Contact tracking: Technology improves epidemic investigation

Contact tracking is used by state health agencies to identify people who may have been exposed to health threats, such as the new coronavirus, either through direct contact with someone with COVID-19 or with someone who has been near that person .

Investigators quickly identify and notify all potential contacts, break the chain of transmission if possible, conduct medical evaluations when necessary, and quarantine contacts if they are (or become) symptomatic. Another result of contact tracking is to influence public health policies through the study of pollution chains.

The goal of contact tracking is to reduce the spread and duration of an epidemic or pandemic. With the COVID-19 pandemic, contact tracking will hopefully have the follow-up effect of helping governments know when it’s safe to start reopening the community and quickly identifying and alerting people to the inevitable resurgence of outbreaks.

Contact tracking sounds straightforward, but it can be overwhelmingly complex and resource-consuming. And how can technology help? It is a very manual process, and while it works well, technology can help improve it and complement it through device resolution, case management, alarm automation and network analytics.

Although contact tracking may seem like a relatively new concept to the public, this practice has been used by health officials for decades as an attempt to ward off a range of infectious diseases by carefully identifying the transfer points and slowing the spread of society.

In fact, the state of New York recently unveiled its contact tracking plan, which requires hiring as many as 17,000 contact trackers to help fight the coronavirus pandemic. And France is hiring large brigades of contact trackers. Belgium employs 2,000 “corona detectives” for a population of approx. 11.5 million people. Not all of these tracers are in the field. Some will be at call centers, others will work with incoming data, and others will be public health experts.

These modern contact tracking efforts can be enhanced with data visualization and analytics to help public health officials reveal insights from tracking efforts and publicly available health data to understand:

  • Missing or unexpected connections in contact data.
  • Who needs to be tested.
  • Where the virus spreads.
  • Which communities are at greatest risk.

This increased awareness is a valuable tool that allows epidemiologists and health officials to respond faster by introducing containment measures and issuing public alarms to COVID-19 “hot zones.”

Contact tracking: A history of disease tracking

One of the most famous cases of contact tracking is “Typhoid Mary” in New York City in the early 20th century. The source of infectiousness turned out to be an asymptomatic carrier, a fluctuating household cook for a number of the city’s wealthy families. Only through the scientific and diligent work of George Soper (considered by many to be the first epidemiologist) were authorities able to not only identify the source but also realize that some people could carry and transmit the disease while appearing to be healthy.

Soper’s detective work, in which we interviewed typhoid patients and their families, became the basis for modern contact tracking. Much of the work is unchanged and contact tracking has become a cornerstone of preventative medicine. From AIDS to Ebola, contact tracking helps fight disease outbreaks worldwide.

Contact tracking in today’s world

A reporter’s standard set of questions – who, what, when, where and why – are the same as a contact find when interviewing someone diagnosed with an infectious disease, such as COVID-19. They seek information directly from the source to help determine who the person came into contact with when these interactions happened and where they occurred. Ultimately, the goal is to establish compounds that help slow down the spread of the virus. But that’s easier said than done. What happens if patients do not remember all their movements for the past two weeks? What if a patient is disabled and unable to answer questions? People who were unknowingly exposed to the infected person could go on with their lives, unaware that they could also be infected and spread the disease further. This is precisely where modern technology can play a key role.

An eleven cumbersome process that depended on the individual’s often incomplete or inaccurate memory, contact tracking has entered the digital era. Thanks to advanced analysis and data visualization, public health officials and investigators are finding new channels to quickly identify (with their consent) people who have been exposed to COVID-19 to isolate themselves, seek treatment if necessary, and prevent the spread of infection .

The latest data management capabilities and advanced analytics give contact trackers a new set of tools to work with. There are four areas where analysis can help.

