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Quach HL, Walsh EI, Hoang TNA, Terrett RNL, Vogt F. Effectiveness of digital contact tracing interventions for COVID-19: A systematic scoping review. Public Health 2025; 242:146-156. [PMID: 40068321 DOI: 10.1016/j.puhe.2025.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2024] [Revised: 01/27/2025] [Accepted: 02/17/2025] [Indexed: 04/29/2025]
Abstract
OBJECTIVES Digital contact tracing (DCT) interventions have been deployed at unprecedented scale during COVID-19. However, no comprehensive appraisal of the evidence exists to date regarding their effectiveness. We aimed to systematically review the global literature for a holistic understanding of DCT effectiveness during COVID-19, and to identify factors that enabled or hindered its effectiveness. STUDY DESIGN Systematic scoping review. METHODS We searched six databases for peer-reviewed literature relevant to the evaluation of DCT interventions during COVID-19 (January 2024) (CRD42021268586). We compiled implemented DCT interventions from grey literature. Effectiveness appraisals, different operationalizations, measurements, and definitions of DCT effectiveness, as well as associated factors were synthesized qualitatively. Study quality was assessed using the Mixed Methods Appraisal Tool. We followed Cochrane and PRISMA guidance. RESULTS We identified 133 studies evaluating 121 different DCT implementations. Seventy-three (60 %) studies found DCT to be effective, mostly when evaluating epidemiological impact metrics. Public trust emerged as crucial for DCT to be effective, which requires high and enforceable data safety and privacy standards, clear and transparent communication, high accuracy and reliability of the intervention, and an acceptance-enhancing implementation approach of other pandemic response measures by public health authorities more broadly. Most evaluations took place in high rather than low-resource settings. CONCLUSION While technical performance matters, DCT effectiveness primarily depends on a relatively small number of non-technical drivers centred around public trust. DCT should only be implemented as integrated part of a broader public health framework. Our findings hold important insights for the design, implementation, and evaluation of other digital technology for pandemic response.
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Affiliation(s)
- Ha-Linh Quach
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Australian Capital Territory, Australia; Centre of Ageing Research & Education, Duke-NUS Medical School, Singapore, Singapore.
| | - Erin I Walsh
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Australian Capital Territory, Australia
| | | | - Richard Norman Leslie Terrett
- School of Science, UNSW Canberra at the Australian Defence Force Academy, Canberra, Australian Capital Territory, Australia
| | - Florian Vogt
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Australian Capital Territory, Australia; The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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Geenen C, Raymenants J, Gorissen S, Thibaut J, McVernon J, Lorent N, André E. Individual level analysis of digital proximity tracing for COVID-19 in Belgium highlights major bottlenecks. Nat Commun 2023; 14:6717. [PMID: 37872213 PMCID: PMC10593825 DOI: 10.1038/s41467-023-42518-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023] Open
Abstract
To complement labour-intensive conventional contact tracing, digital proximity tracing was implemented widely during the COVID-19 pandemic. However, the privacy-centred design of the dominant Google-Apple exposure notification framework has hindered assessment of its effectiveness. Between October 2021 and January 2022, we systematically collected app use and notification receipt data within a test and trace programme targeting around 50,000 university students in Leuven, Belgium. Due to low success rates in each studied step of the digital notification cascade, only 4.3% of exposed contacts (CI: 2.8-6.1%) received such notifications, resulting in 10 times more cases detected through conventional contact tracing. Moreover, the infection risk of digitally traced contacts (5.0%; CI: 3.0-7.7%) was lower than that of conventionally traced non-app users (9.8%; CI: 8.8-10.7%; p = 0.002). Contrary to common perception as near instantaneous, there was a 1.2-day delay (CI: 0.6-2.2) between case PCR result and digital contact notification. These results highlight major limitations of a digital proximity tracing system based on the dominant framework.
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Affiliation(s)
- Caspar Geenen
- KU Leuven, Dept of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, Leuven, Belgium.
