A Biosurveillance System for the Protection of Citizens Aagainst COVID-19

Inte­gra­ti­on, speed, data ana­ly­sis, fore­cas­ting and pro­tec­tion: the­se are the key­words under­ly­ing the Eng-DE4­Bi­os. The data-dri­ven and cloud-nati­ve bio­sur­veil­lan­ce sys­tem deve­lo­ped by Engi­nee­ring for the Vene­to Regi­on and Azi­en­da Zero collects data from dif­fe­rent sources, inte­gra­tes and har­mo­ni­zes it showing an updated view of the epi­de­mic. Engi­nee­ring is Italy’s lar­gest sys­tems inte­gra­ti­on group, mem­ber of the IDSA and part of the IDS Laun­ching Coali­ti­on.

The coro­na­vi­rus epi­de­mic SARS-CoV‑2 (COVID-19) is cha­rac­te­ri­zed by a high index of infec­tion and rapid sprea­ding. To ensu­re that tho­se who are infec­ted by the virus can be iso­la­ted, auto­ma­tic and real-time moni­to­ring is indis­pensable. The solu­ti­on to this chal­len­ge is the bio­sur­veil­lan­ce sys­tem DE4Bios by Engi­nee­ring. Based on Digi­tal Enab­ler, it com­bi­nes hete­ro­ge­ne­ous data sources to crea­te data­ba­ses on which to per­form advan­ced data ana­ly­tics. This way, public admi­nis­tra­ti­ons and health insti­tu­ti­ons can defi­ne and app­ly epi­de­mio­lo­gi­cal models, real-time geo­lo­ca­ti­on of some cli­ni­cal-health phe­no­me­na and pre­dic­ti­ve maps of con­ta­gi­on.

Bio­sur­veil­lan­ce as a basis for decisi­on making

Bio­sur­veil­lan­ce is a medi­ci­ne-rela­ted field in which the detec­tion of patho­gens and their resis­tance are regu­lar­ly moni­to­red, and the infor­ma­ti­on is rou­t­ed to a cen­tral sys­tem for the ana­ly­sis and under­stan­ding of the epi­de­mio­lo­gi­cal phe­no­me­non. It is the pro­cess of collec­ting, com­bi­ning, inter­pre­ting and com­mu­ni­ca­ting essen­ti­al infor­ma­ti­on con­cer­ning dise­a­se-rela­ted thre­ats to obtain ear­ly obser­va­tions and warnings. Bio­sur­veil­lan­ce pro­mo­tes and con­tri­bu­tes to an awa­reness of the over­all health/clinical situa­ti­on and pro­vi­des infor­ma­ti­on for a bet­ter decisi­on-making pro­cess at all levels. The pro­cess is not cycli­cal, but is dyna­mic and inter­acts at various levels, for an ongo­ing con­tri­bu­ti­on and a pro­lon­ged effect.

The Eng-DE4­Bi­os ser­vice deve­lo­ped for the Vene­to regi­on: a detail­ed descrip­ti­on

The Digi­tal Enab­ler is Engineering’s eco­sys­tem plat­form based on open source com­pon­ents of the FIWARE plat­form. It is con­si­de­red the glo­bal stan­dard for deve­lo­ping digi­tal app­li­ca­ti­ons as a basis for new busi­ness and ser­vice manage­ment models. The Digi­tal Enab­lerTM allows the inte­gra­ti­on, har­mo­niz­a­ti­on, and syn­chro­niz­a­ti­on of data from dif­fe­rent sources and in dif­fe­rent for­mats. In this way, they can be asso­cia­ted, quick­ly and easi­ly view­ed, com­bi­ned and ana­ly­zed to build value-added ser­vices.

