Sara Alert: An automated symptom monitoring tool for COVID-19 in 11 jurisdictions in the United States, June - August, 2021

Carla Bezold; Erin Sizemore; Heather Halter; Diana Bartlett; Kelly Hay; Hammad Ali

doi:10.5210/ojphi.v14i1.12449

Sara Alert: An automated symptom monitoring tool for COVID-19 in 11 jurisdictions in the United States, June - August, 2021

Online J Public Health Inform. 2022 Nov 7;14(1):e7. doi: 10.5210/ojphi.v14i1.12449. eCollection 2022.

Authors

Carla Bezold¹, Erin Sizemore², Heather Halter¹, Diana Bartlett², Kelly Hay¹, Hammad Ali²

Affiliations

¹ MITRE Corporation, United States.
² Centers for Disease Control and Prevention, United States.

Abstract

Objectives: Health department personnel conduct daily active symptom monitoring for persons potentially exposed to SARS-CoV-2. This can be resource-intensive. Automation and digital tools can improve efficiency. We describe use of a digital tool, Sara Alert, for automated daily symptom monitoring across multiple public health jurisdictions.

Methods: Eleven of the 20 U.S. public health jurisdictions using Sara Alert provided average daily activity data during June 29 to August 30, 2021. Data elements included demographics, communication preferences, timeliness of symptom monitoring initiation, responsiveness to daily messages, and reports of symptoms.

Results: Participating jurisdictions served a U.S. population of over 22 million persons. Health department personnel used this digital tool to monitor more than 12,000 persons per day on average for COVID-19 symptoms. On average, monitoring began 3.9 days following last exposure and was conducted for an average of 5.7 days. Monitored persons were frequently < 18 years old (45%, 5,474/12,450) and preferred communication via text message (47%). Seventy-four percent of monitored persons responded to at least one daily automated symptom message.

Conclusions: In our geographically diverse sample, we found that use of an automated digital tool might improve public health capacity for daily symptom monitoring, allowing staff to focus their time on interventions for persons most at risk or in need of support. Future work should include identifying jurisdictional successes and challenges implementing digital tools; the effectiveness of digital tools in identifying symptomatic individuals, ensuring appropriate isolation, and testing to disrupt transmission; and impact on public health staff efficiency and program costs.

Keywords: COVID-19; contact tracing; digital health; informatics; public health practice; symptom assessment.

This is an Open Access article. Authors own copyright of their articles appearing in the Journal of Public Health Informatics. Readers may copy articles without permission of the copyright owner(s), as long as the author and OJPHI are acknowledged in the copy and the copy is used for educational, not-for-profit purposes.

Grants and funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work, including no-cost, jurisdictional implementation of Sara Alert^TM and technical assistance, was supported by the Centers for Disease Control and Prevention [Contract 75FCMC18D0047]. The Sara Alert trademark is currently registered with the United States Patent and Trade Office. This technical product was produced for the U.S. Government under Contract Number 75FCMC18D0047, and is subject to Federal Acquisition Regulation Clause 52.227-14, Rights in Data-General. No other use other than that granted to the U.S. Government, or to those acting on behalf of the U.S. Government under that Clause is authorized without the express written permission of The MITRE Corporation. For further information, please contact The MITRE Corporation, Contracts Management Office, 7515 Colshire Drive, McLean, VA 22102-7539, (703) 983-6000. (c) 2021 The MITRE Corporation All Rights Reserved. Approved for Public Release 21-3316.