COVID-19 contact tracing during first delta wave, Lebanon, 2021
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Abstract
Background
On the 11th March, the WHO has declared COVID-19 pandemic. Officially, the virus was introduced in Lebanon on the 21st February 2020. Since then, the national curve has drawn several waves. From July to September 2021, Lebanon has experienced the first delta wave. As part of the investigation, contact tracing was enhanced to limit virus transmission. The objective is to describe close tracing approach and profile of close contacts identified during the first delta wave.
Methods
COVID-19 surveillance is integrated within the national communicable diseases surveillance. The case definitions are adopted from WHO guides. Laboratories report positive cases on daily basis to the Ministry of Public Health, on DHIS2 platform directly or indirectly via excel files importation. Once reported, case investigation is initiated. It includes contact tracing with: 1) identification of close contacts, 2) advice on quarantine and self-monitoring, 3) contact testing. Referral to field testing is made available free of charge for close contacts. Collected data is updated on DHIS2 platform. Later, data is cleaned and analyzed to generate the daily report including description of close contacts. The report is shared with decision makers, professionals, media and public.
Results
From week 2021W27 to week 2021W40, 85490 cases were reported. Case investigation rate reached 78.8% of the cases were investigated within 24 hours. 66.5% of investigated cases shared lists of contacts, with 3.6 as average number of contacts per case.
We identified a total of 161805 close contacts, 95% were from family members, 71% were not vaccinated and 10 % had prior COVID-19 infection.
As for contact testing, 65% had RT-PCR test upon investigation, with 32% positive result. Furthermore, 19205 were referred and tested via field testing, with 25% positivity rate. Of all identified contacts, the reported positive tests reached 56,904 representing 35.2% of all contacts.
Conclusion
During community transmission and mitigation strategy, contact tracing contributes to increase awareness to the contacts and importance to abide to quarantine measures and thus to slow down the virus circulation.
Current close contacts are characterized with new profile of prior infection, vaccination history and testing behavior. There is need to adapt the quarantine measures to close contacts based on their profile, and to ensure easy access to free testing.
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SciScore for 10.1101/2022.01.31.22268856: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:This will aim to identify weaknesses and technical problems, and to demonstrate the improvement to reach the targets such as 80% of case investigation (15), the 70%-75% for cases with shared lists of contacts (contact elicitation success rate) (25, 27), and …
SciScore for 10.1101/2022.01.31.22268856: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:This will aim to identify weaknesses and technical problems, and to demonstrate the improvement to reach the targets such as 80% of case investigation (15), the 70%-75% for cases with shared lists of contacts (contact elicitation success rate) (25, 27), and 5 as average number of contacts per case (27). The indicators vary across countries and by time. In similar analysis, in the USA, in June-July 2020, 57% of cases were interviewed, 1.15 was the median of contacts per case (28). The percentage of cases sharing lists of contacts ranged from 27% in Jun-Jul 2020 up to 45% in Oct 2020, and the average of contacts per case reached 2.6 to 3 in Washington State (29, 30). In USA Connecticut, the percentage of contacts notifiers reached 28% (31). 5) Public awareness: At community level, the public awareness on disease and contact tracing contributes to have better understanding and adherence of the cases and their contacts to the contact tracing measures: isolation, quarantine, sharing lists of close contacts, testing (32)… When initiating contact tracing, there is need to ensure adequate risk communication for the public, including statement related to the confidentiality. Confidentiality is among the frequent concerns of the citizens to provide adequate data (21). On the other hand, the contact tracing contributes to deliver individual preventive measures, and to address the concerns of cases and controls, and to convince them to consider seriously adopting healthy behavior.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- No funding statement was detected.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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