COVID-19 Contact Research Articles

Lived experience of Jordanian front-line healthcare workers amid the COVID-19 pandemic: a qualitative study

ObjectivesThis study aimed to explore the lived experience of Jordanian front-line healthcare workers (FHCWs), including their experienced challenges and adaptations amid the COVID-19 pandemic.DesignA phenomenological qualitative design was used to...

COVID-19 Contact Tracing and the Operationalisation of Somatechnics

This article draws on the paradigm of media operationalism to understand the somatechnical construction of bodies during the COVID-19 pandemic. According to the concept of somatechnics, one’s experience with the social world is articulated through the available technologies and techniques required to and developed from using these technologies ( Sullivan and Murray 2016 ). By drawing on the case of the Service Victoria app, the digital COVID-19 contact tracing system launched by the Victoria State government in Australia, I focus on the transformative meaning of technologies and somatechnics and how subjectivity is being redefined through the lens of technological utilisation. I suggest that all human-related forms of relations (human-to-human and human-to-machine) have become secondary and give way to the synchronic data-to-data relation of the app. In the regime of operational media, the body is not just a historical and cultural construction but a techno-transactional object that supports the optimisation of automated-decision making. The recent operational-turn in media studies provides a useful pathway to rethink the changing meaning of body and the human/technologies entanglement.

Evaluation of a Contact Tracing Training Program and Field Experience

IntroductionThe study objective was to evaluate a contact tracing training program and the role of contact tracing on volunteers’ professional development.MethodsA COVID-19 contact tracing program was conducted at an urban academic medical center, in collaboration with the local health department, between March 2020 and May 2021. Contact tracers, most of whom were health professions students, completed pretraining and post-training surveys to assess knowledge and self-efficacy to conduct contact tracing, plus an 18-month follow-up survey regarding career impacts.ResultsWe observed statistically significant post-training increases in knowledge and self-efficacy to conduct contact tracing. Contact tracers described benefiting from training regarding cultural humility, empathy, and trauma-informed interviewing. They also expressed a deeper understanding of COVID-19 inequities and their structural causes and reported that the work was emotionally demanding.ConclusionsKey to pandemic preparedness is having a trained and supported workforce. This study showed how contact tracing training and field experience strengthened students’ education in the health professions by sharpening interpersonal skills and structural competency and by generating insights regarding current gaps in both public health infrastructure and support for vulnerable populations.

Preferences in the Willingness to Download a COVID-19 Contact Tracing App in the Netherlands and Turkey: Experimental Study.

BackgroundDespite the worldwide growth in using COVID-19 contact tracing apps (CTAs) and the potential benefits for citizens, governments, health care professionals, businesses, and other organizations, only a few studies have examined the factors affecting the levels of willingness to download a CTA.ObjectiveThis study aimed to investigate individuals’ preferences in the willingness to download a health app.MethodsWe conducted an experimental study in 2 countries, the Netherlands (N=62) and Turkey (N=83), using 4 different vignettes (ie, data protection, manufacturer, reward, and gaming models) with different attributes. Participants were randomly assigned to 1 of the conditions within the vignettes.ResultsThe results showed that data protection and gaming elements are factors that influence the willingness to download a COVID-19 CTA. More specifically, we see that data protection is an important factor explaining the willingness to download the app in Turkey, whereas including gaming elements significantly affects the willingness to download the app in the Netherlands.ConclusionsCOVID-19 CTAs are highly promising to reduce the spread of the virus and make it easier to open up society faster, especially because they can be used quickly and share information rapidly. COVID-19 CTA developers must ensure that their apps satisfactorily and sufficiently address ethical considerations, even in times of crisis. Furthermore, integrating gaming elements in the CTA could enhance the willingness to download the CTA.

Appsolutely secure? Psychometric properties of the German version of an app information privacy concerns measure during COVID-19.

