data privacy, smartphone usage and the media's role in motivating people to use this app. Consequently, understanding these issues and challenges could help improve the usage of this contact tracing app, which in turn would contribute to better public health outcomes in disease management and containment.Findings of the study reveals that age, smartphone usage behaviour, and trust in privacy data protection from the app provider has a statistically significant relationship on usage behaviour of the NZ COVID Tracer app. Self-perceived health status and attitudes towards the COVID-19 pandemic did not have a significant relationship on NZ COVID Tracer app usage behaviour. While social media, such as Facebook, has been shown to be the most popular source of news for COVID-19 among New Zealanders, it is television that acted as a motivational tool to encourage people to use the contact tracing mobile application and to practice other measures to help protect against the COVID-19 pandemic.

Different performance of three point-of-care SARS-CoV-2 antigen detection devices in symptomatic patients and close asymptomatic contacts: a real-life study

ObjectivesPCR on nasopharyngeal exudates, the cornerstone of the detection of SARS-CoV-2, is time-consuming and commonly unavailable at primary health care centres. Detection of viral nucleocapsid antigens using lateral flow point-of-care tests is helpful for the early triage of patients who attend health care facilities. MethodsThis was a prospective study carried out in clinically suspected cases and close asymptomatic contacts who attended a primary care centre (Madrid, Spain) for SARS-CoV-2 detection. Patients were divided into three 300-patient cohorts (n = 200 symptomatic cases and n = 100 close asymptomatic contacts per cohort). Three antigen detection tests (SGTI-Flex COVID-19 Ag, Panbio COVID-19 Ag Rapid Test Device, and GSD NovaGen SARS-CoV-2 Ag Rapid Test) were used and compared. Paired nasopharyngeal exudates were obtained, one swab for PCR and the other for antigen detection. Each antigen detection test was evaluated on one cohort. ResultsAll tests showed invariably 100% specificity. Sensitivity was 68.9% (95% CI: 55.7–80; SGTI-Flex), 71.1% (95% CI: 55.6–83.6; Panbio), and 84.6% (95% CI: 72–93.1; NovaGen) in clinically suspected patients and 84.6% (95% CI: 54.5–98.1), 33.3% (95% CI: 11.8–61.6), and 55.6% (95% CI: 30.7–78.4) in close asymptomatic contacts, respectively. Sensitivity was systematically higher in samples yielding positive PCR results with Ct ≤ 20. DiscussionWe found considerable test-to-test antigen detection variations among patients with clinical suspicion of COVID-19 and close asymptomatic contacts. Negative antigen results, regardless of the test used, should be confirmed by PCR.

The Investigation of Awareness And Knowledge In Patient With Severe Mental Illnesses On COVID-19 Pandemic

Purpose: We aimed to investigate the Covid-19 awareness, contact status and COVID-19 testing practices of SMI patients. Following the rules on infection, a face-to-face questionnaire was conducted with 203 patients with bipolar disorder and schizophrenia. Material and Methods: Participants were evaluated with a questionnaire that ınquıres COVID-19 knowledge and awareness, contact history and COVID-19 testing created by researchers Results: : It was observed that the rate of COVID-19 testing was 30% in participants with at least 1 symptom, and 50% in those who were in contact with someone infected with Covid-19. It was observed that those whose COVID-19 information source was TV and social media were more familiar with the COVID-19 terminology than those whose information source was primary caregivers. Conclusion: This study specifically measured the knowledge and awareness of SMI group patients and demonstrated the COVID-19 testing practice. Conducting specific studies for these groups and developing strategies will contribute to better management of both current and future crises.

One for all, all for one: Social considerations in user acceptance of contact tracing apps using longitudinal evidence from Germany and Switzerland

We propose a conceptual model of acceptance of contact tracing apps based on the privacy calculus perspective. Moving beyond the duality of personal benefits and privacy risks, we theorize that users hold social considerations (i.e., social benefits and risks) that underlie their acceptance decisions. To test our propositions, we chose the context of COVID-19 contact tracing apps and conducted a qualitative pre-study and longitudinal quantitative main study with 589 participants from Germany and Switzerland. Our findings confirm the prominence of individual privacy calculus in explaining intention to use and actual behavior. While privacy risks are a significant determinant of intention to use, social risks (operationalized as fear of mass surveillance) have a notably stronger impact. Our mediation analysis suggests that social risks represent the underlying mechanism behind the observed negative link between individual privacy risks and contact tracing apps' acceptance. Furthermore, we find a substantial intention–behavior gap.

Sensitivity of contact-tracing for COVID-19 in Thailand: a capture-recapture application

BackgroundWe investigate the completeness of contact tracing for COVID-19 during the first wave of the COVID-19 pandemic in Thailand, from early January 2020 to 30 June 2020.MethodsUni-list capture-recapture models were applied to the frequency distributions of index cases to inform two questions: (1) the unobserved number of index cases with contacts, and (2) the unobserved number of index cases with secondary cases among their contacts.ResultsGeneralized linear models (using Poisson and logistic families) did not return any significant predictor (age, sex, nationality, number of contacts per case) on the risk of transmission and hence capture-recapture models did not adjust for observed heterogeneity. Best fitting models, a zero truncated negative binomial for question 1 and zero-truncated Poisson for question 2, returned sensitivity estimates for contact tracing performance of 77.6% (95% CI = 73.75–81.54%) and 67.6% (95% CI = 53.84–81.38%), respectively. A zero-inflated negative binomial model on the distribution of index cases with secondary cases allowed the estimation of the effective reproduction number at 0.14 (95% CI = 0.09–0.22), and the overdispersion parameter at 0.1.ConclusionCompleteness of COVID-19 contact tracing in Thailand during the first wave appeared moderate, with around 67% of infectious transmission chains detected. Overdispersion was present suggesting that most of the index cases did not result in infectious transmission chains and the majority of transmission events stemmed from a small proportion of index cases.

Framing ethical issues associated with the UK COVID-19 contact tracing app: exceptionalising and narrowing the public ethics debate

This paper explores ethical debates associated with the UK COVID-19 contact tracing app that occurred in the public news media and broader public policy, and in doing so, takes ethics debate as an object for sociological study. The research question was: how did UK national newspaper news articles and grey literature frame the ethical issues about the app, and how did stakeholders associated with the development and/or governance of the app reflect on this? We examined the predominance of different ethical issues in news articles and grey literature, and triangulated this using stakeholder interview data. Findings illustrate how news articles exceptionalised ethical debate around the app compared to the way they portrayed ethical issues relating to ‘manual’ contact tracing. They also narrowed the debate around specific privacy concerns. This was reflected in the grey literature, and interviewees perceived this to have emerged from a ‘privacy lobby’. We discuss the findings, and argue that this limited public ethics narrative masked broader ethical issues.

Stopping the Spread? Enhancing Legal Frameworks for the Protection of Personal Information in the Context of COVID-19 Contact Tracing

Personal privacy versus public safety is a rights trade-off that has been brought into sharp focus by the COVID-19 pandemic, with flow-on implications for the success of contract tracing regimes implemented across Australia. These contact tracing regimes depend upon the supply of accurate information by individuals, which in turn depends upon the trust that is placed in health authorities and other government officials to handle personal information with care. A range of different laws govern the collection and use of personal information by health authorities at the federal level and in each Australian state or territory. Understanding these rules might help us to work out ways to ensure that everyone in our community feels like they can tell the truth when it matters most. Using a case study from South Australia, this article reviews existing legislative, regulatory and policy frameworks that currently apply to the collection and use of personal information in health care and highlights the tension between creating incentives to share personal information and policing compliance with COVID-19 laws and ensuring robust legal protection for sensitive personal information. Relevant lessons from the South Australian experience are then extrapolated for consideration by other Australian jurisdictions, with a view to identifying what safeguards and protections could be included in current legal frameworks governing the use, sharing and disclosure of personal information in health care settings to help resolve the current tension between protecting individual privacy and promoting public health.

COVID-19, policy change, and post-pandemic data governance: a case analysis of contact tracing applications in East Asia

Abstract In an era of digitalization, governments often turn to digital solutions for pressing policy issues, and the use of digital contact tracing and quarantine enforcement for COVID-19 is no exception. The long-term impacts of the digital solutions, however, cannot be taken for granted. The development and use of data tools for pandemic control, for example, may have potentially detrimental and irreversible impacts on data governance and, more broadly, society, in the long run. In this paper, we aim to explore the extent to which COVID-19 and digital contact tracing have led to policy change in data governance, if at all, and what the implications of such change would be for a post-COVID world. We compare the use of contact tracing and monitoring applications across mainland China, Hong Kong, and Singapore to illustrate both the enormous benefits and potential risks arising from the design of contact tracing applications and the involvement of stakeholders in the various stages of the policy cycle to combat the COVID-19 pandemic. We argue that, while COVID-19 has not changed the nature of issues, such as public trust in data governance, the increasing involvement of big tech in data policies, and data privacy risks, it has exacerbated those issues through the accelerated adoption of data technologies.

Optimising partner notification outcomes for bacterial sexually transmitted infections: a deliberative process and consensus, United Kingdom, 2019.

