COVID-19 Contact Research Articles

Clinical case of severe COVID-19 in a child with morbid obesity

The pandemic of coronavirus infection is characterized by a low percentage of complications and severe forms in sick children compared to the adult population. However, there have been described cases of severe clinical course of COVID-19 in children with comorbidities among which is obesity. The aim of this study was to analyze the severe course of a new coronavirus infection paralleled with morbid obesity in a pediatric patient. Materials and methods. All accompanying patient medical documentation was examined. Results and discussion. From the anamnesis of life it is known that the patient was long time complained of intensively increased body weight, on which she repeatedly underwent examinations. In 2018, hypothalamic pubertal syndrome was diagnosed for the first time, for which the patient received hypoglycemic and antihypertensive drugs, hepatoprotectors on an ongoing basis. In the epidemiological anamnesis, the intrafamilial COVID-19 contact with mother was established. The main disease began acutely with a rise in body temperature up to 3939.5C, cough and weakness. During the first week of illness, the patient did not seek medical help and receive self-treatment, but the positive effect was not achieved. Saturation measurement showed low oxygen level (SpO2 71%). In this regard, the patient underwent chest computed tomography, which revealed a bilateral interstitial polysegmental lung lesion with signs of consolidation. After emergency hospitalization, the patient was prescribed empiric antibiotic therapy, anti-inflammatory and antithrombotic treatment, as well as respiratory support. A positive PCR result of a throat and nasal swab for SARS-CoV-2 was obtained in the hospital. Due to a poor response to therapy, the patient was transferred to a respiratory hospital. At the time of hospitalization, the condition was considered severe due to severe respiratory failure and premorbidity. The range of treatments included oxygenotherapy, antibacterial and anticoagulation therapy, as well as surfactant and the nucleoside analogue Remdesivir. During treatment, the clinical picture gained a positive trend, and after 6 days of hospitalization the patient no longer needed respiratory support. According to the results of repeated computed tomography, bilateral interstitial polysegmental pneumonia was diagnosed with damage to the lung tissue up to 95%. The patient remained stable and showed no signs of respiratory failure during the following days of hospitalization. On the 20th day of ilness, the patient was discharged from hospital with full clinical recovery. Conclusion. This clinical case demonstrates the role of premorbid background in aggravating the clinical picture of a new coronavirus infection in a child. Careful study of anamnestic characteristics is necessary in patients of any age, even with an uncomplicated disease course.

Sero-Detection of Sars-Cov-2 Antibodies and some Associated Risk Factors among Staff of Federal University Gusau, Zamfara State, Nigeria

This study was aimed at detecting the level of SARS-CoV-2 antibody response among the staff of Federal University Gusau, Zamfara State. A cross-sectional study design and clusteredstratified-random sampling strategy were used to sample staff of the University comprising academic, technical and non-academic staff. SARS CoV-2 antigen Rapid Tests were carried out using on the spot analysis of nasopharyngeal and blood samples of the participants using SARS-CoV-2 antigen RDT kits and total antibody ELISA kit. None of the samples collected was positive to the antigen RDT kit, however further confirmation with ELISA kit revealed a prevalence of 32.8%. This study showed that academic staffs are more exposed to SARS-CoV-2 viruses due to high incidence of antibodies detected among the academics; however, the difference in the prevalence between academic and non-academic staff was not statistically significant. Knowledge of SARS-CoV-2, belief, behaviour towards COVID19 protocols, contact history and flu-like symptoms were risk factors that predispose one to SARS-CoV-2 viruses.

