The COVID-19 pandemic is ongoing, and it is too early to fully quantify the added value of digital technologies to the pandemic response. While digital technologies offer tools for supporting a pandemic response, they are not a silver bullet. They complement conventional public-health measures, and thus contribute in reducing the human and economic impact of COVID-19.
Digital technologies are being harnessed to support the public-health response to COVID-19 worldwide, including population surveillance, case identification, contact tracing, training of workforce, evaluation of interventions etc. Digital Surveillance Data dashboards are being used extensively in the pandemic, collating real-time public-health data, including confirmed cases, deaths and testing figures, to keep the public informed and support policymakers in refining interventions.
Early and rapid case identification is crucial during a pandemic for the isolation of cases and appropriate contacts in order to reduce onward spread and understand key risks and modes of transmission. Digital technologies can supplement clinical and laboratory notification, through the use of symptom-based case identification and widespread access to community testing and self testing, and with automation reporting to public-health databases has accelerated.
Contact Tracing: The digitally connected rapid diagnostic tests have widened access to testing, increased capacity and eased the strain on healthcare systems and diagnostic laboratories. The point-of-care rapid diagnostic antibody tests implemented in home or community or social-care settings give results within minutes and help isolate contacts who test positive.
Public education and cooperation: Effective implementation of interventions during a pandemic relies on appropriate communications strategy and active community participation.
• Digital communication platforms are supporting adherence to social-distancing measures and are enabling community-mobilization efforts by providing ways to assist those in need..
• Video conferencing is allowing people to work and attend classes from home.
• Online services are supporting mental health issues and counselling
Digitalisation of health services: Haryana Government has successfully implemented e sanjeevni for online consultation for patients residing anywhere in the state. The medicine prescription is made available from the nearest dispensary of the health centre so as to reduce the visit to the public health facility, save time, travel cost and other inconveniences associated with covid pandemic. The services are available round the clock and patients are followed up for specialist opinion on priority.
E upchar app for digitalisation of health services has provision for e appointments and is widely used by Haryana residents to visit hospital in lean hours and reduce the waiting time and inconvenience due to overcrowding. Telemedicine has been adopted long before the pandemic and is being optimally utilised where primary health centres in rural remote areas are connected to District hospitals with Multi speciality services and District hospitals are in turn in contact with tertiary care hospitals and medical colleges for advance care opinion.
Workforce Training: The spread of the COVID-19 pandemic has exposed the need for government leadership to accelerate the evaluation and adoption of digital technologies. HSHRC in collaboration with MOHFW has been providing resources and coordinating virtual training to build capacity and skill enhancement for management of pandemics on a regular basis. The entire HR of Haryana from different categories have been trained in digital tools for optimum utilisation
Long-term changes will necessitate investment in national and international digital centers of excellence. A substantial investment in workforce education and skills will be needed for growing digital public-health partnership.
Challenge of the digital divide: In 2018, the World Health Assembly Resolution on Digital Health recognized the value of digital technologies in advancing universal health coverage and the Sustainable Development Goals. Although trends are narrowing, there remains a digital divide, and 51% of the population does not subscribe to the mobile internet. There are large disparities between people 18–29 years of age and those over 50 years of age in their mobile-communication access. Due to restricted mobile internet access, some populations are unaware of the pandemic. It is therefore essential to develop tools and messaging that are accessible and can be tailored to specific languages and cultural contexts.
The future of public health is likely to be increasingly digital and recognizing the importance of digital technology in this field and in pandemic preparedness planning has become urgent. Cost-effectiveness and sustainability will require systems-level approaches to building digital online care pathways. The COVID-19 pandemic has confirmed not only the need for data sharing but also the need for rigorous evaluation and ethical frameworks with community participation to evolve alongside the emerging field of mobile and digital healthcare. Building public trust through strong communication strategies across all digital channels and demonstrating a commitment to proportionate privacy are imperative.
Viruses know no borders and, increasingly, neither do digital technologies and data. There is an urgent need for alignment of international strategies for the regulation, evaluation and use of digital technologies to strengthen pandemic management and future preparedness for COVID-19 and other infectious diseases.
Views expressed by Dr Veena Singh, DGHS, Haryana and Dr Rita Kalra, SMO, Civil Hospital, Panchkula