| | - Joren Raymenants
- KU Leuven, Dept of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, Leuven, Belgium
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Sarah Gorissen
- KU Leuven, Dept of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, Leuven, Belgium
| | - Jonathan Thibaut
- KU Leuven, Dept of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, Leuven, Belgium
| | - Jodie McVernon
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Laboratory Epidemiology Unit, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Natalie Lorent
- University Hospitals Leuven, Respiratory Diseases, Leuven, Belgium
- KU Leuven, Dept of CHROMETA, Laboratory of Thoracic Surgery and Respiratory Diseases (BREATHE), Leuven, Belgium
| | - Emmanuel André
- KU Leuven, Dept of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, Leuven, Belgium
- University Hospitals Leuven, Laboratory Medicine, Leuven, Belgium
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3
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Daniore P, Moser A, Höglinger M, Probst Hensch N, Imboden M, Vermes T, Keidel D, Bochud M, Ortega Herrero N, Baggio S, Chocano-Bedoya P, Rodondi N, Tancredi S, Wagner C, Cullati S, Stringhini S, Gonseth Nusslé S, Veys-Takeuchi C, Zuppinger C, Harju E, Michel G, Frank I, Kahlert CR, Albanese E, Crivelli L, Levati S, Amati R, Kaufmann M, Geigges M, Ballouz T, Frei A, Fehr J, von Wyl V. Interplay of Digital Proximity App Use and SARS-CoV-2 Vaccine Uptake in Switzerland: Analysis of Two Population-Based Cohort Studies. Int J Public Health 2023; 68:1605812. [PMID: 37799349 PMCID: PMC10549773 DOI: 10.3389/ijph.2023.1605812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/18/2023] [Indexed: 10/07/2023] Open
Abstract
Objectives: Our study aims to evaluate developments in vaccine uptake and digital proximity tracing app use in a localized context of the SARS-CoV-2 pandemic. Methods: We report findings from two population-based longitudinal cohorts in Switzerland from January to December 2021. Failure time analyses and Cox proportional hazards regression models were conducted to assess vaccine uptake and digital proximity tracing app (SwissCovid) uninstalling outcomes. Results: We observed a dichotomy of individuals who did not use the SwissCovid app and did not get vaccinated, and who used the SwissCovid app and got vaccinated during the study period. Increased vaccine uptake was observed with SwissCovid app use (aHR, 1.51; 95% CI: 1.40-1.62 [CI-DFU]; aHR, 1.79; 95% CI: 1.62-1.99 [CSM]) compared to SwissCovid app non-use. Decreased SwissCovid uninstallation risk was observed for participants who got vaccinated (aHR, 0.55; 95% CI: 0.38-0.81 [CI-DFU]; aHR, 0.45; 95% CI: 0.27-0.78 [CSM]) compared to participants who did not get vaccinated. Conclusion: In evolving epidemic contexts, these findings underscore the need for communication strategies as well as flexible digital proximity tracing app adjustments that accommodate different preventive measures and their anticipated interactions.
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Affiliation(s)
- Paola Daniore
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
| | - André Moser
- Clinical Trials Unit Bern, University of Bern, Bern, Switzerland
| | - Marc Höglinger
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Nicole Probst Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Medea Imboden
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Thomas Vermes
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Dirk Keidel
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Murielle Bochud
- Unisanté, University Center for Primary Care and Public Health, Lausanne, Switzerland
| | - Natalia Ortega Herrero
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Stéphanie Baggio
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Patricia Chocano-Bedoya
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefano Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Cornelia Wagner
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Silvia Stringhini
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Semira Gonseth Nusslé
- Unisanté, University Center for Primary Care and Public Health, Lausanne, Switzerland
| | | | - Claire Zuppinger
- Unisanté, University Center for Primary Care and Public Health, Lausanne, Switzerland
| | - Erika Harju
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Clinical Trial Unit, Lucerne Cantonal Hospital, Lucerne, Switzerland
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Irène Frank
- Clinical Trial Unit, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Christian R. Kahlert
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Infectious Diseases and Hospital Epidemiology, Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Luca Crivelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
- Department Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Sara Levati
- Department Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Rebecca Amati
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Marco Geigges
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Tala Ballouz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Jan Fehr
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Division of Infectious Disease and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Viktor von Wyl
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
- Division of Infectious Disease and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
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Liu X, Zhong C, Xie J, Liu H, Xie Z, Zhang S, Jin J. Geographical region traceability of Poria cocos and correlation between environmental factors and biomarkers based on a metabolomic approach. Food Chem 2023; 417:135817. [PMID: 36905692 DOI: 10.1016/j.foodchem.2023.135817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/20/2023] [Accepted: 02/26/2023] [Indexed: 03/08/2023]
Abstract
The edible values of P. cocos from different origins vary significantly, therefore, it is important to investigate the traceability of geographical regions and identify the geographical biomarkers of P. cocos. The metabolites of P. cocos of the different geographical origins were assessed using liquid chromatography tandem-mass spectrometry, principal component analysis and orthogonal partial least-squares discriminant analysis (OPLS-DA). The OPLS-DA could clearly discriminate the metabolites of P. cocos from the three cultivation regions (YN, Yunnan; AH, Anhui; JZ, Hunan). Finally, three carbohydrates, four amino acids, and four triterpenoids were selected as biomarkers for P. cocos origin tracing. Correlation matrix analysis revealed that the contents of biomarkers were closely related to geographical origin. Altitude, temperature, and soil fertility were the main factors responsible for the differences in biomarker profiles in P. cocos. The metabolomics approach provides an effective strategy for tracing and identifying the biomarkers of P. cocos from different geographical origins.