Contact transaction databases with device resolution

These databases are the home of contact data tracking. They enable device resolution, for example, connecting multiple records in perhaps multiple databases to the same person. This is a huge time saver when speed is important (as it is with contact tracking). Using data management solutions means you can establish (and show) connections between patients, their contacts, and the places they may frequent to narrow and focus efforts on tracking resources for contact. By combining different data sources into a single archive that can be updated in real time, data scientists can gain insight into how connections are formed and changed over time. They can also suggest which contacts in a patient’s network have more current relevance and how wide their geographical area may be.

Enriched contact tracking data

Using analytics and machine learning provides health officials with new and important insights into each patient’s network. Analytics can help determine who may be directly related to a patient – such as family, friends and neighbors – but also employer plans, passenger protests and school records. Machine learning can help automate this effort by building analytical models that reflect real-world data and relationships.

Intelligent alarms

Once the contact tracking team has adequately identified a patient’s links and networks, it can begin the task of automatically notifying people in that network through text / SMS messages or emails. Based on the likelihood of close, extended contact, such as a work colleague, they may be notified of a health assessment. Or in the case of a restaurant, staff may be notified that someone with the virus was a patron, so the restaurant can do a thorough cleaning. Sometimes for large groups, it may be more possible to send an alert and ask people to contact their doctor or health department for screening.

Insights into public health

When assessing a patient’s network, public officials can rely on analytical insights from the data to fill in some of the gaps to answer questions such as:

  • Who should be tested?
  • Who is most likely to spread the virus?
  • How do I find missing or unknown connections?
  • Which communities are most at risk?
  • Does social distance work?

The current pandemic has exposed weaknesses in the traditional approach to contact tracking. The rapidity of the COVID-19 outbreak has exceeded public health infrastructure and has emphasized the need for innovative approaches to increase contact tracking capabilities.

How we can help

With the COVID-19 pandemic affecting communities around the world, public health officials from different regions have different needs and approaches when it comes to contact tracking.

Eg. Combines analytics robust link analysis and visualization with text and geospatial search and analysis, interactive networking, device generation and contact analysis. These capabilities enable health officials and investigators to proactively identify risk contacts and superspreaders.

Analytics software can integrate data from a variety of external sources to quickly implement the right data for our cloud-ready survey and event management solution. From there, users can easily create, triage and manage their efforts to make contact tracking more complete.

Advanced analytical modeling tools help health officials and governments answer the critical questions needed to implement smart public health policies. With data visualization capabilities, users can conduct deeper studies of contacts and data to reveal hidden patterns and share them across different health agencies.

Analytics can help governments establish contact tracking databases where public health workers can enter contact tracking data in real time. In addition, analytics can enrich the data collected from contact tracking conversations by establishing more comprehensive links using direct link data, inferred link data, and communication method data. These links can be visually displayed and analyzed over time.

Once links are established, you can generate alarms that public health officials can send to communicate with contacts for a given patient. These alarms can convey health risk alerts and can be customized for each recipient, such as instructing them to have a COVID-19 test on a specific facility or to self-quarantine for a specific number of days. They can be sent through automatic channels, such as text / SMS messages and emails.

Contact tracking and privacy

Contact tracking collects data that can often be considered protected data under existing privacy laws such as name, address, phone number, email address and, of course, health conditions.

A discussion about contact tracking is not complete without at least touching on the sensitive and genuine privacy issues we all have. And the level of intrusion into a patient’s privacy (and the level of the patient’s network) varies from country to country. Public health officials can turn to analysis again – this time to help protect privacy. Computer scientists can use techniques such as masking, identification and role-based security to maintain a healthy balance between privacy and good public health.

However, it is important to note that some data protection laws regulate, but do not prohibit, contact tracking. And most data protection laws allow for data sharing during public health emergencies, such as pandemics.

Negotiations will and should continue with regard to the legal and ethical challenges of the trade exchange between public welfare and individual personal information, but without access to as much contact data as possible, tracking efforts will be as difficult now as in the 1900s.

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