Analysis of the strategies used by iranian nurses for management of provided care for patients with COVID- 19: a qualitative study

BackgroundNurses have been at the center of managing the COVID-19 outbreak through direct bedside care in respiratory, emergency and intensive care environments, managing hospital units, providing Covid-19 testing, vaccination and contact tracing. Thus, the present study aimed to analysis the strategies used by Iranian nurses for management of Provided Care for patients with COVID- 19.MethodsThe present study was conducted based on the conventional content analysis method and Graneheim & Lundman approach. The participants included the nurses working in the COVID-19 wards and were recruited by purposeful sampling and based on inclusion criteria. The data were collected by conducting semi-structured, in-depth, one-to-one interviews until reaching data saturation.ResultsIn-depth interviews with 10 nurses represented four main categories and fifteen subcategories. Four main categories emerged in this study i.e. “justice in human resources management”, “The art and science of comprehensive nursing care”, “managers as agents of change in crisis” and “challenges and its management”.ConclusionThe nurses’ experiences of management strategies showed that paying attention to the financial, psychological, educational, equipment needs of nurses and maintaining their safety make the suitable environment for providing high quality care for patients with covid-19.

Asymptomatic and Mild SARS-CoV-2 Infections in a Hungarian Outpatient Cohort in the First Year of the COVID-19 Pandemic.

We aimed to estimate the proportion of the population infected with SARS-CoV-2 in the first year of the pandemic. The study population consisted of outpatient adults with mild or no COVID-19 symptoms and was divided into subpopulations with different levels of exposure. Among the subpopulation without known previous COVID-19 contacts, 4143 patients were investigated. Of the subpopulation with known COVID-19 contacts, 594 patients were investigated. IgG- and IgA-seroprevalence and RT-PCR positivity were determined in context with COVID-19 symptoms. Our results suggested no significant age-related differences between participants for IgG positivity but indicated that COVID-19 symptoms occurred most frequently in people aged between 20 and 29 years. Depending on the study population, 23.4-74.0% PCR-positive people (who were symptomless SARS-CoV-2 carriers at the time of the investigation) were identified. It was also observed that 72.7% of the patients remained seronegative for 30 days or more after their first PCR-positive results. This study hoped to contribute to the scientific understanding of the significance of asymptomatic and mild infections in the long persistence of the pandemic.

Nurses' experiences of managing COVID-19 contact tracing clinics in a tertiary care hospital.

The COVID-19 pandemic spread rapidly globally, making the WHO to declare it a public health emergency of international concern. The ability of health institutions to screen and test for COVID-19 has been critical in detecting, preventing, and managing the spread of the disease. This report documents lessons from the ambulatory care nursing for COVID-19 contact tracing at a tertiary care hospital. In March 2020, a multidisciplinary team consisting of staff of the Primary Healthcare Services, Ambulatory Care Center, Infection Prevention and Control Department, and Nursing Services at the Ministry of National Guard Health Affairs in Riyadh, Saudi Arabia, worked collaboratively to establish 2 dedicated COVID-19 contact tracing clinics away from hospital premises, one clinic established for the public and another for hospital staff. Surveillance system was established to detect and contain as many cases as possible. This report highlights the process of establishing and maintaining the structure and managing workflow of the contact tracing clinics. We calculated the number of nasopharyngeal swabs and the daily average number of patient visits for both clinics between March 2020 and March 2021. Over the one-year period, the clinics served 79 146 visitors with an average of 52 visits for staff, 159 visits for adults, and 16 visits for children per day. The 2 clinics conducted 73 924 polymerase chain reaction tests. There was zero transmission of COVID-19 infection to staff working at both clinics. Despite the challenge of setting up contact tracing clinics, the decision to use separate geographic locations contributed to reducing the risk of infection exposure among staff of the clinics. Effective implementation of contact tracing interventions relies on interdepartmental cooperation and effective communication to contain the risk of viral spread.

Challenges of COVID-19 Case Investigation and Contact Tracing in School Settings: An Initial Investigation.

