contact-tracing

接触追踪
  • 文章类型: Journal Article
    自2020年春季COVID-19大流行爆发以来,测试的概念,trace,和分离物(TTI)被用作非药物干预措施,以防止疾病的进一步传播。特此,最近新确诊的SARS-CoV-2感染者的接触伙伴与最初发现的病例一起被确定和隔离,以避免潜在的继发感染。虽然政策是,鉴于被追踪人员的遵守,通常被认为是有效的,关于网络特定的影响因素知之甚少。在这项工作中,我们旨在评估TTI策略在(1)用于不同传染性水平的疾病和(2)用于不同接触网络时的有效性.对于先前的,我们改变每次接触的感染概率,对于后者,我们分析了不同的聚类系数。我们的目标是检验两个假设的有效性:首先,如果疾病的传染性很小,我们预计该政策会更有效,因为隔离人员的时间延迟至关重要。第二,由于友谊悖论的影响,如果基础联系网络的聚类系数较高,我们预计该政策将更有效。我们利用了基于代理的网络模型,该模型由三个交织在一起的模型部分组成:流行病学SEIR模型,隔离模型和联系人跟踪模型。为了测试假设,基础接触网络的疾病参数和聚类系数是变化的。仿真结果表明,的确,跟踪似乎对具有较高聚类的网络有更大的遏制影响,特别是对于快速传播的疾病。然而,与疾病传染性的影响相比,影响很小。因此,我们发现,传播概率越高,政策有效性就会显著下降。后者意味着跟踪和隔离接触的遏制影响变得更加有效,如果有限制感染概率的其他措施支持,或者如果在负面季节性影响较低的时期应用。
    Since the outbreak of the COVID-19 pandemic in spring 2020, the concept of test, trace, and isolate (TTI) was used as a non-pharmaceutical intervention against further spreading of the disease. Hereby, recent contact partners of newly confirmed SARS-CoV-2 infected persons were identified and isolated along with the originally detected case to avoid potential secondary infections. While the policy is, given the compliance of the traced persons, generally deemed efficient, not much is known about network-specific impact factors. In this work, we aim to evaluate the effectiveness of the TTI strategy when used (1) for diseases with different infectiousness levels and (2) on different contact networks. For the prior, we vary the infection probability per contact, for the latter, we analyse different clustering coefficients. Our goal is to test the validity of two hypotheses: First, we expect the policy to be more efficient if the infectiousness of the disease is small, since the time delay for isolating persons is crucial. Second, due to the implications of the friendship paradox, we expect the policy to be more effective if the clustering coefficient of the underlying contact network is high. We make use of an agent-based network model consisting of three intertwined model parts: an epidemiological SEIR model, a quarantine model and a contact-tracing model. To test the hypotheses, the disease parameters and the clustering coefficient of the underlying contact network are varied. The simulation results show that, indeed, tracing seems to have a slightly larger containment impact for networks with higher clustering, in particular for fast-spreading diseases. Yet, the effects are small compared to the impact of the infectiousness of the disease. Therefore, we find a significant decrease of the policy effectiveness the higher the transmission probability. The latter implies that the containment impact of tracing and isolating contacts becomes more efficient, if supported by additional measures that limit the infection probability or if applied in periods with low negative seasonality effects.
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  • 文章类型: Journal Article
    提供者发起的接触者追踪(CT)是减缓COVID-19等传染病传播的重要措施。然而,进行有效的CT取决于患者和接触示踪剂之间的协作。为了改善CT,重要的是要了解哪些因素影响接触示踪剂能够在大流行期间进行CT。
    我们对为鹿特丹-Rijnmond公共卫生服务(PHS)COVID-19单位工作的9名接触示踪剂进行了个人半结构化访谈,荷兰,探索他们进行CT的经验。数据收集时间为2020年7月至2020年12月。访谈协议是基于CT任务构建的,并以文献和解释遵守临床实践指南的框架为指导。
    一般来说,CT检查似乎令人满意。个人因素(面试技巧和技能,对患者的态度和对CT的态度),与患者相关的因素(合作和参与度,情感,语言和文化以及(错误)信息),指南相关因素(特征)和与组织相关的因素(与同事的互动,管理层的支持,工作量和培训)被发现影响CT的执行。
    为了为未来的大流行做好准备,重要的是探索策略,可以有效地支持接触示踪剂在执行CT,支持患者感到舒适的参与和方法,以达到更多的政策和协议的一致性。
    UNASSIGNED: Provider-initiated contact tracing (CT) is an important measure to slow down the spread of infectious diseases such as COVID-19. However, carrying out effective CT depends on the collaboration between the patient and the contact tracer. To improve CT, it is important to understand which factors influence contact tracers in being able to carry out CT during large pandemics.
