The COVID-19 pandemic is challenging our global and national public health preparedness, capacity, and strategies. Key components of the public health strategy to prevent the spread of respiratory virus infections such as COVID-19 include identification, isolation, screening, and monitoring of individuals at risk for infection. These “contacts” include people who may have been in close proximity to another person who has been confirmed or suspected to have COVID-19 infection, such as family members, classmates, co-workers, those who live or travel together, and health care workers.
Most health departments are recommending that potential COVID-19 contacts without symptoms self-quarantine at home for up to 14 days and report any symptoms they may develop to health authorities. If they develop mild symptoms, they will be instructed to remain at home until they are felt to no longer be infectious, in addition to being tested for COVID-19. In order to avoid exposing more people to infection in hospitals, waiting rooms, and the community, persons who have COVID-19 infection but do not have symptoms or have only mild symptoms (e.g. fever and/or sore throat) should not come to the hospital. However, it is important for these patients to be carefully followed at home. If they develop more serious symptoms (e.g. shortness of breath), they may require quick and safe transport to the hospital.
Home monitoring of COVID-19 contacts for up to 14 days is challenging on many levels. As the epidemic continues to spread, we will need increased capacity for monitoring contacts. The rapidly expanding availability and use of COVID-19 diagnostic tests will identify more infected persons. The testing, identification, and diagnosis of more individuals with COVID-19 will require that their contacts also be monitored.
Fortunately, there are novel digital health solutions, including emocha, that provide COVID-19 contacts, their clinicians, and public health authorities with convenient and efficient tools to implement and rapidly scale-up up home monitoring programs. Many of these solutions are limited to daily text messaging, or sending a daily questionnaire to contacts. Yet to ensure that contacts feel reassured with home monitoring and limit overloading EMS, hospitals, clinics, and emergency departments, people need to have confidence that the tech-supported monitoring solutions will also provide them with daily support and timely access to health professionals when they need it.
emocha’s COVID-19 program provides a daily symptoms monitoring service. Patients who require monitoring log into emocha’s mobile app to report symptoms, and those with a fever are prompted to take their temperature and show their thermometer to the camera. emocha’s Symptoms Monitoring Team reviews each video submission within 12 hours, and contacts organizations any time a symptom or fever is reported. Each day, a report of temperatures and symptoms for all monitored users is distributed back to the organization.
emocha’s outbreak symptoms monitoring application has previously been used to monitor members of the public and healthcare workers who have been exposed to highly infectious diseases such as Ebola. In 2015, the Maryland Department of Health and Mental Hygiene (DHMH) leveraged emocha’s Ebola Symptoms Monitoring system to monitor individuals who were returning from Ebola-affected countries in West Africa. Developed in close collaboration with public health officials at DHMH, Ebola Symptoms Monitoring allowed health departments to remotely ensure travelers adhered to their daily check-ins and could take rapid, appropriate action when necessary. Based on previous experience with infectious disease outbreak monitoring, emocha is well-positioned to assist with COVID-19, and help support the healthcare system to overcome this current challenge.