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COVID-19-Outbreak Response combining E-health, Serolomics, Modelling, Artificial Intelligence and Implementation Research

Periodic Reporting for period 4 - CORESMA (COVID-19-Outbreak Response combining E-health, Serolomics, Modelling, Artificial Intelligence and Implementation Research)

Reporting period: 2023-07-01 to 2023-12-31

The CORESMA project has diligently pursued its primary objective of generating crucial clinical and epidemiological data on SARS-CoV-2 to inform targeted public health measures at both national and global levels in response to the COVID-19 pandemic. Additionally, the project has strived to achieve its secondary objective of developing tools and methodologies to enhance global public health preparedness for future infectious disease outbreaks.

Throughout the project, specific objectives have been pursued with determination and adaptability. In WP1, the implementation of eHealth approaches, particularly through the piloting of the SORMAS COVID-19 module in Côte d'Ivoire and Nepal, has enabled real-time data capture and facilitated risk assessment and targeted interventions. Despite challenges such as pandemic-induced disruptions and logistical hurdles, significant progress has been made in both countries, showcasing the potential of innovative approaches in disease surveillance and management.

In WP2, the project successfully established and scaled up multiplex serolomics assays to measure pre-existing immunity against COVID-19 in Germany and enables estimation of seroprevalence in Nepal. While analysis of Nepalese samples faced setbacks, the completion of the German sample analysis represents a significant milestone in understanding population susceptibility.

WP3 focused on enhancing objectives through respondent-driven sampling, comprehensive modeling, and artificial intelligence. While delays in data availability posed challenges, the project has made strides in developing modeling approaches to increase intervention efficiency.

Finally, WP4 aimed to improve the effectiveness of containment measures in Côte d'Ivoire and Nepal through field implementation research. Despite unforeseen delays, efforts to reduce the societal burden of the pandemic have been ongoing, highlighting the project's commitment to practical and impactful interventions.

In summary, the CORESMA project has made significant contributions to the understanding of COVID-19 dynamics and has laid the groundwork for future preparedness and response efforts. Through collaboration, innovation, and perseverance, the project has advanced public health objectives on both local and global scales, marking a crucial step forward in pandemic management and infectious disease control.
In WP1, the primary aim was to gather and furnish real-time data on the spread, transmission, and clinical aspects of SARS-CoV-2 infections in Côte d’Ivoire and Nepal using SORMAS. This mobile eHealth system facilitates disease control, outbreak management, surveillance, and epidemiological analysis across all levels of health administrations. The results demonstrated the continued importance of contact tracing in pandemic response, even post-vaccination. The implementation of SORMAS aided public health authorities in Côte d’Ivoire in identifying and monitoring contacts, leading to the interruption of transmission chains. While delays in implementing SORMAS in Nepal impacted data collection in some provinces, analysis primarily relied on data from Gandaki province.

In WP2, the development of the MULTICOV-AB and RBDCoV-ACE2 multiplex seroassays has yielded significant results. These assays have been used in various studies and provide valuable insights into vaccine-induced immunity and pandemic dynamics. Continued adaptation of the assays to include variant-specific antigens, including those from emerging variants such as Omicron, has been essential.

In WP3, our main objective was to assess the effectiveness of social distancing measures in controlling the pandemic. We published various modeling approaches and strategies, providing recommendations for political decision-makers. This included analyzing the impact of delays on the effectiveness of contact tracing strategies for COVID-19 and identifying key questions for modeling. Additionally, we utilized machine learning algorithms to study the clinical expression of biomarkers across different disease states and to identify predictors for criticality in both healthy and comorbid cohorts.

In WP4, our objective was to conduct a comprehensive revision of the analysis of containment measures and the deployment of SORMAS, addressing feedback received on previous versions. The analysis compared pre- and post-SORMAS implementation pandemic containment measures in Côte d'Ivoire and Nepal. The review highlighted good practices in COVID-19 containment, emphasizing vaccination, testing, clear communication, community engagement, and international cooperation in both countries. We also published results on the acceptability of SORMAS in Côte d’Ivoire, demonstrating high acceptance as a surveillance system. In Nepal, despite delays, a report summarizing baseline results indicated positive opinions regarding SORMAS. Additionally, a sub-study on surveillance systems in Côte d’Ivoire revealed insights into system usage and user perceptions, contributing to the understanding of digital surveillance feasibility and its potential to enhance public health interventions.

In WP5, numerous Project Advisory Board (PAB) and Scientific Steering Committee meetings were successfully conducted, along with two workshops hosted at the HZI in Braunschweig, Germany. All project publications are immediately shared on the project website (www.coresma.eu) which is consistently updated.

In WP6, adherence to ethical requirements was confirmed through a report provided by our external ethics advisor, ensuring compliance with ethical standards throughout the project.
Our findings will provide unique and reliable evidence for improving risk assessment and response management for this pandemic and for future emerging public health threats to come. Furthermore, our methodologies are scalable to larger population sizes and other countries. Demonstrating fully digitalized and real-time provision of complex clinical and epidemiological information shall make SORMAS the best practice use case implementing International Health Regulations (IHR) even in countries with weak health information infrastructure. The project will also provide continuously updated evidence for agile risk assessment and thus de-escalation of measures to limit undesired effects on mobility and trade to the least necessary. Highest technical data protection and security standards of SORMAS serve the patient rights, prevent for abuse from third parties while serving the global community and maintaining national sovereignty. SORMAS will significantly reduce work burden for the public health service as already evidenced by systematic analyses in other occasions. Our innovative differential serolomics approach will also support clinical trials for potential novel vaccines and thus accelerate their development. The combination of state of the art modelling and innovative artificial intelligence will result in more accurate disease metrics to improve public health interventions and medical treatment.
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