Partner notification (PN) is an essential element of sexually transmitted infection (STI) control. It enables identification, treatment and advice for sexual contacts who may benefit from additional preventive interventions such as HIV pre- and post-exposure prophylaxis. PN is most effective in reducing STI transmission when it reaches individuals who are most likely to have an STI and to engage in sexual behaviour that facilitates STI transmission, including having multiple and/or new sex partners. Outcomes of PN practice need to be measurable in order to inform standards. They need to address all five stages in the cascade of care: elicitation of partners, establishing contactable partners, notification, testing and treatment. In the United Kingdom, established outcome measures cover only the first three stages and do not take into account the type of sexual partnership. We report an evidence-based process to develop new PN outcomes and inform standards of care. We undertook a systematic literature review, evaluation of published information on types of sexual partnership and a modified Delphi process to reach consensus. We propose six new PN outcome measures at five stages of the cascade, including stratification by sex partnership type. Our framework for PN outcome measurement has potential to contribute in other domains, including Covid-19 contact tracing.

COVID-19 Case Investigation and Contact Tracing Programs and Practice: Snapshots From the Field.

Between Fall 2020 and Spring 2021, the Association of State and Territorial Health Officials conducted 2 rapid queries to collect information from the field regarding the status of COVID-19 case investigation and contact tracing (CI/CT) programs and practice. These short surveys were distributed to senior deputies in state and territorial health agencies, yielding a response rate of 45.8% (November 2020) and 40.7% (April 2021). Findings indicated that CI/CT staff roles and assigned functions varied across jurisdictions, as did staffing levels/capacity, approaches for linking individuals to social supports, and program changes that were planned or underway. Agency-reported staffing levels/capacity and programmatic challenges changed over time, highlighting the dynamic nature of CI/CT program practice and implementation. While findings from the surveys cannot be generalized to the national level, they provide critical insights from the field on CI/CT program implementation, challenges, and changes in response to the evolving COVID-19 epidemic in the United States.

Reasons for Nonuse, Discontinuation of Use, and Acceptance of Additional Functionalities of a COVID-19 Contact Tracing App: Cross-sectional Survey Study.

BackgroundIn several countries, contact tracing apps (CTAs) have been introduced to warn users if they have had high-risk contacts that could expose them to SARS-CoV-2 and could, therefore, develop COVID-19 or further transmit the virus. For CTAs to be effective, a sufficient critical mass of users is needed. Until now, adoption of these apps in several countries has been limited, resulting in questions on which factors prevent app uptake or stimulate discontinuation of app use.ObjectiveThe aim of this study was to investigate individuals’ reasons for not using, or stopping use of, a CTA, in particular, the Coronalert app. Users’ and nonusers’ attitudes toward the app’s potential impact was assessed in Belgium. To further stimulate interest and potential use of a CTA, the study also investigated the population’s interest in new functionalities.MethodsAn online survey was administered in Belgium to a sample of 1850 respondents aged 18 to 64 years. Data were collected between October 30 and November 2, 2020. Sociodemographic differences were assessed between users and nonusers. We analyzed both groups’ attitudes toward the potential impact of CTAs and their acceptance of new app functionalities.ResultsOur data showed that 64.9% (1201/1850) of our respondents were nonusers of the CTA under study; this included individuals who did not install the app, those who downloaded but did not activate the app, and those who uninstalled the app. While we did not find any sociodemographic differences between users and nonusers, attitudes toward the app and its functionalities seemed to differ. The main reasons for not downloading and using the app were a perceived lack of advantages (308/991, 31.1%), worries about privacy (290/991, 29.3%), and, to a lesser extent, not having a smartphone (183/991, 18.5%). Users of the CTA agreed more with the potential of such apps to mitigate the consequences of the pandemic. Overall, nonusers found the possibility of extending the CTA with future functionalities to be less acceptable than users. However, among users, acceptability also tended to differ. Among users, functionalities relating to access and control, such as digital certificates or “green cards” for events, were less accepted (358/649, 55.2%) than functionalities focusing on informing citizens about the spread of the virus (453/649, 69.8%) or making an appointment to get tested (525/649, 80.9%).ConclusionsOur results show that app users were more convinced of the CTA’s utility and more inclined to accept new app features than nonusers. Moreover, nonusers had more CTA-related privacy concerns. Therefore, to further stimulate app adoption and use, its potential advantages and privacy-preserving mechanisms need to be stressed. Building further knowledge on the forms of resistance among nonusers is important for responding to these barriers through the app’s further development and communication campaigns.