    UNASSIGNED: We performed individual semi-structured interviews with nine contact tracers working for the COVID-19 unit of the Public Health Service (PHS) Rotterdam-Rijnmond, the Netherlands, to explore their experiences with carrying out CT. Data were collected between July 2020 and December 2020. The interview protocol was structured based on the CT tasks and guided by the literature and the framework explaining adherence to clinical practice guidelines.
    UNASSIGNED: In general, CT seemed to be carried out satisfactorily. Individual factors (interviewing techniques and skills, attitude towards the patient and attitude towards CT), factors related to the patient (cooperativeness and engagement, emotions, language and culture and (mis)information), guideline-related factors (characteristics) and factors related to the organisation (interactions with colleagues, support from management, workload and training) were found to influence the carrying out of CT.
    UNASSIGNED: To be well prepared for future pandemics, it is important to explore strategies that can be effective to support the contact tracer in performing CT, support patients in feeling comfortable to be engaged and ways to reach more consistency in policies and protocols.
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  • 文章类型: Journal Article
    尽管计算语言学方法——比如主题建模,情绪分析和情绪检测-可以为社交媒体研究人员提供对在线公共话语的见解,如何使用这些方法并不是固有的,缺乏关于如何以关键方式应用它们的透明说明。越来越多的工作集中在这些方法的优点和缺点上。通过在文献中应用使用这些方法的最佳实践,我们专注于设定期望,呈现轨迹,结合上下文进行审查,并批判性地反思两个案例研究的历时Twitter话语:NHSCovid-19数字联系人追踪应用程序的纵向话语和OfqualALevel等级计算算法的快照话语,两者都与英国有关。我们确定了所有三种方法在解释和潜在应用方面的困难。其他缺点,这种否定和讽刺的检测,也被发现了。我们讨论了对历时社交媒体研究人员进一步透明这些方法的必要性,包括将这些方法与定性方法(如语料库语言学和批判性语篇分析)结合在一个更正式的框架中的潜力。
    Although computational linguistic methods-such as topic modelling, sentiment analysis and emotion detection-can provide social media researchers with insights into online public discourses, it is not inherent as to how these methods should be used, with a lack of transparent instructions on how to apply them in a critical way. There is a growing body of work focusing on the strengths and shortcomings of these methods. Through applying best practices for using these methods within the literature, we focus on setting expectations, presenting trajectories, examining with context and critically reflecting on the diachronic Twitter discourse of two case studies: the longitudinal discourse of the NHS Covid-19 digital contact-tracing app and the snapshot discourse of the Ofqual A Level grade calculation algorithm, both related to the UK. We identified difficulties in interpretation and potential application in all three of the approaches. Other shortcomings, such the detection of negation and sarcasm, were also found. We discuss the need for further transparency of these methods for diachronic social media researchers, including the potential for combining these approaches with qualitative ones-such as corpus linguistics and critical discourse analysis-in a more formal framework.