IntroductionPrivacy concerns are an important barrier to adoption and continued use of digital technologies, particularly in the health sector. With the introduction of mobile health applications (mHealth apps), the construct of app information privacy concerns has received increased attention. However, few validated measures exist to capture said concerns in population samples, although they can help to improve public health efforts.MethodsUsing a cross-sectional survey of German adults (mean age = 35.62; 63.5% female), this study examined psychometric properties of the app information privacy concerns scale (AIPC). Analyses comprised confirmatory factor analysis, factorial validity (exploratory factor analysis), internal consistency, convergent validity (i.e., correlations with privacy victimhood, and app privacy concerns), and discriminant validity (i.e., daily app use, adoption intentions, and attitudes toward COVID-19 contact tracing app use).ResultsThe analysis did not support the proposed three-factor structure of the AIPC (i.e., anxiety, personal attitude, and requirements). Instead, a four-factor model was preferable that differentiated requirements regarding disclosure policies, and personal control. In addition, factors mirroring anxiety and personal attitude were extracted, but shared a significant overlap. However, these factors showed good reliability, convergent and discriminant validity.DiscussionThe findings underline the role of app information privacy concerns as a significant barrier to mHealth app use. In this context, anxiety and personal attitudes seemed particularly relevant, which has implications for health communication. Moreover, the observed differentiation of external (disclosure) and internal (control) requirements aligns with health behavior change models and thus is a promising area for future research.

Community-Based Workforce for COVID-19 Contact Tracing and Prevention Activities in New York City, July-December 2020.

High rates of hospitalization and death disproportionately affected Black, Latino, and Asian residents of New York City at the beginning of the COVID-19 pandemic. To suppress COVID-19 transmission, New York City implemented a workforce of community engagement specialists (CESs) to conduct home-based contact tracing when telephone numbers were lacking or telephone-based efforts were unsuccessful and to disseminate COVID-19 information and sanitary supplies. We describe the recruitment, training, and deployment of a multilingual CES workforce with diverse sociodemographic backgrounds during July-December 2020 in New York City. We developed standard operating procedures for infection control and safety measures, procured supplies and means of transportation, and developed protocols and algorithms to efficiently distribute workload. From July through December 2020, 519 CESs were trained to conduct in-person contact tracing and activities in community settings, including homes, schools, and businesses, where they disseminated educational materials, face masks, hand sanitizer, and home-based specimen collection kits. During the study period, 94 704 records of people with COVID-19 and 61 246 contacts not reached by telephone-based contact tracers were referred to CESs. CESs attempted home visits or telephone calls with 84 230 people with COVID-19 and 49 303 contacts, reaching approximately 55 592 (66%) and 35 005 (71%), respectively. Other CES activities included monitoring recently arrived travelers under quarantine, eliciting contacts at point-of-care testing sites, and advising schools on school-based COVID-19 mitigation strategies. This diverse CES workforce allowed for safe, in-person implementation of contact tracing and other prevention services for individuals and communities impacted by COVID-19. This approach prioritized equitable delivery of community-based support services and resources.

Challenges of contact tracing during COVID-19 pandemic response in a tertiary hospital in Northwestern Nigeria

Abstract Background: Contact tracing is a traditional pillar of infectious disease control, especially for illnesses involving direct transmission from person to person, such as COVID-19. Several challenges have arisen from COVID-19 contact tracing activities, particularly in low-resource settings. These include refusal of positive clients to disclose their close contacts, difficulties in conducting risk assessment for contacts traced, among others. Objectives: To explore the activities and identify challenges of contact tracing during COVID -19 pandemic response in a tertiary hospital in Northwestern Nigeria from May, 2020 to March, 2021. Methodology: A mixed method approach was done with quantitative secondary data analysis of COVID-19 contacts traced, and qualitative assessment through Key Informant Interviews (KII) of Ahmadu Bello University Teaching Hospital staff involved in COVID-19 outbreak response during the period. Results: A total of 2,249 clients were tested for COVID-19, of which 925 (41.1%) were healthcare workers. The identified challenges included problems with contact identification, delay in notification of results, refusal to disclose contacts by cases, contacts refusing to allow risk assessment, and health workers being overwhelmed by the task of contact tracing. Conclusion: Challenges identified include refusal of cases to disclose their contacts, overwhelming number of contacts, and delay in notification of results. There is need to institute contact tracing protocols to mandate cases to disclose their contacts, train more manpower to reduce the burden of contact tracing, and improve the notification of results.

The Relative Importance of Vulnerability and Efficiency in COVID-19 Contact Tracing Programmes: A Discrete Choice Experiment.