AI Applications and Regulation: Mapping the Regulatory Strata

Many accounts suggest that artificial intelligence (AI) law is still in its infancy with few statutes and other regulatory instruments regulating AI development and use. In this paper, we argue that such accounts are misguided. AI applications exist in a rich regulatory landscape, subject to multiple rules. To demonstrate our claim, we conduct two semi-fictional case studies under Finnish law. In the first case study, we chart the rules that currently would govern and impact AI tool use in recruitment. In the second case study, we map the legal framework for the Finnish COVID-19 contact tracing app. The article makes three contributions to the literature. First, the case studies provide ample evidence that the prevailing orthodoxy misstates the state of AI law. There is AI law on the books and existing laws have a profound impact on AI application design. Second, the mappings provide building material for developing a grounded theory framework for categorizing AI law and its types and modalities, allowing us to formulate a heuristic for understanding AI regulation. We argue that developers and AI application stakeholders should construe AI law as a complex stratigraphy consisting of five layers: data rules that regulate data use, application-specific AI rules that target specific AI applications or application domains, general AI rules that apply to a wide range of AI applications, application-specific non-AI rules that apply to specific activities but not to AI specifically and general non-AI rules that apply generically and across domains. Third, we provide guidance for practitioners for structuring AI compliance processes. We argue that practitioners should keep in mind that the rules and standards differ in their scopes, targets, certainty, and regulatory modalities. Consequently, understanding the AI regulatory landscape requires developing an understanding of multiple rule complexes, their dynamics, and regulatory modalities.

Cross-reactive memory T cells associate with protection against SARS-CoV-2 infection in COVID-19 contacts

Cross-reactive immune responses to SARS-CoV-2 have been observed in pre-pandemic cohorts and proposed to contribute to host protection. Here we assess 52 COVID-19 household contacts to capture immune responses at the earliest timepoints after SARS-CoV-2 exposure. Using a dual cytokine FLISpot assay on peripheral blood mononuclear cells, we enumerate the frequency of T cells specific for spike, nucleocapsid, membrane, envelope and ORF1 SARS-CoV-2 epitopes that cross-react with human endemic coronaviruses. We observe higher frequencies of cross-reactive (p = 0.0139), and nucleocapsid-specific (p = 0.0355) IL-2-secreting memory T cells in contacts who remained PCR-negative despite exposure (n = 26), when compared with those who convert to PCR-positive (n = 26); no significant difference in the frequency of responses to spike is observed, hinting at a limited protective function of spike-cross-reactive T cells. Our results are thus consistent with pre-existing non-spike cross-reactive memory T cells protecting SARS-CoV-2-naïve contacts from infection, thereby supporting the inclusion of non-spike antigens in second-generation vaccines.

Management skin manifestation of multisystem inflammatory syndrome associated with SARS-CoV-2

BackgroundMultisystem inflammatory syndrome (MIS), which develops after a past covid-19 infection. MIS can be described in different tissue inflammation, including the heart, lung, kidney, brain, skin, eye, and or gastrointestinal organs at the presence of COVID-19. Initially, MIS was described in Europe in children infected with SARS-CoV-2, then it was recently seen in the USA in 2020. MIS is a rare but serious disease condition associated with COVID-19 that can affect children (MIS-C) and adults (MIS-A).Case presentationA 44-year-old male who showed MIS-A in 59-day after his first covid-19 contact history. The patient presented to our emergency department with complaints of high fever, nausea, weakness, redness of the eyes, headache, and joint pain. On the second day of his hospitalization, a maculopapular skin lesion was seen in most of the skin. His fever could not be controlled even given paracetamol and broad effective antibiotics. His clinical, radiological, and laboratory findings showed that he had MIS-A. The patient was given intravenous pulse methylprednisolone and intravenous immunoglobulin (IVIG). These treatments, then, resulted in improvement of his clinical conditions, including fever and skin lesions, on the second day of the treatment. The patient was discharged in 14 days after the treatment.ConclusionThis report indicated that diagnosis and treatment of MIS-A could result in reducing patient morbidity and mortality.

Prognostic Value of Cardiac Biomarkers in Children with Acute Bronchiolitis

Introduction: Determining the severity of acute bronchiolitis in children is important for the clinical management of the disease. Therefore, we aimed to reveal their prognostic importance by examining cardiac markers in our patients with acute bronchiolitis. Materials and Methods: We conducted a single-center retrospective, observational study with children with acute bronchiolitis between 1 month and 2 years of age, between December 2020 and December 2021, who were covid-19 PCR test negative and had no covid-19 contact. We scanned demographic, clinical and laboratory parameters from medical records. Results: A total of 45 (44% female) children with acute bronchiolitis, a median (IQR) age of 5 (5) months were included in the study. There were 7 (16%) mild bronchiolitis, 23 (51%) moderate and 15 (33%) severe bronchiolitis patients. The cutoff point of Nt-proBNP to be ≥1025 ng/L to predict severe bronchiolitis with a sensitivity of 71% and a specificity of 80 % at admission in children with acute bronchiolitis. Conclusion: We think that the threshold value for Nt-proBNP in the study can be used to identify patients with severe bronchiolitis in the early period and to reduce mortality and morbidity by earlier intervention.