Case investigation and contact tracing (CI/CT) are important public health tools to interrupt COVID-19 transmission. Our study aims to understand how parents and school staff perceive COVID-19 CI/CT. Using a mixed methods approach, we distributed a community survey and conducted 15 focus group discussions (FGDs) in English and Spanish between December 2020 and March 2021 with 20 parents and 22 staff from schools in San Diego County ZIP Codes with COVID-19 rates in the top quintile as of August 2020. One in 4 survey respondents reported that they would be reluctant to participate in CI/CT. FGDs revealed themes of mistrust in government authorities, overburdened institutions, unfamiliarity with CI/CT, and uncertainty about its reliability. School community members emphasized that parents trust schools to be involved in CI/CT efforts, but schools are overwhelmed with this added responsibility. Investing in schools as community hubs is necessary so they can become important partners in prevention and mitigation in public health.

Barriers to COVID-19 contact tracing: View from frontline healthcare students in Vietnam.

In the context of the complicated continuous waves of the COVID-19 pandemic in Vietnam, contact tracing, along with social distancing and lock-down, proved its crucial role in the suppression of epidemic spreading and management. With the high demand for responsiveness, healthcare students were constantly involved in the process, and challenges have emerged along the way. This study aims to identify the barriers faced by healthcare students while performing the contact tracing task at the frontline of the pandemic. A qualitative study was conducted in July 2021 in a health center in Binh Duong province, Vietnam. A total of 20 healthcare students were invited through random recruitment of participants and interviewed until the principle of saturation was reached. Three main barriers were identified including ineffective work management of local managers, lack of capability of human resources and facilities, and uncooperative attitude of local residents. Given the existing barriers, cooperative, innovative strategies, shared data systems, and timely public awareness campaigns, especially among primary health centers of the healthcare system, are imperative to reduce the workload and optimize the efficacy of healthcare students' support.

Experiences with COVID-19 case investigation and contact tracing: A qualitative analysis

Case investigation and contact tracing (CI/CT) is a critical part of the public health response to COVID-19. Individuals’ experiences with CI/CT for COVID-19 varied based on geographic location, changes in knowledge and guidelines, access to testing and vaccination, as well as demographic characteristics including age, race, ethnicity, income, and political ideology. In this paper, we explore the experiences and behaviors of adults with positive SARS-CoV-2 test results, or who were exposed to a person with COVID-19, to understand their knowledge, motivations, and facilitators and barriers to their actions. We conducted focus groups and one-on-one interviews with 94 cases and 90 contacts from across the United States. We found that participants were concerned about infecting or exposing others, which motivated them to isolate or quarantine, notify contacts, and get tested. Although most cases and contacts were not contacted by CI/CT professionals, those who were reported a positive experience and received helpful information. Many cases and contacts reported seeking information from family, friends, health care providers, as well as television news and Internet sources. Although participants reported similar perspectives and experiences across demographic characteristics, some highlighted inequities in receiving COVID-19 information and resources.

Preparedness Plan Ensures Dental Service Sustainability During a Public Health State of Emergency

Background In early 2020, the COVID-19 pandemic emerged bringing risk of disease, disability and death to all Americans. As public health officials scrambled to respond, dental offices were shuttered leaving little access to dental care.Methods Collaborating with medical colleagues and partnering with the local public health department, the Asian Health Services (AHS) dental team developed a preparedness plan to ensure the safe and effective ongoing delivery of oral health care services, respond to the national public health state of emergency and support local public health efforts to contain the pandemic.Results AHS dental services remained operational throughout the COVID-19 pandemic due to the swift and strategic response of the dental team. COVID-19 contact tracing, testing and vaccination became new services rendered by dental personnel, which are now integrated into policies, programs and services. Professional education and training were also updated to ensure sustained preparedness.Conclusions By having a comprehensive and coordinated preparedness plan in place, AHS was able to effectively support public health efforts and serve the oral health care needs of the community.Practical Implications Preparedness efforts implemented by a coordinated effort between AHS’s medical and dental leadership in cooperation with local public health officials during the recent COVID-19 pandemic may serve as a future model for all health care professionals.

Modeling COVID-19 contact-tracing using the ratio regression capture-recapture approach.

