Detecting COVID-19 infection hotspots in England using large-scale self-reported data from a mobile application: a prospective, observational study.


Journal

medRxiv : the preprint server for health sciences
Titre abrégé: medRxiv
Pays: United States
ID NLM: 101767986

Informations de publication

Date de publication:
17 Nov 2020
Historique:
pubmed: 4 11 2020
medline: 4 11 2020
entrez: 3 11 2020
Statut: epublish

Résumé

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. We performed modelling on longitudinal, self-reported data from users of the COVID Symptom Study app in England between 24 March and 29 September, 2020. Combining a symptom-based predictive model for COVID-19 positivity and RT-PCR tests provided by the Department of Health we were able to estimate disease incidence, prevalence and effective reproduction number. Geographically granular estimates were used to highlight regions with rapidly increasing case numbers, or hotspots. More than 2.8 million app users in England provided 120 million daily reports of their symptoms, and recorded the results of 170,000 PCR tests. On a national level our estimates of incidence and prevalence showed similar sensitivity to changes as two national community surveys: the ONS and REACT-1 studies. On 28 September 2020 we estimated 15,841 (95% CI 14,023-17,885) daily cases, a prevalence of 0.53% (95% CI 0.45-0.60), and R(t) of 1.17 (95% credible interval 1.15-1.19) in England. On a geographically granular level, on 28 September 2020 we detected 15 of the 20 regions with highest incidence according to Government test data, with indications that our method may be able to detect rapid case increases in regions where Government testing provision is more limited. Self-reported data from mobile applications can provide an agile resource to inform policymakers during a fast-moving pandemic, serving as an independent and complementary resource to more traditional instruments for disease surveillance. Zoe Global Limited, Department of Health, Wellcome Trust, EPSRC, NIHR, MRC, Alzheimer's Society.

Sections du résumé

BACKGROUND 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 METHODS
We performed modelling on longitudinal, self-reported data from users of the COVID Symptom Study app in England between 24 March and 29 September, 2020. Combining a symptom-based predictive model for COVID-19 positivity and RT-PCR tests provided by the Department of Health we were able to estimate disease incidence, prevalence and effective reproduction number. Geographically granular estimates were used to highlight regions with rapidly increasing case numbers, or hotspots.
FINDINGS RESULTS
More than 2.8 million app users in England provided 120 million daily reports of their symptoms, and recorded the results of 170,000 PCR tests. On a national level our estimates of incidence and prevalence showed similar sensitivity to changes as two national community surveys: the ONS and REACT-1 studies. On 28 September 2020 we estimated 15,841 (95% CI 14,023-17,885) daily cases, a prevalence of 0.53% (95% CI 0.45-0.60), and R(t) of 1.17 (95% credible interval 1.15-1.19) in England. On a geographically granular level, on 28 September 2020 we detected 15 of the 20 regions with highest incidence according to Government test data, with indications that our method may be able to detect rapid case increases in regions where Government testing provision is more limited.
INTERPRETATION CONCLUSIONS
Self-reported data from mobile applications can provide an agile resource to inform policymakers during a fast-moving pandemic, serving as an independent and complementary resource to more traditional instruments for disease surveillance.
FUNDING BACKGROUND
Zoe Global Limited, Department of Health, Wellcome Trust, EPSRC, NIHR, MRC, Alzheimer's Society.

Identifiants

pubmed: 33140073
doi: 10.1101/2020.10.26.20219659
pmc: PMC7605586
pii:
doi:

Types de publication

Preprint

Langues

eng

Subventions

Organisme : NIDDK NIH HHS
ID : K01 DK120742
Pays : United States

Commentaires et corrections

Type : UpdateIn

Auteurs

Thomas Varsavsky (T)

School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.

Mark S Graham (MS)

School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.

Liane S Canas (LS)

School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.

Sajaysurya Ganesh (S)

Zoe Global Limited, London, UK.

Joan Capdevila Pujol (JC)

Zoe Global Limited, London, UK.

Carole H Sudre (CH)

School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
MRC Unit for Lifelong Health and Ageing,Department of Population Science and Experimental Medicine, University College London, UK.
Centre for Medical Image Computing, Department of Computer Science, University College London, UK.

Benjamin Murray (B)

School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.

Marc Modat (M)

School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.

M Jorge Cardoso (MJ)

School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.

Christina M Astley (CM)

Division of Endocrinology and Computational Epidemiology, Boston Children's Hospital, Harvard Medical School, USA.

David A Drew (DA)

Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, MA, USA.

Long H Nguyen (LH)

Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, MA, USA.

Tove Fall (T)

Department of Medical Sciences, Uppsala University, Uppsala, Sweden.

Maria F Gomez (MF)

Department of Clinical Sciences, Lund University Diabetes Centre, Sweden.

Paul W Franks (PW)

Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Sweden.

Andrew T Chan (AT)

Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, MA, USA.

Richard Davies (R)

Zoe Global Limited, London, UK.

Jonathan Wolf (J)

Zoe Global Limited, London, UK.

Claire J Steves (CJ)

Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.

Tim D Spector (TD)

Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.

Sebastien Ourselin (S)

School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.

Classifications MeSH