背景:在COVID-19大流行期间,远程医疗已广泛用于新病例检测和远程监护。它安全地提供医疗保健服务,并将援助扩展到偏远地区,在缺乏专业卫生专业人员的情况下,农村地区和服务不足的社区。合格的数据是由卫生保健工作者系统地收集的,其中包含有关疑似病例的信息,可用于监测目的的疾病传播指标。然而,这种方法在综合征监测中的应用还有待探索.此外,流行病的数学建模是一个成熟的领域,已成功用于追踪SARS-CoV-2感染的传播,支持公共卫生应对COVID-19大流行的各个方面的决策过程。当前模型的响应取决于输入数据的质量,特别是传输速率,初始条件,和其他存在于隔室模型中的参数。远程医疗系统可以提供开发的数值模型,以模拟在特定地区传播的病毒。
目的:在此,我们评估了从基于州的远程医疗服务获得的高质量数据集是否可用于预测COVID-19新病例的地域传播,并提供疾病传播的计算模型.
方法:我们分析了在巴伊亚州首次收到COVID-19通知后的4个月内从全州免费远程医疗服务获得的结构化数据,巴西。在远程通信期间,由医生监督的医学生健康团队收集了结构化数据。出于计划和监视目的,数据已注册在响应式Web应用程序中。该数据集旨在快速识别用户,城市,住宅区,date,性别,年龄,和COVID-19样症状。我们对报告COVID-19样症状的呼叫和COVID-19病例的通知进行了时空比较。电话的数量被用作暴露个体的代理,以提供一个名为“易感”的数学模型,暴露,感染,恢复,死者。\"
结果:对于巴伊亚州417个城市中的181个(43%),第一次打电话给远程医疗服务,报告类似COVID-19症状,是在第一次通知该病之前。电话之前,平均而言,在巴伊亚州各市通知COVID-19的30天,巴西。此外,远程医疗服务获得的数据被用来有效地再现COVID-19在萨尔瓦多的传播,国家的首都,使用“易感”,暴露,感染,恢复,“死者”模型模拟疾病的时空传播。
结论:来自远程医疗服务的数据在预测新一波COVID-19方面具有很高的有效性,可能有助于了解流行动态。
Telehealth has been widely used for new case detection and telemonitoring during the COVID-19 pandemic. It safely provides access to health care services and expands assistance to remote, rural areas and underserved communities in situations of shortage of specialized health professionals. Qualified data are systematically collected by health care workers containing information on suspected
cases and can be used as a proxy of disease spread for surveillance purposes. However, the use of this approach for syndromic surveillance has yet to be explored. Besides, the mathematical modeling of epidemics is a well-established field that has been successfully used for tracking the spread of SARS-CoV-2 infection, supporting the decision-making process on diverse aspects of public health response to the COVID-19 pandemic. The response of the current models depends on the quality of input data, particularly the transmission rate, initial conditions, and other parameters present in compartmental models. Telehealth systems may feed numerical models developed to model virus spread in a specific region.
Herein, we evaluated whether a high-quality data set obtained from a state-based telehealth service could be used to forecast the geographical spread of new
cases of COVID-19 and to feed computational models of disease spread.
We analyzed structured data obtained from a statewide toll-free telehealth service during 4 months following the first notification of COVID-19 in the Bahia state, Brazil. Structured data were collected during teletriage by a health team of medical students supervised by physicians. Data were registered in a responsive web application for planning and surveillance purposes. The data set was designed to quickly identify users, city, residence neighborhood, date, sex, age, and COVID-19-like symptoms. We performed a temporal-spatial comparison of calls reporting COVID-19-like symptoms and notification of COVID-19
cases. The number of calls was used as a proxy of exposed individuals to feed a mathematical model called \"susceptible, exposed, infected, recovered, deceased.\"
For 181 (43%) out of 417 municipalities of Bahia, the first call to the telehealth service reporting COVID-19-like symptoms preceded the first notification of the disease. The calls preceded, on average, 30 days of the notification of COVID-19 in the municipalities of the state of Bahia, Brazil. Additionally, data obtained by the telehealth service were used to effectively reproduce the spread of COVID-19 in Salvador, the capital of the state, using the \"susceptible, exposed, infected, recovered, deceased\" model to simulate the spatiotemporal spread of the disease.
Data from telehealth services confer high effectiveness in anticipating new waves of COVID-19 and may help understand the epidemic dynamics.