Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 12, 2023
Date Accepted: Sep 29, 2023
Community-based Digital Contact Tracing for Emerging Infectious Disease: The Empirical COVID-19 Case with Digital Cluster Investigation
ABSTRACT
Background:
Contact tracing for containing emerging disease such as COVID-19 is resource-intensive and requires digital transformation to enable quick decision-making.
Objective:
This study proposes a framework for digital contact tracking using multimodal health informatics to efficiently acquire personal information and contain community outbreaks. The framework's structure is outlined, offering potential benefits in controlling the spread of emerging disease on a large scale.
Methods:
The implementation in Changhua, Taiwan served as a demonstration of the multisectoral informatics and connectivity between electronic health systems needed for digital contact tracing. The proposed framework incorporates both traditional Travel, Occupation, Contact, and Cluster (TOCC) approach and a dynamic contact process enabled by digital technology. A centralized registry system, accessible only to authorized health personnel, ensures privacy and data security. The effectiveness of the proposed digital contact tracing system was evaluated by using effect reproduction number (Rt) through a field study in Changhua.
Results:
The digital contact tracing system integrates the Immigration Registry, Communicable Disease Report System, and National Health Records to provide real-time information on TOCC for potential contacts and to facilitates a timely assessment for the risk of COVID-19 transmission. The digitalized system allows for effective decision-making on quarantine, isolation, and treatment with a focus on personal privacy. The system has proven effective in containing community clustered infections in Taiwan. In the first clustered infection, the system monitored 665 contacts, isolated four cases, and none of the contacts were infected during quarantine. The estimated Rt of 0.92 suggests an effective containment strategy in preventing community-acquired outbreak. The system was also used in a cluster investigation involving foreign workers, where none of the 462 contacts tested positive for SARS-CoV-2.
Conclusions:
By integrating the multisectoral database the contact tracing process can be digitalized to feed the information required for risk assessment and decision making with a timely manner to efficiently contain the community-acquired outbreak while facing the outbreak of emerging infectious disease resulting from new variants or sub-variants virus. Clinical Trial: Not applicable
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