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  • 文章类型: Journal Article
    这项研究采用了公共价值视角,研究了国家和地区政府为遏制冠状病毒(新冠肺炎)大流行而部署的电子健康服务,包括症状检查,信息门户和联系人跟踪应用程序。我们分析了25个欧洲经济区(EEA)采用的50个电子健康应用案例,并概述了这些系统和技术如何针对公共价值的四个维度进行映射:用户导向,参与,合法性和公平性。我们的发现表明,在当前大流行的背景下采用的电子健康应用的公共价值受到内源性和外源性因素的影响,这些因素破坏了其提高医疗服务质量和社会福祉的能力。最后,我们提出了进一步研究的领域,以解决这些因素以及公共价值不同维度之间出现的权衡。
    This study adopts a public value perspective to examine the eHealth services deployed by national and regional governments to contain the coronavirus (Covid-19) pandemic, including symptoms checkers, information portals and contact-tracing applications. We analyse 50 cases of eHealth applications adopted in 25 European Economic Area (EEA) and outline how these systems and technologies map against four dimensions of public value: user orientation, participation, legality and equity. Our findings reveal that the public value of the eHealth applications adopted in the context of the current pandemic is affected by both endogenous and exogenous factors that undermine their ability to improve the quality of healthcare services and social wellbeing. We conclude by suggesting areas for further research to address such factors and the trade-offs emerging between different dimensions of public value.
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  • 文章类型: Journal Article
    背景:超过78个国家已经开发了COVID接触者追踪应用程序,以限制冠状病毒的传播。然而,许多专家和科学家对这些应用程序的有效性表示怀疑。对于每个应用程序,最终用户在应用商店中输入了大量评论。
    目标:我们的目标是深入了解这些应用程序的用户评论,并找出用户反映的主要问题。我们的重点是评估应用程序的“社会软件”方面,基于用户评论。
    方法:我们选择了9个欧洲国家应用程序进行分析,并使用商业应用程序评论分析工具提取和挖掘用户评论。对于所有组合的应用程序,我们的数据集包括39,425条用户评论。
    结果:结果显示,用户普遍对正在研究的9个应用不满意,除了苏格兰(“保护苏格兰”)应用程序。用户抱怨的一些主要问题是电池耗电量高,以及对应用程序是否真正工作的怀疑。
    结论:我们的结果表明,应用程序背后的利益相关者需要做更多的工作(例如,应用程序开发人员,决策者,公共卫生专家)以改善公众收养,软件质量和公众对这些应用程序的看法。
    BACKGROUND: More than 78 countries have developed COVID contact-tracing apps to limit the spread of coronavirus. However, many experts and scientists cast doubt on the effectiveness of those apps. For each app, a large number of reviews have been entered by end-users in app stores.
    OBJECTIVE: Our goal is to gain insights into the user reviews of those apps, and to find out the main problems that users have reported. Our focus is to assess the \"software in society\" aspects of the apps, based on user reviews.
    METHODS: We selected nine European national apps for our analysis and used a commercial app-review analytics tool to extract and mine the user reviews. For all the apps combined, our dataset includes 39,425 user reviews.
    RESULTS: Results show that users are generally dissatisfied with the nine apps under study, except the Scottish (\"Protect Scotland\") app. Some of the major issues that users have complained about are high battery drainage and doubts on whether apps are really working.
    CONCLUSIONS: Our results show that more work is needed by the stakeholders behind the apps (e.g., app developers, decision-makers, public health experts) to improve the public adoption, software quality and public perception of these apps.
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  • 文章类型: Journal Article
    背景:接触者追踪和隔离传染性个体是控制COVID-19大流行的基石。确定应与SARS-CoV-2检测呈阳性的索引儿童隔离的家庭接触者的策略仍有待澄清。我们旨在使用血清学快速诊断测试(RDT,色谱免疫测定)。方法:我们在巴黎地区的指数病例儿童家庭中进行了接触者追踪研究,法国,2020年5月8日至7月27日。我们比较了两种策略,一种使用SARS-CoV-2逆转录聚合酶链反应(RT-PCR),一种结合RT-PCR和血清学RDT,一旦RDT可用,就开始了。接触RT-PCR-/RDT+被认为先前已被感染,不需要隔离。主要结果是可以通过两种筛查策略避免隔离的接触者比例。结果:我们纳入了34例儿童作为指标病例。中位年龄为7岁。他们产生了184个联系人(111个成年人,73名儿童)通过RT-PCR检测:24/184(13%)为阳性。RDT和RT-PCR相结合的策略在120/184个接触者中进行(77个成年人,26名指数儿童中的43名儿童):16/120(13%)为RT-PCR+,47/120(39%)为RDT+。在RT-PCR+的16个人中,14(87%)也为RDT+。在RT-PCR-的104个人中,33分别为RDT+。因此,33/120(27%)的个体没有被隔离。结论:在诊断出儿童SARS-CoV-2感染后,血清学RDT和鼻咽RT-PCR相结合的策略使我们能够识别约1/4的既往感染接触者,并避免对这些个体进行不必要的隔离.
