期刊
LANCET PUBLIC HEALTH
卷 6, 期 1, 页码 E21-E29出版社
ELSEVIER SCI LTD
DOI: 10.1016/S2468-2667(20)30269-3
关键词
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资金
- National Institute for Health Research (NIHR)
- Wellcome Trust
- UK Medical Research Council
- British Heart Foundation
- Alzheimer's Society
- EU
- UK NIHR
- Chronic Disease Research Foundation
- NIHR
- King's College London
- UK Research and Innovation London Medical Imaging and Artificial Intelligence Centre for Value Based Healthcare
- Wellcome Flagship Programme [WT213038/Z/18/Z]
- DHSC
- National Institute of Diabetes and Digestive and Kidney Diseases [K23 DK120899, K23 DK125838, K01DK120742]
- American Gastroenterological Association-Takeda COVID-19 Rapid Response Research Award [AGA2021-5102]
- Massachusetts Consortium on Pathogen Readiness
- American Gastroenterological Association Research Scholars Award
- Stuart and Suzanne Steele MGH Research Scholar Award
- Swedish Research Council
- Swedish Heart-Lung Foundation
- Swedish Foundation for Strategic Research [LUDC-IRC 15-0067]
- European Research Council Starting Grant
This study used data from users of the COVID Symptom Study app in England to track COVID-19 cases and epidemic trends, highlighting the importance of local-level disease tracking without reimposing national restrictions. By utilizing self-reported data, policymakers can gain insights into the pandemic and take targeted measures in a timely manner.
Background As many countries seek to slow the spread of COVID-19 without reimposing national restrictions, it has become important to track the disease at a local level to identify areas in need of targeted intervention. Methods In this prospective, observational study, we did modelling using longitudinal, self-reported data from users of the COVID Symptom Study app in England between March 24, and Sept 29, 2020. Beginning on April 28, in England, the Department of Health and Social Care allocated RT-PCR tests for COVID-19 to app users who logged themselves as healthy at least once in 9 days and then reported any symptom. We calculated incidence of COVID-19 using the invited swab (RT-PCR) tests reported in the app, and we estimated prevalence using a symptom-based method (using logistic regression) and a method based on both symptoms and swab test results. We used incidence rates to estimate the effective reproduction number, R(t), modelling the system as a Poisson process and using Markov Chain Monte-Carlo. We used three datasets to validate our models: the Office for National Statistics (ONS) Community Infection Survey, the Real-time Assessment of Community Transmission (REACT-1) study, and UK Government testing data. We used geographically granular estimates to highlight regions with rapidly increasing case numbers, or hotspots. Findings From March 24 to Sept 29, 2020, a total of 2 873 726 users living in England signed up to use the app, of whom 2 842 732 (98.9%) provided valid age information and daily assessments. These users provided a total of 120 192 306 daily reports of their symptoms, and recorded the results of 169 682 invited swab tests. On a national level, our estimates of incidence and prevalence showed a similar sensitivity to changes to those reported in the ONS and REACT-1 studies. On Sept 28, 2020, we estimated an incidence of 15 841 (95% CI 14 023-17 885) daily cases, a prevalence of 0.53% (0.45-0.60), and R(t) of 1.17 (1.15-1.19) in England. On a geographically granular level, on Sept 28, 2020, we detected 15 (75%) of the 20 regions with highest incidence according to government test data. Interpretation Our method could help to detect rapid case increases in regions where government testing provision is lower. Self-reported data from mobile applications can provide an agile resource to inform policy makers during a quickly moving pandemic, serving as a complementary resource to more traditional instruments for disease surveillance.
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