Post-COVID multisystem inflammatory syndrome in adults: a study from a tertiary care hospital in south India.

There are limited data from India on the post-COVID multisystem inflammatory syndrome in adults (MIS-A). The objective of the present study was to evaluate the clinical profile of patients with MIS-A admitted to a tertiary care centre in southern India. This single-centre retrospective study was conducted from November 2020 to July 2021, and included patients aged >18 yr admitted to the hospital as per the inclusion and exclusion criteria. Nine patients (5 male, mean age 40±13 yr) met the criteria for MIS-A. Five patients had proven COVID-19 infection or contact history 36.8±11.8 days back. All patients were positive for SARS-CoV-2 IgG antibody, negative for COVID-19 PCR, and had negative blood, urine and sputum cultures. All patients had fever and gastrointestinal (GI) symptoms, and five patients had left ventricular dysfunction. All patients had neutrophilic leucocytosis at presentation and elevated biomarkers such as C-reactive protein serum procalcitonin, D-dimer and ferritin. The majority of the patients (7/9 i.e. 77.78%) were treated with intravenous hydrocortisone (50-100 mg q6h-q8h). Six patients recovered completely whereas three patients expired. Fever and GI symptoms were the most common presentation of MIS-A. Elevated serum procalcitonin may not be useful in differentiating bacterial sepsis from MIS-A. Most patients responded to corticosteroids.

The Relative Importance of Equity and Efficiency in the Design and Performance Management of COVID-19 Contact Tracing Programmes: A Discrete Choice Experiment

The Relative Importance of Equity and Efficiency in the Design and Performance Management of COVID-19 Contact Tracing Programmes: A Discrete Choice Experiment

An Effective Communication Strategy Based on Trust: the Key Element to Adopting a Covid-19 Contact Tracking Application

To cope with the COVID-19 pandemic, contact tracing applications have been proposed to limit positive cases and reinforce other measures, especially before the appearance of vaccines. A high rate of adoption by citizens is required. This study investigates the impact of trust on the adoption of tracking applications. A survey was administered in Morocco, where the authorities proposed the «Wiqaytna» application. Structural Equation Modeling was used to test the hypotheses of the proposed model. The model explains 53% of the variance of the “intention to use” and 40.8% of the “actual use” of the application. The model was based on the UTAUT technology acceptance model and the GAM model of e-gov service acceptance. Our main objective was to study the impact of trust in the decision of Moroccans to use this type of application. Technology trust, government trust and social influence were important determinants of intention to use. The proposed model also shows that perceived awareness is an important antecedent of trust constructs. The impact of «perceived awareness» on the trust constructs (technology and government) is stronger than the social influence on the latter. Moreover, our model shows that «Perceived Awareness» has a more significant impact on «technology trust» than on «government trust». Due to their lack of interest (in seeking information) and attention (communications on the application), citizens lack information about the application's usefulness and the security of users' data. Even those who have had contact with the information they are looking for cannot often verify its credibility (e.g. the source code of the «Wiqaytna» application was available on Github). Therefore, cognitive and individual factors give way to social influence, and the intention to use becomes dependent on the norms and suggestions of influential people in the individual's environment. The latter construct is complex and has multiple determinants. Several factors act on the construction of trust in the authorities' quality of public services. Finally, the strongest relationship in the model is the effect of intention to use on using the Wiqaytna application. Based on these findings, suggestions are made for policymakers. First, a significant effort must be made to improve citizens' awareness of the importance of such an application for the control of the pandemic, even after the launch of the vaccination campaign and the application of social distancing measures. Indeed, a few posters here and there and a few commercials are not enough. An effective communication strategy must be built to explain to citizens the critical role these applications can play and reduce fears about citizens' privacy to increase the adoption rate of these applications. Secondly, the role of social influence is critical in adopting applications. This must be considered in communication campaigns and the involvement of opinion leaders and influencers to be more effective and increase the intention to use them.

Aarogya Setu - Digitized COVID-19 contact tracing in India with infinite possibilities.

Aarogya Setu - Digitized COVID-19 contact tracing in India with infinite possibilities.