Objectives: This study aims to assess the trade-offs between vulnerability and efficiency attributes of contact tracing programmes based on preferences of COVID-19 contact tracing practitioners, researchers and other relevant stakeholders at the global level. Methods: We conducted an online discrete choice experiment (DCE). Respondents were recruited globally to explore preferences according to country income level and the prevailing epidemiology of COVID-19 in the local setting. The DCE attributes represented efficiency (timeliness, completeness, number of contacts), vulnerability (vulnerable population), cooperation and privacy. A mixed-logit model and latent class analysis were used. Results: The number of respondents was 181. Timeliness was the most important attribute regardless of country income level and COVID-19 epidemiological condition. Vulnerability of contacts was the second most important attribute for low-to-lower-middle-income countries and third for upper-middle-to-high income countries. When normalised against conditional relative importance of timeliness, conditional relative importance of vulnerability ranged from 0.38 to 0.42. Conclusion: Vulnerability and efficiency criteria were both considered to be important attributes of contact tracing programmes. However, the relative values placed on these criteria varied significantly between epidemiological and economic context.

COVID-19 Prediction With Machine Learning Technique From Extracted Features of Photoplethysmogram Morphology.

At present, COVID-19 is spreading widely around the world. It causes many health problems, namely, respiratory failure and acute respiratory distress syndrome. Wearable devices have gained popularity by allowing remote COVID-19 detection, contact tracing, and monitoring. In this study, the correlation of photoplethysmogram (PPG) morphology between patients with COVID-19 infection and healthy subjects was investigated. Then, machine learning was used to classify the extracted features between 43 cases and 43 control subjects. The PPG data were collected from 86 subjects based on inclusion and exclusion criteria. The systolic-onset amplitude was 3.72% higher for the case group. However, the time interval of systolic-systolic was 7.69% shorter in the case than in control subjects. In addition, 12 out of 20 features exhibited a significant difference. The top three features included dicrotic-systolic time interval, onset-dicrotic amplitude, and systolic-onset time interval. Nine features extracted by heatmap based on the correlation matrix were fed to discriminant analysis, k-nearest neighbor, decision tree, support vector machine, and artificial neural network (ANN). The ANN showed the best performance with 95.45% accuracy, 100% sensitivity, and 90.91% specificity by using six input features. In this study, a COVID-19 prediction model was developed using multiple PPG features extracted using a low-cost pulse oximeter.

COVID-19 contact tracking by group activity trajectory recovery over camera networks

Contact tracking plays an important role in the epidemiological investigation of COVID-19, which can effectively reduce the spread of the epidemic. As an excellent alternative method for contact tracking, mobile phone location-based methods are widely used for locating and tracking contacts. However, current inaccurate positioning algorithms that are widely used in contact tracking lead to the inaccurate follow-up of contacts. Aiming to achieve accurate contact tracking for the COVID-19 contact group, we extend the analysis of the GPS data to combine GPS data with video surveillance data and address a novel task named group activity trajectory recovery. Meanwhile, a new dataset called GATR-GPS is constructed to simulate a realistic scenario of COVID-19 contact tracking, and a coordinated optimization algorithm with a spatio-temporal constraint table is further proposed to realize efficient trajectory recovery of pedestrian trajectories. Extensive experiments on the novel collected dataset and commonly used two existing person re-identification datasets are performed, and the results evidently demonstrate that our method achieves competitive results compared to the state-of-the-art methods.

Evaluating a contact tracing course: How universities can develop the public health workforce

Objectives To describe the participants of a university-based COVID-19 contact tracing course and determine whether the course changed knowledge, attitudes, and intention to participate in contact tracing. Participants Faculty, staff, and students were eligible. Methods Surveys evaluated the impact of the course on participant intentions to engage in contact tracing. Logistic regression identified characteristics associated with increased likelihood of participating in contact tracing. Results Nearly 800 individuals participated, of whom 26.2% identified as Hispanic/Latino and 14.0% as Black. Nearly half (48.8%) planned to conduct contact tracing. While attitudes did not change, knowledge improved (67.9% vs. 93.8% scores on assessments; p < 0.001). Younger participants and Black individuals were more more likely to be confident that they would participate in contact tracing. Conclusions Course completion was associated with increased knowledge. Participants were racially and ethnically diverse, highlighting how universities can partner with health departments to develop workforces that reflect local communities.