    Background: The contact tracing and isolation of contagious individuals are cornerstones in the control of the COVID-19 pandemic. Strategies to identify household contacts who should be isolated around index children that tested positive for SARS-CoV-2 remain to be clarified. We aimed to compare contact tracing strategies around an index child positive for SARS-CoV-2 using serological rapid diagnostic testing (RDT, chromatography immunoassay). Methods: We conducted a contact tracing study in households of index cases children in the Paris region, France, between May 8 and July 27, 2020. We compared two strategies, one using SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) and one combining RT-PCR and serological RDT, initiated once RDT was available. The contacts RT-PCR-/RDT+ were considered to have been previously infected and not requiring quarantine. The primary outcome was the proportion of contacts that could avoid quarantine with the two screening strategies. Results: We included 34 children as index cases. Median age was 7 years. They generated 184 contacts (111 adults, 73 children) tested by RT-PCR: 24/184 (13%) were positive. The strategy combining RDT and RT-PCR was performed in 120/184 contacts (77 adults, 43 children) of 26 index children: 16/120 (13%) were RT-PCR+ and 47/120 (39%) were RDT+. Among the 16 individuals who were RT-PCR+, 14 (87%) were also RDT+. Among the 104 individuals who were RT-PCR-, 33 were RDT+. Hence 33/120 (27%) individuals were not isolated. Conclusions: Following the diagnosis of SARS-CoV-2 infection in children, a strategy combining serological RDT and nasopharyngeal RT-PCR enabled us to identify around one fourth of contacts with past infection and avoid unnecessary quarantine of these individuals.
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  • 文章类型: Journal Article
    新型COVID-19的出现导致卫生系统超负荷和高死亡率。关键的优先事项是控制流行病并防止感染率。在这种情况下,许多国家现在处于某种程度的封锁状态,以确保整个人口的极端社会距离,从而减缓流行病的传播。此外,当局使用病例隔离策略和手动第二/第三次接触者追踪来遏制COVID-19疾病。然而,手动接触者追踪是耗时且费力的任务,极大地超负荷了公共卫生系统。在本文中,我们开发了一种基于智能手机的方法,可以自动和广泛地追踪确认的COVID-19病例的联系人。特别是,接触者追踪方法创建了一份附近个人名单,并将确认的COVID-19病例通知接触者或官员。这种方法不仅使人们意识到他们在感染区域附近,但也追踪COVID-19携带者可能不记得的偶然接触。此后,我们开发了一个仪表板,为政策制定者提供如何安全解除封锁/大规模隔离的计划,从而解决经济危机。仪表板用于根据附近注册用户的收集位置和距离测量来预测封锁区域的水平。预测模型使用k-means算法作为一种无监督的机器学习技术进行封锁管理。
    The emergence of novel COVID-19 causes an over-load in health system and high mortality rate. The key priority is to contain the epidemic and prevent the infection rate. In this context, many countries are now in some degree of lockdown to ensure extreme social distancing of entire population and hence slowing down the epidemic spread. Furthermore, authorities use case quarantine strategy and manual second/third contact-tracing to contain the COVID-19 disease. However, manual contact-tracing is time-consuming and labor-intensive task which tremendously over-load public health systems. In this paper, we developed a smartphone-based approach to automatically and widely trace the contacts for confirmed COVID-19 cases. Particularly, contact-tracing approach creates a list of individuals in the vicinity and notifying contacts or officials of confirmed COVID-19 cases. This approach is not only providing awareness to individuals they are in the proximity to the infected area, but also tracks the incidental contacts that the COVID-19 carrier might not recall. Thereafter, we developed a dashboard to provide a plan for policymakers on how lockdown/mass quarantine can be safely lifted, and hence tackling the economic crisis. The dashboard used to predict the level of lockdown area based on collected positions and distance measurements of the registered users in the vicinity. The prediction model uses k-means algorithm as an unsupervised machine learning technique for lockdown management.