Contact-tracing is one of the most effective tools in infectious disease outbreak control. A capture-recapture approach based upon ratio regression is suggested to estimate the completeness of case detection. Ratio regression has been recently developed as flexible tool for count data modeling and has proved to be successful in the capture-recapture setting. The methodology is applied here to Covid-19 contact tracing data from Thailand. A simple weighted straight line approach is used which includes the Poisson and geometric distribution as special cases. For the case study data of contact tracing for Thailand, a completeness of 83% could be found with a 95% confidence interval of 74%-93%.

The impact of COVID-19 on social inequalities in German higher education. An analysis of dropout intentions of vulnerable student groups

ABSTRACT Due to the COVID-19 pandemic, contact, education, and employment opportunities have fundamentally changed worldwide. However, various studies have pointed out that not everyone is equally affected by the changed circumstances. This paper focuses on the impact of the pandemic on the study situation in German higher education and explores the question to what extent the pandemic has led to increasing or decreasing social inequalities. Building on social stratification research and Tinto’s model of social and academic integration we focus on dropout intentions of traditionally disadvantaged student groups – students with disabilities, with children, from families with lower levels of education, and with a migrant background. Based on comparable data from a German-wide representative student survey ‘Studying in Corona Times’ (2020) and data from the ‘21st Social Survey’ (2016) our analysis shows to what extent the outbreak of the COVID-19 pandemic has influenced students’ dropout intentions in Germany and which vulnerable student groups are particularly affected. The results of our logistic regression analysis indicate that compared to 2016 social inequalities in dropout intention have increased significantly in all vulnerable student groups. In particular, students with disabilities and students with children have a higher risk of intending to drop out in 2020.

Acceptability and Effectiveness of COVID-19 Contact Tracing Applications: A Case Study in Saudi Arabia of the Tawakkalna Application.

Background Contact tracing applications were introduced during the COVID-19 pandemic to mitigate the spread of the infection in several countries. In Saudi Arabia, the Tawakkalna application was developed. The Tawakkalna application is a mobile health solution aimed to track infection cases, save lives, and reduce the burden on health facilities. This study aims to explore the public's attitude to and acceptance levels of the Tawakkalna application and to evaluate its effectiveness regarding privacy and security. The main objective of this study is to investigate the user acceptability of contact tracing applications and explore the safety and privacy effectiveness of the COVID-19 contact tracing application, the Tawakkalna application. In addition, the study analyzes factors associated with acceptance levels and compares the results obtained to similar studies in other countries using similar applications. Methodology This study used a valid and reliable online survey that was used in similar studies conducted in other countries to assess the acceptability of the application. The survey was conducted from September to November 2021, and the final dataset included 205 participants. To investigate the privacy and security performance of the Tawakkalna application, we followed the investigation method used by similar research that investigated 28 contact tracing applications across Europe. Results Out of the 205 participants, 84.87% were in favor of the opt-in voluntary installation of the Tawakkalna application, and 49.75% of the participants were in favor of the opt-out automatic installation. Individuals' trust in the government had a huge impact on acceptance, with 60.98% of the participants supporting the application because they believed that the Tawakkalna application would help them stay healthy during the COVID-19 pandemic. Overall, 49% of the participants supporting the application also agreed to the de-identification of their collected data and providing it for research. The Tawakkalna application ranked at the top compared to other contact tracing applications regarding privacy and security. Conclusions The Tawakkalna application developed by the Saudi Data and Artificial Intelligence Authority was a response to the COVID-19 pandemic, which is considered the biggest public health crisis in recent times. The Saudi Arabian government gained the population's acceptance through effective endorsement and the spread of educational content through media channels. By complying with privacy policies, the Tawakkalna application is an effective tool to combat public health infectious diseases.

