Effectiveness of containment strategies in preventing SARS-CoV-2 transmission

Contact tracing strategies for infectious diseases: A systematic literature review

Contact tracing has been a crucial public health strategy for breaking infectious diseases chains of transmission. Although many resources exist for disease outbreak management none address the rationale of contact tracing. This comprehensive review aims to evaluate contact tracing strategies, their effectiveness, and health systems governance across various diseases to inform a disease-agnostic contact tracing guideline. This systematic review was registered with PROSPERO (ID: CRD42023474507) and follows Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Descriptive and interventional studies in the six official United Nations languages were included, excluding modelling studies and animal-to-human transmission. An electronic search was conducted in Embase, Medline, Medline-in-process, and Cochrane libraries from inception to September 2023. The revised Cochrane Risk of Bias Tool and the Risk of Bias in Non-Randomized Studies of Interventions were used for bias assessment. The search yielded 378 studies, primarily from Europe (29.6%) and North America (21.6%) and focusing on diseases such as the coronavirus disease (COVID-19) (47.4%) or tuberculosis (26.7%). 244 (64.5%) studies addressed contact tracing definitions, commonly based on physical proximity, including duration of contact and sexual partnerships (47.6%) and household exposure (27%). Effectiveness was examined in 330 (87.3%) studies, showing variation across diseases and contexts, with only five studies evaluating epidemiological impacts. Socio-cultural aspects were covered in 166 (43.9%) studies, revealing that stigma and public trust may affect the adherence to contact tracing. Health systems governance was discussed in 278 (73.5%) studies, emphasising the need for coordination among international organisations, national governments, and local health authorities, alongside a sustained and adequately supported workforce. This review provides critical insights into optimising contact tracing strategies. Effective contact tracing requires robust health systems governance, adequate resources, and community involvement. Future research should focus on establishing standardised metrics for comparative analysis and investigating the impact of contact tracing on disease incidence and mortality.

Introduction and acceptability of the Surveillance Outbreak Response Management and Analysis System (SORMAS) during the COVID-19 pandemic in Côte d'Ivoire

BACKGROUND

The Surveillance Outbreak Response Management and Analysis System (SORMAS) has been implemented for various infectious diseases since 2015. 2020, at the beginning of the COVID-19 pandemic, SORMAS was adapted to SARS-CoV2.

METHODS

We assessed the acceptability and usability of SORMAS and accompanied its implementation in two pilot regions of Côte d'Ivoire (Abidjan 2 and Gbêkê) from July/August 2021 to March 2022. We conducted 136 semi-structured interviews to cover knowledge on COVID-19, information on conventional surveillance systems for disease monitoring including COVID-19, acceptability of SORMAS, and impact of SORMAS on epidemic preparedness and surveillance. Scores before and 6-8 months after implementation were compared.

RESULTS

SORMAS was implemented in two pilot regions in Côte d'Ivoire. The conventional software for the surveillance of the COVID-19 pandemic by the company MAGPI was maintained in parallel; the additional time needs to enter and manage the data in SORMAS were the main concern. SORMAS acceptance and satisfaction scores were high after the user training, which was prior to implementation, and after 6-8 months of use. The ability of SORMAS to improve COVID-19 preparedness and early detection of cases and contacts was widely acknowledged. To keep the understanding and skills of users up-to-date, regular refresher trainings were requested. The expectation to be able to make decisions based on data produced by SORMAS was high at baseline and the perceived experience after several months of use of the software was very positive. Unfortunately, the link with the laboratories could not be established in the pilot regions, but it is an existing feature of SORMAS that many users were asking for. Following the positive experience using SORMAS for COVID-19, the pilot regions expanded its use for monitoring and management of measles, yellow fever, meningitis, and cholera.

CONCLUSION

SORMAS was very well accepted by users and decision makers in the two pilot regions of Côte d'Ivoire and its ability to improve epidemic preparedness and surveillance was acknowledged. If the hurdles of maintenance (tablets, server, and maintaining user skills) are handled sustainably, it can serve as a valid tool to identify, surveil and manage future outbreaks of various infectious diseases in Côte d'Ivoire.

Attitudes and practices toward COVID-19 precautionary measures: A comparative study of health professionals and public

BACKGROUND

Containment of the COVID-19 pandemic has been impaired by the denial and defiance of preventive recommendations.

