DETECT - Tracking and tackling infectious diseases with new technologies

Tracking – and tackling – infectious diseases with new technologies

The COVID-19 pandemic exposed a critical need to improve the detection, containment and management of infectious disease outbreaks. The global scientific community rallied to meet the challenges by developing novel technologies including mRNA vaccine platforms, rapid at-home diagnostic tests and international genomic surveillance networks to detect new variants.

At the Scripps Research Digital Trials Center, scientists leveraged their extensive expertise in mobile app-based digital trials and the analysis of wearable sensor data to gain valuable insights into key facets of COVID-19, including the early onset of illness, disease severity, prolonged effects of infection, vaccine response and disease rebound.

Epidemiologists, artificial intelligence specialists and digital trial experts continue to work with partners around the globe to develop new tools and knowledge to bring an end to the current pandemic, while preparing the world to more effectively respond to future pandemic threats.

Crowdsourcing COVID-19 related health information

In response to the emergence of COVID-19 in early 2020, the Digital Trials Center team launched the DETECT (Digital Engagement and Tracking for Early Control and Treatment) study with the aim of improving our ability to identify and track individual and population-level viral illness, including COVID-19. The study rapidly engaged over 40,000 individuals nationwide, including in Alaska, Guam and Puerto Rico, who agreed to share sensor data, self-reported symptoms, diagnoses and electronic health records with scientists.

Initial findings were encouraging, suggesting wearable devices and mobile apps can be effective tools for monitoring and controlling the spread of infectious diseases. The DETECT team was the first group to publish algorithms to detect COVID-19 with data from wearables and additional analyses provided important insights into prolonged effects of infection on the body, as well as individual physiological responses to the COVID-19 vaccine.

The work spurred local, national and international collaborations with industry, academia and government and garnered support from The Rockefeller Foundation to expand digital surveillance efforts and boost pandemic preparedness.

STUDY WEBSITE

At-home early alert and diagnosis

Building on the successes of DETECT, the DETECT-AHEAD sub-study aimed at exploring the implementation, usability and value of at-home diagnostics triggered by an early-alerting algorithm using wearable sensor data and self-reported symptom data. Study participants were recruited from the larger DETECT study cohort with heightened efforts to enroll individuals from underserved and historically underrepresented populations.

(DETECT-AHEAD is not enrolling new participants at this time.)

Early detection and treatment to reduce hospitalization of immunocompromised individuals

While COVID-19 vaccines have been proven to protect most people from adverse outcomes, the risk of developing severe disease remains high for those who are immunocompromised or elderly. To address this, scientists at the Digital Trials Center have partnered with healthcare technology company Cue Health on the ImmunoCARE remote trial. By providing study participants with a combination of fast and accurate molecular at-home tests to diagnose infection, on-demand telemedicine consultations, and same-day delivery of antivirals to treat COVID-19, the team seeks to determine if early detection and treatment can reduce hospitalizations and adverse outcomes in these vulnerable groups.

STUDY WEBSITE

eMed-Scripps COVID-19 Study

Understanding the epidemiology of COVID-19 rebound

Since receiving emergency use authorization from the Food and Drug Administration in late 2021, nirmatrelvir/ritonavir, sold under the brand name Paxlovid, became the primary oral antiviral medication for the treatment of COVID-19. Subsequently, reports began to emerge of symptom rebound in patients after having taken the initial course of treatment, but robust data on incidence numbers was lacking.

Scientists at the Digital Trials Center partnered with telehealth experts at eMed, a digital health company, to conduct a remote study to better understand COVID-19 rebound. Preliminary results show an unexpectedly high proportion of rebound cases in untreated people, as well as those treated with the antiviral medication. Further studies are being conducted to answer key questions including whether COVID-19 rebound is enhanced by Paxlovid, what role different viral variants play, and how a patient’s immune system impacts outcomes.

(The Scripps-eMed COVID-19 Study is not current enrolling new participants.)

The knowledge we seek

Can digital biomarkers predict disease severity and need for supportive care?
What are the long term impacts of COVID-19 on physiological markers and health outcomes?
Can large scale wearable data improve timeliness and geographic specificity of outbreak detection?
How does vaccination impact physiological metrics?
Can a combination of molecular at-home tests, on-demand telemedicine and home delivery of antiviral medications reduce severe outcomes in immunocompromised and elderly patients with COVID-19 infections?

Partners

Researchers at the Digital Trials Center collaborate with a broad network of stakeholders with a joint commitment to accelerating progress in infectious disease research. Our partners include: