Contact tracing with digital assistance in Taiwan's COVID-19 outbreak response

Aim: Comprehensive case investigation and contact tracing are crucial to prevent community spread of COVID-19. We demonstrated a utility of using traditional contact tracing measures supplemented with symptom tracking and contact management system to assist public health workers with high efficiency. Methods: A centralized contact tracing system was developed to support data linkage, cross-jurisdictional coordination, and follow-up of contacts' health status. We illustrated the process of how digital tools support contact tracing and management of COVID-19 cases and measured the timeliness from case detection to contact monitoring to evaluate system performance. Results: Among the 8051 close contacts of the 487 confirmed cases (16.5 close contacts/case, 95% CI [13.9-19.1]), the median elapsed time from last exposure to quarantine was three days (IQR 1-5). By implementing the approach of self-reporting using automatic text-messages and web-app, the percentage of health status updates from self-reporting increased from 22.5% to 61.5%. The high proportion of secondary cases detected via contact tracing (88%) might reduce the R0 to under one and minimize the impact of local transmission in the community. Conclusion: Comprehensive contact tracing and management with complementary technology would still be a pillar of strategies for containing outbreaks during de-escalation or early in the next wave of COVID-19 pandemic. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.