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  • 文章类型: Journal Article
    为了应对冠状病毒病的大流行,许多国家实施了为期14天的检疫。韩国对与感染者密切接触的人和从国外返回的人实施了强制隔离。本研究探讨了2019年强制性冠状病毒疾病检测的影响,然后将个人从仁川的14天检疫中释放出来,韩国。2020年2月11日至7月5日,19,296人被自我隔离,其中56例(0.3%)为COVID-19确诊病例。通过检疫期间的症状报告确定了20名(35.7%),32例(57.1%)采用强制性预发布RT-PCR检测。在32个个体中,14个(25%)个体报告轻度症状,18个(32.1%)无症状。建议发布前的强制性诊断测试和14天隔离后的基于症状的监测可能有助于控制延迟或无症状的COVID-19病例。
    A 14-day quarantine is implemented in many countries in response to the coronavirus disease pandemic. Korea implemented a mandatory quarantine for those who had close contact with infected patients and those returning from abroad. The present study explored the implications of mandatory coronavirus disease 2019 testing before releasing individuals from the 14-day quarantine in Incheon, Korea. From February 11 to July 5, 2020, 19,296 people were self-quarantined, and 56 (0.3%) of them were confirmed cases of COVID-19. Twenty (35.7%) were identified through the reporting of symptoms during quarantine, and 32 (57.1%) were identified using mandatory pre-release RT-PCR tests. Among the 32, 14 (25%) individuals reported mild symptoms and 18 (32.1%) were asymptomatic. It is suggested that mandatory diagnostic testing prior to release and the symptom-based surveillance after the 14-day quarantine may help control delayed or asymptomatic COVID-19 cases.
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  • 文章类型: Journal Article
    非洲的几个国家已经部署或考虑使用数字接触者追踪(DCT)作为其新冠肺炎遏制战略的一部分,在呼吁使用技术来提高传统接触者追踪的效率的过程中。我们讨论了在非洲使用DCT所带来的一些复杂性。采用社会技术观点,我们认为,如果DCT的设计和部署没有经过深思熟虑,它会导致意想不到的后果,特别是在像非洲大陆,数字鸿沟和其他结构性不平等的程度不成比例。我们建议,非洲国家采用DCT必须考虑到它们与当地资源的兼容性,值,社会结构,国内政治因素。因此,我们提出了一个翻译过程,通过利用从埃博拉等以往大流行中学习到的当地实践,开发一种混合流行病学方法来(数字)接触者追踪,从而使DCT适应适应非洲国家独特的制度和技术特征.
    Several countries in Africa have either deployed or considering using digital contact-tracing (DCT) as part of their Covid-19 containment strategy, amidst calls for the use of technology to improve the efficiency of traditional contact-tracing. We discuss some of the complexities entailed in using DCT in Africa. Adopting a socio-technical perspective, we argue that if DCT design and deployment are not well thought out, it can lead to unintended consequences, particularly in a continent like Africa with disproportionate levels of digital divides and other structural inequalities. We suggest that any adoption of DCT by African countries must take account of their compatibility with local resources, values, social structure, and domestic political factors. Accordingly, we propose a process of translation whereby DCT adaptation is made to accommodate the unique institutional and technological characteristics of African countries by leveraging local practices learned from previous pandemics like Ebola to develop a blended epidemiological approach to (digital) contact-tracing.