The experiences of nurses who were involved in the COVID-19 contact tracing and tracking activities in Bulawayo, Zimbabwe

Background: The COVID-19 pandemic had a significant impact on the healthcare systems worldwide. For countries to contain the spread of COVID-19 and to mitigate its impact, contact tracing was adopted as one of the COVID-19 response strategies. The objective of this study was to explore and describe the experiences of nurses who were involved in the COVID-19 contact tracing and tracking activities in Bulawayo, Zimbabwe. Methods: A descriptive phenomenological design was utilised in this study. Data was collected telephonically using in-depth individual interviews between the 28th of December 2020 and 25th February 2021. Twelve participants comprising of two males and ten females with experience in contact tracing were purposively sampled and interviewed telephonically to get lived experiences. The number of females and males who were purposefully sampled depended on the proportion of this participants in the setting. Analysis followed the seven steps by Colaizzi strategies. Results: The study findings demonstrated that the participants experienced challenges as they implemented contact tracing activities. Four themes on contact tracing emerged: follow-up and contact-tracing activities; support systems; psychosocial implications; and witnessed patients’ experiences. Fourteen sub-themes were identified: negative perceptions of the re-assigned roles; unintended outcomes; delayed COVID-19 test results; increased workload; provision of personal protective equipment; training and orientation on COVID-19; meals for providers involved in contact tracing; we want to be heard and listened to; anxiety and fear; stress; emotionally challenging moments; unable to provide a service; witnessed discomfort; and stigma and discrimination. Conclusions: Contact tracing is key in the response to the COVID-19 pandemic. The strategy has proven to be complex, with increased workload, which is emotionally draining – hence the need for an effective support system for staff conducting contact-tracing activities.

COVID-19 diagnosis and SARS-CoV-2 viral load in hospitalized patients versus people with Flu-Like Syndrome

At the beginning of the pandemic, the Brazilian Public Health System (SUS) did not to test all suspects cases of COVID-19, thus, hospitalized individuals, health professionals, and symptomatic contacts were prioritized. Contrary to the criteria adopted by the government, the municipality of Botucatu chose to test all people who manifested flu-like syndrome. We aimed to investigate whether positive cases for COVID-19 were more frequent in patients seeking diagnosis via SUS or in the group of people seeking diagnosis via Municipal Health Center and whether the viral load was expressed differently in hospitalized patients (HP) compared to mild symptoms (MHC). Results showed that there were no differences in the percentage between the groups. Regarding the viral load, significant differences were found between the samples from HP and MHC (3-10 days of symptoms), with HP presenting a lower viral load. The results provide significant information about the viral load at different time-lapses.

The Relative Contributions of Occupational and Community Risk Factors for COVID-19 among Hospital Workers: The HOP-COVID Cohort Study.

The relative contributions of occupational and community sources of COVID-19 among health-care workers (HCWs) are still subject to debate. In a cohort study at a 2814-bed tertiary medical center (five hospitals) in the Paris area of France, we assessed the proportion of hospital-acquired cases among staff and identified risk factors. Between May 2020 and June 2021, HCWs were invited to complete a questionnaire on their COVID-19 risk factors. RT-PCR and serology test results were retrieved from the virology department. Mixed-effects logistic regression was used to account for clustering by hospital. The prevalence of COVID-19 was 15.6% (n = 213/1369 respondents) overall, 29.7% in the geriatric hospitals, and 56.8% of the infections were hospital-acquired. On multivariable analyses adjusted for COVID-19 incidence and contact in the community, a significantly higher risk was identified for staff providing patient care (especially nursing assistants), staff from radiology/functional assessment units and stretcher services, and staff working on wards with COVID-19 clusters among patients or HCWs. The likelihood of infection was greater in geriatric wards than in intensive care units. The presence of significant occupational risk factors after adjustment for community exposure is suggestive of a high in-hospital risk and emphasizes the need for stronger preventive measures-especially in geriatric settings. Clinicaltrials.gov NCT04386759.

Resident Willingness to Participate in Digital Contact Tracing in a COVID-19 Hotspot: Findings From a Detroit Panel Study.

