Epidemic Intelligence Center, Taiwan Centers for Disease Control, Taipei, Taiwan.
Taipei Regional Control Center, Taiwan Centers for Disease Control, Taipei, Taiwan.
Int J Infect Dis. 2020 Dec;101:348-352. doi: 10.1016/j.ijid.2020.09.1483. Epub 2020 Oct 6.
Comprehensive case investigation and contact tracing are crucial to prevent community spread of COVID-19. We demonstrated a utility of using traditional contact tracing measures supplemented with symptom tracking and contact management system to assist public health workers with high efficiency.
A centralized contact tracing system was developed to support data linkage, cross-jurisdictional coordination, and follow-up of contacts' health status. We illustrated the process of how digital tools support contact tracing and management of COVID-19 cases and measured the timeliness from case detection to contact monitoring to evaluate system performance.
Among the 8051 close contacts of the 487 confirmed cases (16.5 close contacts/case, 95% CI [13.9-19.1]), the median elapsed time from last exposure to quarantine was three days (IQR 1-5). By implementing the approach of self-reporting using automatic text-messages and web-app, the percentage of health status updates from self-reporting increased from 22.5% to 61.5%. The high proportion of secondary cases detected via contact tracing (88%) might reduce the R0 to under one and minimize the impact of local transmission in the community.
Comprehensive contact tracing and management with complementary technology would still be a pillar of strategies for containing outbreaks during de-escalation or early in the next wave of COVID-19 pandemic.
全面的病例调查和接触者追踪对于防止 COVID-19 社区传播至关重要。我们证明了使用传统接触者追踪措施辅以症状跟踪和接触管理系统来协助公共卫生工作者提高效率的实用性。
开发了一个集中的接触者追踪系统，以支持数据链接、跨辖区协调和接触者健康状况的随访。我们说明了数字工具如何支持 COVID-19 病例的接触者追踪和管理，并衡量了从病例发现到接触监测的及时性，以评估系统性能。
在 487 例确诊病例的 8051 名密切接触者中（16.5 名密切接触者/例，95%CI[13.9-19.1]），从末次接触到隔离的中位时间为 3 天（IQR 1-5）。通过实施自动短信和网络应用程序的自我报告方法，自我报告的健康状况更新比例从 22.5%增加到 61.5%。通过接触者追踪发现的继发性病例比例很高（88%）可能会将 R0 降低到 1 以下，并最大限度地减少社区内本地传播的影响。
全面的接触者追踪和管理与互补技术仍然是遏制疫情缓解或下一波 COVID-19 大流行期间爆发的策略的支柱。
