Effectiveness evaluation of digital contact tracing for COVID-19 in New South Wales, Australia.
Effectiveness evaluation of digital contact tracing for COVID-19 in New South Wales, Australia.
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DOI：
10.1016/s2468-2667(22)00010-x
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发表时间：
2022-03
期刊：
影响因子：
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通讯作者：
Kaldor J
中科院分区：
文献类型：
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作者：
Vogt F;Haire B;Selvey L;Katelaris AL;Kaldor J
在COVID-19大流行早期，许多国家推出了数字近距离追踪应用程序，以补充传统的接触者追踪。关于它们对大流行应对的益处的经验证据仍然很少。我们评估了澳大利亚基于智能手机的COVID-19近距离追踪应用程序covid - safe的有效性和实用性。在这项在澳大利亚新南威尔士州（NSW）进行的前瞻性研究中，我们纳入了该州所有在2020年5月4日至11月4日期间确诊本地获得性SARS-CoV-2感染的12岁以上的个体。我们使用了来自新南威尔士州应通报条件信息管理系统、国家covid - safe数据库的数据，以及来自病例访谈的信息，包括应用程序使用信息、应用程序建议的联系人数量，以及公共卫生工作人员确定为实际密切接触者的应用程序建议的联系人数量。我们计算了covid - safe的阳性预测值和敏感性、其额外接触量和避免的公众暴露事件数量。对公共卫生工作人员进行了半结构化访谈，以评估该应用程序的感知有用性。研究期间，通过常规接触者追踪发现新冠肺炎确诊病例619例，密切接触者25 300余人。137例（22%）病例使用了covid - safe，检测到205名接触者，其中79人（39%）符合密切接触者定义。其阳性预测值为39%。在研究期间可能使用该应用程序的236名密切接触者中，有35人（15%）被该应用程序识别出来，使其估计敏感性达到15%。在新南威尔士州估计的25 300名接触者中，有79名（0.3%）是应用程序推荐的，符合密切接触者定义。该应用程序检测到17名（< 0.1%）未通过常规接触者追踪确定的额外密切接触者。covid - safe给公共卫生工作人员带来了大量额外的工作量，并且被认为是无用的。考虑到只有使用该应用程序的联系人才能被检测到，该应用程序在病例中的低使用率可能导致我们研究中的敏感性估计降低。covid - safe在6个月的时间里没有足够的效力，无法为澳大利亚人口最多的州的COVID-19应对工作做出有意义的贡献。我们对这款数字接触者追踪应用程序进行了实证评估，质疑数字接触者追踪应用程序对公共卫生应对COVID-19的潜在益处。应将有效性评估纳入近距离接触追踪系统的未来实施，以证明其投资的合理性。新南威尔士州卫生部（澳大利亚）；国家卫生和医学研究委员会（澳大利亚）
Digital proximity tracing apps were rolled out early in the COVID-19 pandemic in many countries to complement conventional contact tracing. Empirical evidence about their benefits for pandemic response remains scarce. We evaluated the effectiveness and usefulness of COVIDSafe, Australia's national smartphone-based proximity tracing app for COVID-19. In this prospective study, done in New South Wales (NSW), Australia, we included all individuals in the state who were older than 12 years with confirmed, locally acquired SARS-CoV-2 infection between May 4 and Nov 4, 2020. We used data from the NSW Notifiable Conditions Information Management System, the national COVIDSafe database, and information from case interviews, including information on app usage, the number of app-suggested contacts, and the number of app-suggested contacts determined by public health staff to be actual close contacts. We calculated the positive predictive value and sensitivity of COVIDSafe, its additional contact yield, and the number of averted public exposure events. Semi-structured interviews with public health staff were done to assess the app's perceived usefulness. There were 619 confirmed COVID-19 cases with more than 25 300 close contacts identified by conventional contact tracing during the study period. COVIDSafe was used by 137 (22%) cases and detected 205 contacts, 79 (39%) of whom met the close contact definition. Its positive predictive value was therefore 39%. 35 (15%) of the 236 close contacts who could have been expected to have been using the app during the study period were identified by the app, making its estimated sensitivity 15%. 79 (0·3%) of the estimated 25 300 contacts in NSW were app-suggested and met the close contact definition. The app detected 17 (<0·1%) additional close contacts who were not identified by conventional contact tracing. COVIDSafe generated a substantial additional perceived workload for public health staff and was not considered useful. The low uptake of the app among cases probably led to a reduced sensitivity estimate in our study, given that only contacts who were using the app could be detected. COVIDSafe was not sufficiently effective to make a meaningful contribution to the COVID-19 response in Australia's most populous state over a 6 month period. We provide an empirical evaluation of this digital contact tracing app that questions the potential benefits of digital contact tracing apps to the public health response to COVID-19. Effectiveness evaluations should be integrated into future implementations of proximity contact tracing systems to justify their investment. New South Wales Ministry of Health (Australia); National Health and Medical Research Council (Australia)