Tapping into the minds and hearts of the local public health workforce during the COVID-19 pandemic.

SettingOttawa Public Health (OPH) provides public health programming and services in the Ottawa region. At the onset of the COVID-19 pandemic in March 2020, the OPH COVID-19 Case and Contact Management Team was established to help manage the spread of COVID-19 and support individuals who test positive, and their close contacts.InterventionIn order to guide and support the COVID-19 Case and Contact Management Team, the COVID-19 Strategic Support Team implemented an anonymous internal communication tool called the COVID-19 Case Management Forum. Case and Contact Management employees were invited to submit their questions, concerns, and words of encouragement on the forum, and the COVID-19 Strategic Support Team routinely replied to forum submissions via team email.OutcomesQualitative analyses of employee forum submissions revealed 6 main themes and 31 unique sub-themes related to questions, concerns, and feelings that arose throughout this pandemic response. Recurrent themes emerged relating to process questions, communication challenges, solution generation, and feelings of frustration. Summative content analyses of the COVID-19 Strategic Support team’s replies demonstrated 6 main answer types: explaining procedures, identifying resources, explaining rationales, human resource explanations, sharing employee feedback with relevant parties, and creating practice tools.ImplicationsThe online forum tool was developed and implemented early in the pandemic response to provide key insights into OPH’s public health workforce needs and well-being throughout the COVID-19 response. The forum encouraged open dialogue and provided opportunities to establish clarity in a time of rapid situational change.

Drivers of downloading and reasons for not downloading COVID-19 contact tracing and exposure notification apps: A national cross-sectional survey.

BackgroundBluetooth-enabled smartphone apps have been developed and implemented in different sites globally to help overcome capacity limitations of traditional interview-based COVID-19 contact tracing. Two apps are currently available in Canada: ABTraceTogether exclusively in Alberta and COVID Alert in nine other provinces and territories. This study aims to examine factors associated with downloading of these apps to inform targeted promotion and marketing to increase app uptake.MethodsWe performed a cross-sectional survey with adult participants (≥18 years old) from an online national panel. Participants were asked if they had downloaded an app and, if applicable, reasons for not downloading. Logistic regression was used to identify sociodemographic factors and trusted information sources associated with downloading and reasons for not downloading.ResultsOf the included 4,503 respondents (36% response rate), 1,394 (31%) had downloaded an app. Demographic and socioeconomic factors positively associated with app download were: 1) being female, 2) higher household income, 3) higher education level attained, and 4) more liberal political views. The odds of downloading an app were higher for participants who trusted health-related information sources, and lower for those who trusted internet searches, family and friend, or Facebook. The most cited reasons for not downloading were related to data security concerns and perceived lack of benefit from the apps.InterpretationThese findings identify sociodemographic segments with the lowest app uptake, reasons for not downloading and trusted information sources to inform targeted promotion and marketing strategies to improve uptake of apps to facilitate contact tracing.

Adoption of Covid-19 contact tracing app by extending UTAUT theory: Perceived disease threat as moderator

ObjectivesContact tracing applications are technological solutions that can quickly trace and notify users of their potential exposure to the Covid-19 virus and help contain the spread of the disease. However, extant research delineating the various factors predicting the adoption of contact tracing apps is scant. The study's primary objective is to develop and validate a research model based on the unified theory of acceptance and use of technology (UTAUT), health belief model (HBM), perceived privacy risk and perceived security risk to understand the adoption of contact tracing application. MethodsAn online survey was carried out among users of the ‘Aarogya Setu’ contact tracing app in India. The partial least squares structural equation modelling (PLS-SEM) tool was employed to analyze data from 307 respondents. ResultsThe results showed that performance expectancy, social influence, and facilitating conditions positively influenced users’ intention to adopt the app. In contrast, perceived privacy and security risks were significant barriers to app adoption. Perceived disease threat as a moderator mitigated the adverse impact of perceived privacy risk on users' intention to adopt contact tracing apps. ConclusionsThe current study gives insights on both drivers and barriers to the adoption of contract tracing applications. Various theoretical and practical implications of significance are provided for academicians and practitioners to effectively promote app adoption to tackle the Covid-19 pandemic.