The Eng-DE4­Bi­os ser­vice deve­lo­ped for the Vene­to Regi­on and Azi­en­da Zero hel­ps the Regio­nal Admi­nis­tra­ti­on mana­ge the epi­de­mic by pro­vi­ding:

  1. gene­ral prac­ti­tio­ners with a real-time over­view of their pati­ents, detail­ing who have under­go­ne COVID-19 tests, com­ple­te with the results and rapid geo­lo­ca­ti­on of all cases on a map
  2. mem­bers of the Task For­ce / Regio­nal Cri­sis Unitwith a view to moni­tor real time the epi­de­mic and car­ry out epi­de­mio­lo­gi­cal simu­la­ti­ons, iden­ti­fy clus­ters that requi­re high atten­ti­on (nur­sing homes, posi­ti­vi­zed fami­lies), a geo­re­fe­ren­ced view of the tests car­ri­ed out on the ter­ri­to­ry, of aggre­ga­ted posi­ti­ve cases and the ope­ra­tio­nal sta­tus of all regio­nal struc­tures.
  3. ope­ra­tors of health­ca­re orga­niz­a­ti­onswith indi­ca­tors on the evo­lu­ti­on of the epi­de­mic, a geo­re­fe­ren­ced view of the tests car­ri­ed out (their out­co­me and the ana­ly­sis of the fami­ly, resi­dence and work con­text of the exami­ned sub­ject), a view to eva­lua­te, real time, the avail­ab­le work­for­ce wit­hin orga­niz­a­ti­ons, and to moni­tor clus­ters at risk (nur­sing homes, housing con­texts with many posi­ti­ve cases)
  4. occup­a­tio­nal doc­torswith real-time indi­ca­tors of posi­ti­ve Covid-19 cases wit­hin the busi­nes­ses they assist, a view on workers who car­ri­ed out the tests, the pos­si­bi­li­ty of record­ing the results of tests car­ri­ed out by the busi­ness, a tool to app­ly the cor­rect pro­to­cols and safe­ly approach work acti­vi­ties

The sys­te­ma­tic collec­tion of all this infor­ma­ti­on makes it pos­si­ble to crea­te a data­ba­se for the imple­men­ta­ti­on of dif­fe­rent types of epi­de­mio­lo­gi­cal models that can be used to illus­tra­te pos­si­ble trends of the epi­de­mic. The­se models have been imple­men­ted using the Any­lo­gic mode­ling soft­ware, an app­li­ca­ti­on that allows the epi­de­mic to be auto­ma­ti­cal­ly cali­bra­ted and simu­la­ted, with the pos­si­bi­li­ty of fore­cas­ting the dif­fe­rent sce­n­a­ri­os whenever the models’ para­me­ters are chan­ged.

Auto­ma­tic Simu­la­ti­on of the Epi­de­mic

In limi­t­ing the con­ta­gi­on, the pos­si­bi­li­ty of immedia­te­ly see­ing the posi­ti­ve cases and their rela­ti­ons­hips has pro­ven to be extre­me­ly valu­able and is not offe­red by any other con­trol sys­tem used in other regi­ons. The pos­si­bi­li­ty of acting upon inte­gra­ted data has also allo­wed the Vene­to Regi­on to imple­ment several known epi­de­mio­lo­gi­cal models. This has impro­ved the manage­ment of the cri­sis thanks to the pos­si­bi­li­ty of making reli­able fore­casts in terms of the trend of the hypo­the­ti­cal cur­ve (and the­re­fo­re of the peak) and the manage­ment of the inten­si­ve care tre­at­ments for each indi­vi­du­al hos­pi­tal.

The bio­sur­veil­lan­ce sys­tem is more fun­da­men­tal than ever for the post-lock­down pha­se 2; the real time moni­to­ring of the mole­cu­lar and the sero­lo­gi­cal test results will make it pos­si­ble to have widespread con­trol of the ter­ri­to­ry and the onset of new clus­ters (both fami­li­ar and in the work­place), allowing app­li­ca­ti­on of the region's pro­to­cols for the safe reco­very of pro­duc­tion acti­vi­ties.

Data­sets Based on Assu­red Usa­ge Poli­ci­es

Eng-DE4­Bi­os uses exclu­si­ve­ly per­so­nal and cli­ni­cal-health data. The­se data are alrea­dy in the pos­ses­si­on of the Regi­ons and the Local Health Offices (ULSS) for tre­at­ment rea­sons, and the Regi­ons and Local Health Offices are aut­ho­ri­zed to access and ana­ly­ze them. Their aggre­ga­ti­on and ana­ly­sis fall wit­hin the scope of the epi­de­mio­lo­gi­cal inves­ti­ga­ti­on acti­vi­ties for which the health­ca­re struc­tures and the admi­nis­tra­ti­ve public health pro­tec­tion bodies are respon­si­ble. This use of the data is even com­pli­ant with the GDPR.