Digital surveillance tools and health informatics show promise in counteracting diseases but have limited uptake. A notable illustration of the limits of such tools is the general failure of digital contact tracing in the United States in response to COVID-19. We investigated the associations between individual characteristics and the willingness to use app-based contact tracing in Detroit, a majority-minority city that experienced multiple waves of COVID-19 outbreaks and deaths since the start of the pandemic. The aim of this study was to examine variations among residents in the willingness to download a contact tracing app on their phones to provide public health officials with information about close COVID-19 contact during summer 2020. To examine residents' willingness to participate in digital contact tracing, we analyzed data from 2 waves of the Detroit Metro Area Communities Study, a population-based survey of Detroit, Michigan residents. The data captured 1873 responses from 991 Detroit residents collected in June and July 2020. We estimated a series of multilevel logit models to gain insights into differences in the willingness to participate in digital contact tracing across a variety of individual attributes, including race/ethnicity, degree of trust in the government, and level of education, as well as interactions among these variables. Our results reflected widespread reluctance to participate in digital contact tracing in response to COVID-19, as less than half (826/1873, 44.1%) of the respondents said they would be willing to participate in app-based contact tracing. Compared to White respondents, Black (odds ratio [OR] 0.45, 95% CI 0.23-0.86) and Latino (OR 0.32, 95% CI 0.11-0.99) respondents were significantly less willing to participate in digital contact tracing. Trust in the government was positively associated with the willingness to participate in digital contact tracing (OR 1.17, 95% CI 1.07-1.27), but this effect was the strongest for White residents (OR 2.14, 95% CI 1.55-2.93). We found similarly divergent patterns of the effects of education by race. While there were no significant differences among noncollege-educated residents, White college-educated residents showed greater willingness to use app-based contact tracing (OR 6.12, 95% CI 1.86-20.15) and Black college-educated residents showed less willingness (OR 0.46, 95% CI 0.26-0.81). Trust in the government and education contribute to Detroit residents' wariness of digital contact tracing, reflecting concerns about surveillance that cut across race but likely arise from different sources. These findings point to the importance of a culturally informed understanding of health hesitancy for future efforts hoping to leverage digital contact tracing. Though contact tracing technologies have the potential to advance public health, unequal uptake may exacerbate disparate impacts of health crises.

Perceived Stress and Hopelessness in COVID-19 Contacts

Aim: We aimed to determine the perceived stress and hopelessness levels in COVID-19 patient contacts.Materials and Methods: The study included all COVID-19 contacts who presented to a family health center in Niğde, Turkey between August and October 2020. The data were collected from contacts who were reached daily for a period of 14 days using the Beck Hopelessness Scale (BHS) and the Perceived Stress Scale (PSS). The data were analyzed using the SPSS package program, and p<0.05 was considered significant. Results: While 55.8% of the participants were female, 71% were married, and 46.9% had a chronic disease. The mean age of the participants was 53.44 years. Their mean BHS and PSS scores were 4.40±3.33 and 25.07±5.98, respectively. A statistically significant relationship was found between the participants’ places of residence and occupations and their mean BHS loss of motivation subscale scores (p<0.05). Among the participants, homemakers, those living in districts, towns, or villages, and those with chronic diseases had significantly higher PSS total scale and.stress-distress subscale mean scores than the others. A statistically significant positive correlation was found between the ages of the participants and their PSS total scale and stress-distress subscale scores (p<0.05). Conclusion: Although the hopelessness levels of the participants were found low, their stress levels were determined to be high, and most of them thought the pandemic was exaggerated. Due to the psychological consequences of the COVID-19 pandemic such as shock, denial, anxiety, worry, and stress in people, it is important to strengthen crisis and stress management efforts and increase awareness, coping and social support resources by prioritizing high-risk groups such as healthcare workers, women, the elderly, those with chronic diseases, and COVID-19 contacts.

