Trevino Jesus, Keswani Meghana, Pourmand Ali
Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Telemed J E Health. 2022 Mar;28(3):317-324. doi: 10.1089/tmj.2021.0148. Epub 2021 Jun 3.
Conventional contact tracing approaches have not kept pace with the scale of the coronavirus disease 2019 (COVID-19) pandemic and the highly anticipated smartphone applications for digital contact tracing efforts are plagued by low adoption rates attributed to privacy concerns; therefore, innovation is needed in this public health capability. This study involved a cross-sectional, nonrepresentative, online survey in the United States of individuals tested for COVID-19. Testing survey items measured the performance of conventional contact tracing programs, quantified the stigma related to the notification of COVID-19 close contacts, and assessed the acceptability of a website service for digital contact tracing. A sample of 668 (19.9%) individuals met the inclusion criteria and consented to participation. Among the 95 participants with COVID-19, results were received after a median of 2 days, 63.2% interacted with a contact tracing program a median of 2 days after receiving test results, 62.1% had close contacts, and 37.1% of participants with COVID-19 and close contacts did not disclose their results to all close contacts. Among all participants, 17% had downloaded a mobile application and 40.3% reported interest in a website service. One hundred and nine participants perceived stigma with the disclosure of COVID-19 test results; of these, 58.7% reported that a website service for close contact notification would decrease this stigma. Conventional contact tracing programs did not comprehensively contact individuals who tested positive for COVID-19 nor did so within a meaningful time frame. Digital contact tracing innovations may address these shortcomings; however, the low penetration of mobile application services in the United States indicates that a suite of digital contact tracing tools, including website services, are warranted for a more exhaustive coverage of the population. Public health officials should develop a complementary toolkit of digital contact tracing strategies to enable effective pandemic containment strategies.
传统的接触者追踪方法未能跟上2019冠状病毒病（COVID-19）大流行的规模，而备受期待的用于数字接触者追踪的智能手机应用程序因隐私问题而采用率较低；因此，这一公共卫生能力需要创新。本研究在美国对接受COVID-19检测的个体进行了一项横断面、非代表性的在线调查。检测调查项目衡量了传统接触者追踪计划的表现，量化了与COVID-19密切接触者通知相关的污名化情况，并评估了数字接触者追踪网站服务的可接受性。668名（19.9%）个体符合纳入标准并同意参与。在95名感染COVID-19的参与者中，中位数2天后收到结果，63.2%的人在收到检测结果中位数2天后与接触者追踪计划进行了互动，62.1%的人有密切接触，37.1%感染COVID-19且有密切接触的参与者未将结果告知所有密切接触者。在所有参与者中，17%下载了移动应用程序，40.3%表示对网站服务感兴趣。109名参与者认为披露COVID-19检测结果存在污名化；其中，58.7%报告称用于密切接触者通知的网站服务会减少这种污名化。传统的接触者追踪计划并未全面联系COVID-19检测呈阳性的个体，也未在有意义的时间范围内做到这一点。数字接触者追踪创新可能会解决这些缺点；然而，移动应用服务在美国的低普及率表明，包括网站服务在内的一系列数字接触者追踪工具对于更全面地覆盖人群是必要的。公共卫生官员应开发一套数字接触者追踪策略的补充工具包，以实现有效的疫情防控策略。
