The emergence of COVID-19 required swift action to develop systems and processes that support public health agencies and their pandemic response efforts. In the last seven months, APHL has worked to create new connections, develop new message formats, standardize language and host a variety of solutions to aid in the COVID-19 response. This blog post is the second in a series that outlines and explains these efforts.

In order for public health officials to successfully respond to an emerging threat, they need to have a direct line to the public to understand the situation, monitor the spread of disease and provide potentially life-saving guidance to a variety of audiences. In the case of COVID-19, the ability for health departments to monitor those at-risk and advise appropriate isolation measures and medical needs has been critical. Health informatics technology solutions are providing health departments with real-time data, ensuring they can respond quickly to changing threats.

Meet Sara Alert^TM

A real-time COVID-19 monitoring and reporting tool, Sara Alert was developed by MITRE Corporation in collaboration with APHL and other national public health organizations. Available in the public domain and free of charge to public health agencies, Sara Alert is designed to contain the spread of disease through automated and remote monitoring and rapid response. Here’s how it works:

For Monitoring Exposed Individuals

• • Sara Alert enables public health officials to enroll individuals who are ill or at risk of developing COVID-19 (e.g., individuals from affected areas or contacts of known cases).
  • Enrolled individuals enter their (and other members of their household) symptoms daily through their preferred platform (i.e., web browser via mobile or desktop, text-based, voice), providing public health officials real-time insights.
  • The information is stored in a secure database and displayed on monitoring line lists so that public health officials can quickly and efficiently identify individuals requiring care coordination or follow up for non-response.

For Monitoring Ill Individuals

• • Sara Alert enables public health officials to enroll individuals who have developed a disease, like COVID-19, who need to be monitored to determine when it is safe to discontinue isolation.
  • Once enrolled, individuals enter their symptoms daily through their preferred platform (i.e., web browser via mobile or desktop, text-based, voice), providing public health officials real-time insights.
  • The information is stored in a secure database and displayed on monitoring line lists so that public health officials can quickly and efficiently identify individuals who may discontinue isolation.

Sara Alert modernizes the public health monitoring and response system by providing increased efficiency in tracking both active and potential cases, leading to earlier containment of the virus and reduction of burden on public health resources. As an open source tool, Sara Alert is available for public and private use and is easily integrated into other healthcare tools.

Sara Alert is hosted on the APHL Informatics Messaging Services (AIMS) platform, a secure, cloud-based environment that provides shared services to aid in the transport, validation, translation and routing of electronic data.

A deluge of data

In addition to hosting Sara Alert, APHL has built and maintains a data lake on AIMS to help paint a comprehensive picture of the nation’s testing landscape and needs.

In the simplest terms, a “data lake” is a repository—it hosts raw data of diverse formats from various sources with no real organizational structure. These data can be accessibly stored and repurposed to meet multiple data needs, such as reporting and visualization of disease trends.

APHL originally developed its data lake as a resource for monitoring cases of antibiotic resistance and was designed with the security and functionality needed to work as part of AIMS. But two weeks before going live, the extent of the COVID-19 pandemic became apparent and priorities for the data lake shifted.

Knowing states had valuable data and APHL had technology to scale, the US Centers for Disease Control and Prevention (CDC) asked APHL to reconfigure its data lake to focus on COVID-19. In a matter of weeks, the data late was modified to capture positive, negative and inconclusive COVID-19 testing data.

Today, APHL’s data lake holds nearly all the nation’s COVID-19 testing data sent from public health departments who are reporting their states’ testing data county by county. These data are analyzed and visualized for surveillance and provide a real-time snapshot of the testing landscape nationwide.

Ready for what’s next

Public health officials and epidemiologists remain on high alert for a COVID-19 resurgence, both in the weeks ahead and into the next flu season. Since both the Sara Alert platform and COVID-19 data lake are configurable for other conditions, they give scientists an invaluable head start for monitoring in the event of new pandemics and large-scale outbreaks. The advancements and refinements made with monitoring tools and technologies now will help the public health community respond even faster to track and contain an outbreak in the future.

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