COVID-19 Case Investigation and Contact Tracing in the US, 2020.
COVID-19 Case Investigation and Contact Tracing in the US, 2020.
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DOI：
10.1001/jamanetworkopen.2021.15850
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发表时间：
2021-06-01
影响因子：
13.8
通讯作者：
COVID-19 Contact Tracing Assessment Team
中科院分区：
文献类型：
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作者：
Lash RR;Moonan PK;Byers BL;Bonacci RA;Bonner KE;Donahue M;Donovan CV;Grome HN;Janssen JM;Magleby R;McLaughlin HP;Miller JS;Pratt CQ;Steinberg J;Varela K;Anschuetz GL;Cieslak PR;Fialkowski V;Fleischauer AT;Goddard C;Johnson SJ;Morris M;Moses J;Newman A;Prinzing L;Sulka AC;Va P;Willis M;Oeltmann JE;COVID-19 Contact Tracing Assessment Team
对实验室确诊的COVID-19患者及其接触者进行病例调查和接触者追踪的比例是多少？在这项基于监测的横断面研究中，3名COVID-19患者中有2人没有接受采访，或者在采访时没有透露任何联系人。公共卫生当局通过电话平均联系了0.7名接触者，每个病例仅监测了0.5名接触者，低于克服估计的全球SARS-CoV-2生殖数量所需的比率。这项研究的结果表明，目前的接触者追踪实践对SARS-CoV-2传播的影响并不理想。这项横断面研究调查了公共卫生当局接触到的确诊COVID-19病例及其接触者的比例，以及接触他们所需的时间，并比较了接触者和普通公众之间检测结果呈阳性的风险。接触者追踪是限制SARS-CoV-2传播的一个多步骤过程。过程中的差距导致错失预防COVID-19的机会。量化公共卫生当局接触到的病例及其接触者的比例以及接触他们所需的时间，并在4周的评估期内比较接触者和普通公众之间COVID-19检测结果呈阳性的风险。这项横断面研究在11个州和1个部落国家的13个卫生部门和1个印第安卫生服务单位进行。参与者包括所有实验室确诊的COVID-19患者及其指定的接触者。本地COVID-19监测数据用于确定2020年6月至10月期间接受采访并指定接触者的报告实验室确诊COVID-19的人数。对于接触者，计算了被识别、被告知其暴露并同意监测的人数。计算了从索引病例标本采集到通知接触者的中位时间，以及随后通知其暴露并监测的指定接触者人数。在相同的4周内，将指定和测试的接触者中SARS-CoV-2测试阳性的患病率与该管辖区的一般人群进行比较。呈报的个案总数为74 185宗。其中43 931人（59%）接受了访问，24 705人（33%）说出了任何接触者。在74 839名被点名的接触者中，53 314人（71%）被告知其接触，34 345人（46%）同意接受监测。公共卫生当局通过电话平均联系了0.7名接触者，每个病例仅监测了0.5名接触者。一般而言，在评估期间报告大量病例（≥5000例）的卫生部门进行的病例访谈和接触者通知比例较小。在9个地点，从标本采集到接触通知的中位时间为6天或更短。在有人口比较数据的8个地点中，6个地点的指定接触者阳性检测流行率高于一般人群。在这项对美国当地COVID-19监测数据的横断面研究中，对指定接触者进行检测是发现病例的高收益活动。然而，这项评估表明，接触者追踪对SARS-CoV-2传播的影响不是最佳的，主要是因为3例病例中有2例没有接受采访，或者在采访时没有提到接触者。这些研究结果与在各种预防战略之间分配公共卫生资源的决定以及病例调查和接触者追踪工作的优先次序有关。
What proportion of persons with laboratory-confirmed COVID-19 and their contacts are reached for case investigation and contact tracing? In this surveillance-based, cross-sectional study, 2 of 3 individuals with COVID-19 were either not reached for interview or named no contacts when interviewed. A mean of 0.7 contacts were reached by telephone by public health authorities, and only 0.5 contacts per case were monitored, a lower rate than needed to overcome the estimated global SARS-CoV-2 reproductive number. The findings of this study suggest that current contact tracing practice had suboptimal impact on SARS-CoV-2 transmission. This cross-sectional study examines proportions of individuals with confirmed COVID-19 cases and their contacts reached by public health authorities and the amount of time needed to reach them and compares the risk of a positive test result between contacts and the general public. Contact tracing is a multistep process to limit SARS-CoV-2 transmission. Gaps in the process result in missed opportunities to prevent COVID-19. To quantify proportions of cases and their contacts reached by public health authorities and the amount of time needed to reach them and to compare the risk of a positive COVID-19 test result between contacts and the general public during 4-week assessment periods. This cross-sectional study took place at 13 health departments and 1 Indian Health Service Unit in 11 states and 1 tribal nation. Participants included all individuals with laboratory-confirmed COVID-19 and their named contacts. Local COVID-19 surveillance data were used to determine the numbers of persons reported to have laboratory-confirmed COVID-19 who were interviewed and named contacts between June and October 2020. For contacts, the numbers who were identified, notified of their exposure, and agreed to monitoring were calculated. The median time from index case specimen collection to contact notification was calculated, as were numbers of named contacts subsequently notified of their exposure and monitored. The prevalence of a positive SARS-CoV-2 test among named and tested contacts was compared with that jurisdiction’s general population during the same 4 weeks. The total number of cases reported was 74 185. Of these, 43 931 (59%) were interviewed, and 24 705 (33%) named any contacts. Among the 74 839 named contacts, 53 314 (71%) were notified of their exposure, and 34 345 (46%) agreed to monitoring. A mean of 0.7 contacts were reached by telephone by public health authorities, and only 0.5 contacts per case were monitored. In general, health departments reporting large case counts during the assessment (≥5000) conducted smaller proportions of case interviews and contact notifications. In 9 locations, the median time from specimen collection to contact notification was 6 days or less. In 6 of 8 locations with population comparison data, positive test prevalence was higher among named contacts than the general population. In this cross-sectional study of US local COVID-19 surveillance data, testing named contacts was a high-yield activity for case finding. However, this assessment suggests that contact tracing had suboptimal impact on SARS-CoV-2 transmission, largely because 2 of 3 cases were either not reached for interview or named no contacts when interviewed. These findings are relevant to decisions regarding the allocation of public health resources among the various prevention strategies and for the prioritization of case investigations and contact tracing efforts.
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影响因子：
--
作者：
Harris, Gibbie;Ong, Jonathan
通讯作者：
Ong, Jonathan
DOI：
10.15585/mmwr.mm6945e1
发表时间：
2020-11-13
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Kanu FA;Smith EE;Offutt-Powell T;Hong R;Delaware Case Investigation and Contact Tracing Teams3;Dinh TH;Pevzner E
通讯作者：
Pevzner E
DOI：
10.1007/s11524-009-9378-z
发表时间：
2009-09-01
影响因子：
6.6
作者：
Asghar, Rana Jawad;Patlan, David E.;Oeltmann, John E.
通讯作者：
Oeltmann, John E.
DOI：
10.1097/phh.0000000000000918
发表时间：
2019-03-01
影响因子：
3.3
作者：
McFarlane, Timothy D.;Dixon, Brian E.;Gibson, P. Joseph
通讯作者：
Gibson, P. Joseph
影响因子：
11.8
作者：
Nyenswah, Tolbert G.;Fallah, Mosaka;Moonan, Patrick K.
通讯作者：
Moonan, Patrick K.