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Affiliation(s)
- Xiaoliu Liu
- Hunan Academy of Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410208, China; Institute of Chinese Medicine Resources, Hunan Academy of Chinese Medicine, Changsha 410013, China
| | - Can Zhong
- Institute of Chinese Medicine Resources, Hunan Academy of Chinese Medicine, Changsha 410013, China
| | - Jing Xie
- Hunan Academy of Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410208, China; Institute of Chinese Medicine Resources, Hunan Academy of Chinese Medicine, Changsha 410013, China
| | - Hao Liu
- Institute of Chinese Medicine Resources, Hunan Academy of Chinese Medicine, Changsha 410013, China
| | - Zhenni Xie
- Hunan Academy of Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410208, China; Institute of Chinese Medicine Resources, Hunan Academy of Chinese Medicine, Changsha 410013, China
| | - Shuihan Zhang
- Institute of Chinese Medicine Resources, Hunan Academy of Chinese Medicine, Changsha 410013, China
| | - Jian Jin
- Institute of Chinese Medicine Resources, Hunan Academy of Chinese Medicine, Changsha 410013, China.
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5
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Daniore P, Nittas V, Ballouz T, Menges D, Moser A, Höglinger M, Villiger P, Schmitz-Grosz K, Von Wyl V. Performance of the Swiss Digital Contact-Tracing App Over Various SARS-CoV-2 Pandemic Waves: Repeated Cross-sectional Analyses. JMIR Public Health Surveill 2022; 8:e41004. [PMID: 36219833 PMCID: PMC9700234 DOI: 10.2196/41004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/28/2022] [Accepted: 10/09/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Digital proximity-tracing apps have been deployed in multiple countries to assist with SARS-CoV-2 pandemic mitigation efforts. However, it is unclear how their performance and effectiveness were affected by changing pandemic contexts and new viral variants of concern. OBJECTIVE The aim of this study is to bridge these knowledge gaps through a countrywide digital proximity-tracing app effectiveness assessment, as guided by the World Health Organization/European Center for Prevention and Disease Control (WHO/ECDC) indicator framework to evaluate the public health effectiveness of digital proximity-tracing solutions. METHODS We performed a descriptive analysis of the digital proximity-tracing app SwissCovid in Switzerland for 3 different periods where different SARS-CoV-2 variants of concern (ie, Alpha, Delta, and Omicron, respectively) were most prevalent. In our study, we refer to the indicator framework for the evaluation of public health effectiveness of digital proximity-tracing apps of the WHO/ECDC. We applied this framework to compare the performance and effectiveness indicators of the SwissCovid app. RESULTS Average daily registered SARS-CoV-2 case rates during our assessment period from January 25, 2021, to March 19, 2022, were 20 (Alpha), 54 (Delta), and 350 (Omicron) per 100,000 inhabitants. The percentages of overall entered authentication codes from positive tests into the SwissCovid app were 9.9% (20,273/204,741), 3.9% (14,372/365,846), and 4.6% (72,324/1,581,506) during the Alpha, Delta, and Omicron variant phases, respectively. Following receipt of an exposure notification from the SwissCovid app, 58% (37/64, Alpha), 44% (7/16, Delta), and 73% (27/37, Omicron) of app users sought testing or performed self-tests. Test positivity among these exposure-notified individuals was 19% (7/37) in the Alpha variant phase, 29% (2/7) in the Delta variant phase, and 41% (11/27) in the Omicron variant phase compared to 6.1% (228,103/3,755,205), 12% (413,685/3,443,364), and 41.7% (1,784,951/4,285,549) in the general population, respectively. In addition, 31% (20/64, Alpha), 19% (3/16, Delta), and 30% (11/37, Omicron) of exposure-notified app users reported receiving mandatory quarantine orders by manual contact tracing or through a recommendation by a health care professional. CONCLUSIONS In constantly evolving pandemic contexts, the effectiveness of digital proximity-tracing apps in contributing to mitigating pandemic spread should be reviewed regularly and adapted based on changing requirements. The WHO/ECDC framework allowed us to assess relevant domains of digital proximity tracing in a holistic and systematic approach. Although the Swisscovid app mostly worked, as reasonably expected, our analysis revealed room for optimizations and further performance improvements. Future implementation of digital proximity-tracing apps should place more emphasis on social, psychological, and organizational aspects to reduce bottlenecks and facilitate their use in pandemic contexts.