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  • 文章类型: Journal Article
    2019年12月出现了一种新型冠状病毒(COVID-19)的大流行,在全世界造成毁灭性的公共卫生影响。在没有安全有效的疫苗或抗病毒药物的情况下,控制和减轻大流行负担的战略侧重于非药物干预,比如社交距离,接触追踪,检疫,隔离,以及在公共场合使用口罩。我们开发了一种新的数学模型,用于评估上述控制和缓解策略的人口水平影响。对模型的严格分析表明,如果一定的流行病学阈值,无病均衡是局部渐近稳定的,称为再现数(用c表示),小于统一。模型的模拟,使用与美国纽约州和整个美国的COVID-19传输动态相关的数据,表明大流行负担将在4月中下旬达到顶峰,分别。对累积死亡率的最坏情况预测(基于研究中考虑的抗COVID非药物干预措施的基线水平)急剧下降80%和64%,分别,如果实施的严格的社会距离措施维持到5月底或6月底,2020年。放松或终止严格的社会距离措施的持续时间和时间对于确定COVID-19大流行的未来轨迹至关重要。这项研究表明,提前终止严格的社会距离措施可能会引发毁灭性的第二波负担,其负担与实施严格的社会距离措施之前的预期相似。使用有效的口罩(如外科口罩,如果纽约州至少70%的居民在公共场合一致使用这种口罩(全国范围内,使用此类面罩将需要至少80%的依从性)。使用低功效口罩,如布口罩(估计功效低于30%),也可能导致COVID-19负担的显著减少(尽管,他们无法导致淘汰)。将低功效口罩与其他抗COVID-19干预策略的水平提高相结合,可以消除大流行。这项研究强调了社交距离在减轻COVID-19负担方面的重要作用。社会距离协议遵守水平的提高导致大流行的负担急剧减轻,在美国许多州及时实施社会疏远措施可能避免了COVID-19负担的灾难性后果。在公共场所使用口罩(包括低效能布口罩)对于最大程度地减少COVID-19的社区传播和负担非常有用,前提是其覆盖率很高。如果基于口罩的干预与严格的社交距离策略相结合,则消除COVID-19所需的口罩覆盖率会降低。
    A pandemic of a novel Coronavirus emerged in December of 2019 (COVID-19), causing devastating public health impact across the world. In the absence of a safe and effective vaccine or antivirals, strategies for controlling and mitigating the burden of the pandemic are focused on non-pharmaceutical interventions, such as social-distancing, contact-tracing, quarantine, isolation, and the use of face-masks in public. We develop a new mathematical model for assessing the population-level impact of the aforementioned control and mitigation strategies. Rigorous analysis of the model shows that the disease-free equilibrium is locally-asymptotically stable if a certain epidemiological threshold, known as the reproduction number (denoted by ℛc), is less than unity. Simulations of the model, using data relevant to COVID-19 transmission dynamics in the US state of New York and the entire US, show that the pandemic burden will peak in mid and late April, respectively. The worst-case scenario projections for cumulative mortality (based on the baseline levels of anti-COVID non-pharmaceutical interventions considered in the study) decrease dramatically by 80% and 64%, respectively, if the strict social-distancing measures implemented are maintained until the end of May or June, 2020. The duration and timing of the relaxation or termination of the strict social-distancing measures are crucially-important in determining the future trajectory of the COVID-19 pandemic. This study shows that early termination of the strict social-distancing measures could trigger a devastating second wave with burden similar to those projected before the onset of the strict social-distancing measures were implemented. The use of efficacious face-masks (such as surgical masks, with estimated efficacy ≥ 70%) in public could lead to the elimination of the pandemic if at least 70% of the residents of New York state use such masks in public consistently (nationwide, a compliance of at least 80% will be required using such masks). The use of low efficacy masks, such as cloth masks (of estimated efficacy less than 30%), could also lead to significant reduction of COVID-19 burden (albeit, they are not able to lead to elimination). Combining low efficacy masks with improved levels of the other anti-COVID-19 intervention strategies can lead to the elimination of the pandemic. This study emphasizes the important role social-distancing plays in curtailing the burden of COVID-19. Increases in the adherence level of social-distancing protocols result in dramatic reduction of the burden of the pandemic, and the timely implementation of social-distancing measures in numerous states of the US may have averted a catastrophic outcome with respect to the burden of COVID-19. Using face-masks in public (including the low efficacy cloth masks) is very useful in minimizing community transmission and burden of COVID-19, provided their coverage level is high. The masks coverage needed to eliminate COVID-19 decreases if the masks-based intervention is combined with the strict social-distancing strategy.
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