Learning about COVID-19: sources of information, public trust, and contact tracing during the pandemic

ObjectiveTo assess the association between public attitudes, beliefs, and information seeking about the COVID-19 pandemic and willingness to participate in contact tracing in Michigan.MethodsUsing data from the quarterly Michigan State of the State survey conducted in May 2020 (n = 1000), we conducted multiple regression analyses to identify factors associated with willingness to participate in COVID-19 contact tracing efforts.ResultsPerceived threat of the pandemic to personal health (B = 0.59, p = <.00, Ref = No threat) and general trust in the health system (B = 0.17, p < 0.001), were the strongest positive predictors of willingness to participate in contact tracing. Concern about misinformation was also positively associated with willingness to participate in contact tracing (B = 0.30, p < 0.001; Ref = No concern). Trust in information from public health institutions was positively associated with willingness to participate in contact tracing, although these institutions were not necessarily the main sources of information about COVID-19.ConclusionPolicy makers can enhance willingness to participate in public health efforts such as contact tracing during infectious disease outbreaks by helping the public appreciate the seriousness of the public health threat and communicating trustworthy information through accessible channels.

Symptomatic and Asymptomatic Transmission of SARS-CoV-2 in K-12 Schools, British Columbia, Canada April to June 2021.

ABSTRACTWe prospectively studied SARS-CoV-2 transmission at schools in an era of variants of concern, offering all close contacts serial viral asymptomatic testing up to 14 days. From the 69 primary cases detected in schools, 392 close contacts were identified and offered asymptomatic testing. A total of 229 (58%) were close school contacts, and of these, 3 tested positive (1.3%), 2 of which were detected through asymptomatic testing. This is in contrast to the 117 household contacts, where 43 (37%) went on to become secondary cases. Routine asymptomatic testing of close contacts should be examined in the context of local testing rates, preventive measures, programmatic costs, and health impacts of asymptomatic transmission.IMPORTANCE There is concern that schools may be a setting where asymptomatic infections might result in significant “silent” transmission of SARS-CoV-2, particularly after the emergence of more transmissible variants of concern. After the programmatic implementation of a strategy of asymptomatic testing of close COVID-19 contacts as part of contact tracing in the school setting, the majority of the secondary cases were still found to have occurred in home or social contacts. However, for the 6.2% of secondary cases that occurred in close school contacts, the majority were detected through asymptomatic testing. The potential added yield of this approach needs to be considered within the overall setting, including consideration of the local epidemiology, ongoing goals of case and contact management, additional costs, logistical challenges for families, and possible health impacts of asymptomatic transmission.

Implementation of a Nationwide Knowledge-Based COVID-19 Contact Tracing Training Program, 2020.

In the United States, the public health response to control COVID-19 required rapid expansion of the contact tracing workforce from approximately 2200 personnel prepandemic to more than 100 000 during the pandemic. We describe the development and implementation of a free nationwide training course for COVID-19 contact tracers that launched April 28, 2020, and summarize participant characteristics and evaluation findings through December 31, 2020. Uptake of the online asynchronous training was substantial: 90 643 registrants completed the course during the first 8 months. In an analysis of a subset of course participants (n = 13 697), 7724 (56.4%) reported having no prepandemic public health experience and 7178 (52.4%) reported currently serving as case investigators, contact tracers, or both. Most participants who completed a course evaluation reported satisfaction with course utility (94.8%; 59 497 of 62 753) and improved understanding of contact tracing practice (93.0%; 66 107 of 71 048). These findings suggest that the course successfully reached the intended audience of new public health practitioners. Lessons learned from this implementation indicate that an introductory course level is appropriate for a national knowledge-based training that aims to complement jurisdiction-specific training. In addition, offering a range of implementation options can promote course uptake among public health agency staff. This course supported the emerging needs of the public health practice community by training a workforce to fill an important gap during the COVID-19 pandemic and could serve as a feasible model for enhancing workforce knowledge for future and ongoing public health threats.

Healthcare workers' SARS-CoV-2 infection rates during the second wave of the pandemic: follow-up study.