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Affiliation(s)
- Paola Daniore
- Institute for Implementation Science in Healthcare, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
| | - Vasileios Nittas
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Tala Ballouz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Dominik Menges
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - André Moser
- Clinical Trials Unit, University of Bern, Bern, Switzerland
| | - Marc Höglinger
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | | | | | - Viktor Von Wyl
- Institute for Implementation Science in Healthcare, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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6
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Ballouz T, Menges D, Aschmann HE, Jung R, Domenghino A, Fehr JS, Puhan MA, von Wyl V. Individual-level Evaluation of the Exposure Notification Cascade in the SwissCovid Digital Proximity Tracing App: An Observational Study. JMIR Public Health Surveill 2022; 8:e35653. [PMID: 35476726 PMCID: PMC9122110 DOI: 10.2196/35653] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/03/2022] [Accepted: 04/26/2022] [Indexed: 12/31/2022] Open
Abstract
Background Digital proximity tracing (DPT) aims to complement manual contact tracing (MCT) in identifying exposed contacts and preventing further transmission of SARS-CoV-2 in the population. Although several DPT apps, including SwissCovid, have shown to have promising effects on mitigating the pandemic, several challenges have impeded them from fully achieving the desired results. A key question now relates to how the effectiveness of DPT can be improved, which requires a better understanding of factors influencing its processes. Objective In this study, we aim to provide a detailed examination of the exposure notification (EN) cascade and to evaluate potential contextual influences for successful receipt of an EN and subsequent actions taken by cases and contacts in different exposure settings. Methods We used data from 285 pairs of SARS-CoV-2-infected cases and their contacts within an observational cohort study of cases and contacts identified by MCT and enrolled between August 6, 2020, and January 17, 2021, in the canton of Zurich, Switzerland. We surveyed participants with electronic questionnaires. Data were summarized descriptively and stratified by exposure setting. Results We found that only 79 (58.5%) of 135 contacts using the SwissCovid app whose corresponding cases reported to have triggered the EN also received one. Of these, 18 (22.8%) received the EN before MCT. Compared to those receiving an EN after MCT (61/79, 77.2%), we observed that a higher proportion of contacts receiving an EN before MCT were exposed in nonhousehold settings (11/18, 61.1%, vs 34/61, 55.7%) and their corresponding cases had more frequently reported mild-to-moderate symptoms (14/18, 77.8%, vs 42/61, 68.9%). Of the 18 contacts receiving an EN before MCT, 14 (77.8%) took recommended measures: 12 (66.7%) were tested for SARS-CoV-2, and 7 (38.9%) called the SwissCovid Infoline. In nonhousehold settings, the proportion of contacts taking preventive actions after receiving an EN was higher compared to same-household settings (82%, vs 67%). In addition, 1 (9%) of 11 ENs received in the nonhousehold setting before MCT led to the identification of a SARS-CoV-2-infected case by prompting the contact to get tested. This corresponds to 1 in 85 exposures of a contact to a case in a nonhousehold setting, in which both were app users and the case triggered the EN. Conclusions Our descriptive evaluation of the DPT notification cascade provides further evidence that DPT is an important complementary tool in pandemic mitigation, especially in nonhousehold exposure settings. However, the effect of DPT apps can only be exerted if code generation processes are efficient and exposed contacts are willing to undertake preventive actions. This highlights the need to focus efforts on keeping barriers to efficient code generation as low as possible and promoting not only app adoption but also compliance with the recommended measures upon an EN. Trial Registration International Standard Randomised Controlled Trial Number Registry 14990068; https://doi.org/10.1186/ISRCTN14990068
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Affiliation(s)
- Tala Ballouz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich, CH
| | - Dominik Menges
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich, CH
| | - Hélène E Aschmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich, CH.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, US
| | - Ruedi Jung
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich, CH
| | - Anja Domenghino
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich, CH.,Department of Visceral and Transplantation Surgery, University Hospital Zurich (USZ), University of Zurich, Zurich, CH
| | - Jan S Fehr
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich, CH
| | - Milo Alan Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich, CH
| | - Viktor von Wyl
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich, CH.,Institute for Implementation Science in Health Care, University of Zurich, Zurich, CH
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