COVID-19 telephone contact tracing in Flanders as a “contested” new genre of conversation: Discrepancies between interactional practice and media image

During the COVID-19 pandemic in Belgium, most COVID-19-related information was communicated to the public through mainstream media such as newspaper outlets, television, and radio. These media had substantial influence over which information was (widely) distributed and how this information was framed, subsequently shaping citizens' interpretations of matters concerning the pandemic. This chapter considers one of the government's endeavors to contain the pandemic: COVID-19 telephone contact tracing. Specifically, we compare the image of such telephone contact tracing generated by the media with the de facto interactional practice. We report on analyses made as part of a 1 year applied conversation analytic and pragmatic study conducted at Ghent University and the University of Antwerp in collaboration with the Flemish Agency of Health and Care. Methodologically, we use thematic content analysis to examine the portrayal of COVID-19 telephone contact tracing in widespread Flemish newspapers and its evolution throughout the pandemic. We then compare this media analysis to our analysis of a corpus of 170 recorded, transcribed, and interactionally analyzed contact tracing calls. Our results demonstrate how the mainstream media's image of contact tracing does not align with the various (interactional) functions of COVID-19 contact tracing calls identified in the study. We argue that this one-sided, distorted image produced by the media may have had considerable consequences for the efficacy of contact tracing, especially because the contact tracing call was a new genre of conversation. It was introduced to the public almost exclusively through mainstream media and, at the same time, its success relied for the most part on citizens' voluntary participation, trust, and willingness to share private information.

SMS-based digital health intervention in Rwanda's home-based care program for remote management of COVID-19 cases and contacts: A qualitative study of sustainability and scalability.

COVID-19 pandemic resulted in unprecedented global health challenges. Rwanda identified its first COVID-19 case on March 14, 2020 and subsequently introduced Home-Base Care (HBC) Program in August 2020 following community transmission of the virus and to alleviate logistical and financial strain on the healthcare system. Cases and contacts eligible for HBC were remotely supported by WelTel, an SMS-based mHealth intervention that was successfully implemented before for HIV epidemic in Rwanda. Enrolled cases and contacts were supported and monitored daily via their cell and/or mobile phones until they complete isolation/quarantine period. This study explored the rationale, perspectives, and experiences of key informants (KIs) during the implementation WelTel's mHealth tool for HBC in Rwanda. Semi-structured one-on-one virtual interviews were conducted with KIs in this qualitative study. The KIs were classified into 2 major categories: (A) Senior staff including policymakers, directors, and senior managers; (B) Technical teams including case managers, and other staff supporting the implementation of WelTel (e.g., IT staff). Interviews were audio-recorded, transcribed, and analyzed in NVivo. Thematic analysis was conducted using a hybrid approach. A topic guide was developed using the Modified Consolidated Framework for Implementation Research and feedback from local stakeholders. 7 KIs were interviewed. Five themes emerged following thematic analysis including: SMS-Based mHealth for Home-Isolation; Facilitators for Intervention Adoption; Barriers for Intervention Adoption; Infection prevention and control for Home-Isolation; and SMS-Based mHealth for Future Pandemics and Epidemics. Based on interviews, strong political commitment and advanced digital infrastructure were major facilitators for adopting WelTel for HBC. A major barrier to adopting WelTel was identified as technical-based issues. This was followed by local communication culture. All participates agreed on the significance of using WelTel to improve access and adherence to infection prevention and control measures, understand transmission dynamics, and inform public health decision-making regarding HBC. Rwanda successfully adopted WelTel for supporting and monitoring COVID-19 cases and contacts in home-isolation and the implementation was instrumental to the country's effort to manage the pandemic. Experiences and perspectives of cases and contacts enrolled into WelTel must be explored to understand the appropriateness and effectiveness of the intervention.

The use of COVID-19 contact tracing app data as evidence of a crime

This commentary draws attention to the introduction of data collected by COVID-19 tracing apps as evidence in criminal proceedings and the novel considerations this evidence presents for criminal justice agents and digital forensics professionals.