This study aimed to assess if, during the second wave of the COVID-19 pandemic, healthcare workers had increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates, following close contact with patients, co-workers and persons outside work with COVID-19. A follow-up study of 5985 healthcare workers from Denmark was conducted between November 2020 and April 2021 and provided day-to-day information on COVID-19 contacts. SARS-CoV-2 infection was defined by the first positive polymerase chain reaction (PCR) test ever. Data was analyzed in multivariable Poisson regression models. The SARS-CoV-2 infection rates following close contact 3-7 days earlier with patients, co-workers and persons outside work with COVID-19 were 153.7, 240.8, and 728.1 per 100 000 person-days, respectively. This corresponded with age, sex, month, number of PCR tests and mutually adjusted incidence rate ratios of 3.17 [40 cases, 95% confidence interval (CI) 2.15-4.66], 2.54 (10 cases, 95% CI 1.30-4.96) and 17.79 (35 cases, 95% CI 12.05-26.28). The risk of SARS-CoV-2 infection was thus lower, but the absolute numbers affected was higher following COVID-19 contact at work than COVID-19 contact off work. Despite strong focus on preventive measures during the second wave of the pandemic, healthcare workers were still at increased risk of SARS-CoV-2 infection when in close contact with patients or co-workers with COVID-19. There is a need for increased focus on infection control measures in order to secure healthcare workers' health and reduce transmission into the community during ongoing and future waves of SARS-CoV-2 and other infections.

Applied Ethics and Digital Information Privacy: Informing the Design of Covid-19 Contact Tracing Apps

To counteract the spread of Covid-19, many countries have introduced mobile applications for contact tracing, which raises considerable questions about how these apps protect users’ information privacy. Through an exploratory analysis of Covid-19 contact tracing apps being used in Australia, France, Germany, Japan, and New Zealand, we identify normative and technical principles for the design of privacy-sensitive contact tracing apps. Based on a Restricted Access/Limited Control (RALC) account of information privacy, we discuss how the apps protect users’ information privacy through limiting access to and allowing users to actively manage their personal information. Our findings illustrate what understanding of information privacy is evident from the various designs of Covid-19 contact tracing apps, and how competing design principles can contribute to users’ information privacy. From a practical perspective, our findings can inform the design of contact tracing apps and the development of privacy approaches that can be applied in particular contexts. Our work thus bridges the gap between ethical design guidelines and technical analyses of specific implementations.

Big Data Analytics Model for Preventing the Spread of COVID-19 During Hajj using the Proposed Smart Hajj Application

Unlike the Pool of Bethesda, Makkah is a moment of sacrifice, a space of unified worship in the lives of Muslim worshipers. The Makkah experience symbolizes the “farewell pilgrimage” of the Prophet Muhammad through the Arabian desert in 632 A.D. (Aljazeera, 2021). The annual Hajj expedition to the Saudi holy city is the fifth of the five Muslim Pillars of Islam. Hajj occurs during Dhu’al-Hijjah, the last month of the year according to the Islamic calendar. Millions of people from across the world assemble to pray in the direction of Ka’bah, the holiest Islamic shrine constructed by Abraham and Ishmael. The 2012 Hajj attracted more than 3 million pilgrims journeyed to Hajj. However, the 2019 SARS-CoV-2 outbreak has since forced decision-makers for the Kingdom of Saudi Arabia to take further preventive measures in the interests of public health that affect the outcomes of the traditional prayer and worship. Saudi Arabian government officials significantly downsized capacity and instituted protocols for attendance to the 2020 and 2021 Hajj events due to the Covid-19 pandemic. In addition to Muslim pilgrimages, several nations have implemented mHealth apps designed for Covid-19 contact tracing, quarantine enforcement, symptom monitoring, and information provision for mass crowding events. Independently, the apps do not provide a holistic approach to Covid-19 transmission control in mass gatherings. A more universal, less intrusive technological approaches to managing and protecting the Hajj pilgrimage populations using credible, real-time data is needful. This study proposes an information-generating SMART app based on the success of prior apps, the implementation of a Smart Hajj application, which allows authorities to track Hajj pilgrim movement, and collect data as a part of efforts to prevent Covid-19 from disrupting centuries-old tradition Muslim pilgrimages to worship in sacred places.