AIMS

We aimed to study the attitudes toward COVID-19 social measures among laypersons and healthcare professionals.

METHODS

We conducted a cross-sectional study in the United Arab Emirates using a self-administered online questionnaire. Both healthcare workers and laypersons were actively recruited. In addition to sociodemographic variables, the questionnaire included questions on anxiety, knowledge, and defiance related to COVID-19.

RESULTS

A total of 615 individuals with a mean age of 32 years (SD, 12) participated. Females comprised 69% and healthcare workers constituted 60% of the study sample. Among laypersons, over 42% reported having social gatherings at home, and 44% admitted to visiting crowded places. More than half of the respondents felt increased anxiety. Previous COVID-19 infection did not affect attitudes or anxiety levels. Knowledge about COVID-19 was higher among those who were more educated (r = .21). Healthcare workers had lower anxiety than laypersons (p = .002). COVID-19 anxiety was higher among older persons and did not decrease with more knowledge. COVID-19 defiance was higher among younger male respondents from larger households and did not correlate with knowledge. Multivariate analysis showed more defiant attitudes at younger ages.

CONCLUSIONS

Anxiety-related to the COVID-19 pandemic is more common in older individuals, whereas younger persons were more likely to deny and defy prevention recommendations despite having knowledge of viral transmission. Voluntary compliance by young individuals requires an engaging communication strategy to generate more compassionate attitudes.

The German COVID-19 Digital Contact Tracing App: A Socioeconomic Evaluation

The COVID-19 pandemic posed challenges to governments in terms of contact tracing. Like many other countries, Germany introduced a mobile-phone-based digital contact tracing solution ("Corona Warn App"; CWA) in June 2020. At the time of its release, however, it was hard to assess how effective such a solution would be, and a political and societal debate arose regarding its efficiency, also in light of its high costs. This study aimed to analyze the effectiveness of the CWA, considering prevented infections, hospitalizations, intensive care treatments, and deaths. In addition, its efficiency was to be assessed from a monetary point of view, and factors with a significant influence on the effectiveness and efficiency of the CWA were to be determined. Mathematical and statistical modeling was used to calculate infection cases prevented by the CWA, along with the numbers of prevented complications (hospitalizations, intensive care treatments, deaths) using publicly available CWA download numbers and incidences over time. The monetized benefits of these prevented cases were quantified and offset against the costs incurred. Sensitivity analysis was used to identify factors critically influencing these parameters. Between June 2020 and April 2022, the CWA prevented 1.41 million infections, 17,200 hospitalizations, 4600 intensive care treatments, and 7200 deaths. After offsetting costs and benefits, the CWA had a net present value of EUR 765 m in April 2022. Both the effectiveness and efficiency of the CWA are decisively and disproportionately positively influenced by the highest possible adoption rate among the population and a high rate of positive infection test results shared via the CWA.

SARS-CoV-2 seroprevalence among cancer patients and household caregivers in a cancer hospital: Cross-sectional survey after the second COVID-19 wave in Thailand

Objectives

Patients with cancer may be at an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and experience more severe outcomes. Low vaccine coverage in the early phase of the coronavirus disease 2019 (COVID-19) pandemic meant that personal and social measures to reduce viral spread were the only methods of lowering the risk of infection among cancer patients. This study explored the prevalence of SARS-CoV-2 antibodies in cancer patients and caregivers in a cancer hospital after the second COVID-19 outbreak in Thailand.

Study design

Cross-sectional study.

Methods

A SARS-CoV-2 seroprevalence cross-sectional survey was conducted among 200 cancer patients and 200 household caregivers in a tertiary cancer care hospital in Bangkok, Thailand. The survey took place between 4 March and May 31, 2021 - a time period covering the end of the second COVID-19 wave and the early phase of the third wave in Thailand.

Results

Rigorous personal and social measures to reduce viral spread among cancer patients and caregivers lead to an extremely low prevalence of SARS-CoV2 infection (0% among cancer patients and 1% among household caregivers).

Conclusion

This study demonstrates the importance of social distancing and personal hygiene measures for the prevention of SARS-CoV-2 infection, even when vaccine coverage is low.