Week 1 Topic discussion 2

[Lokachet Tanasugarn]

Please read the article by Jobie Budd, et al. Digital technologies in the public-health response to COVID-19. (2020) Nature Medicine. Vol 26:1183-1192

This article gave examples on the application of digital technologies to enhance COVID-19 surveillance and response. Please give 1 technology or tool that you like most and briefly explain how it works and how important it is.

[Than Htike Aung]

One of the digital technologies highlighted in Budd et al. (2020) that I find particularly significant is the use of Bluetooth-enabled COVID-19 contact-tracing applications. While the article discusses a variety of approaches, I will focus on the joint Google–Apple framework, which was rolled out in April and May 2020.

COVID-19 spreads primarily through close contact over a sustained period. To detect such interactions without compromising individual privacy, Bluetooth Low Energy (BLE) technology was applied. The system works as follows: when two smartphones come within close range (approximately one to two meters), they exchange anonymous identification keys. These keys act like digital “tokens” of interaction, containing no personal details or location data, thereby preserving user privacy.

If an individual later tests positive for COVID-19, their device holds a record of the anonymized keys from previous close contacts. With the user’s consent, these keys can be uploaded, enabling Apple and Google’s system to notify the corresponding contacts that they may have been exposed and should consider testing or self-isolation. Importantly, the keys are randomly generated and cannot be traced back to a specific person or device. You can read details here

This technology was crucial because it enabled rapid, large-scale, and automated contact tracing, minimizing reliance on traditional manual methods, which are often slow and dependent on human memory. In densely populated or highly mobile settings, the framework offered a powerful tool to break transmission chains and support public health teams. Although its effectiveness depended on widespread adoption and public trust, Bluetooth-based contact tracing marked an important advancement in the application of digital technologies for pandemic response.

[Siriluk Dungdawadueng]

Hi Than Htike Aung, thank you for sharing your opinion. I completely agree with the use of Bluetooth-based COVID-19 contact-tracing applications, as they enable rapid and comprehensive tracking of close contacts, which is highly suitable during an outbreak situation. This technology plays a crucial role in helping to stop the spread of infection.

I also checked out the additional information from the link you shared about Apple and Google partnering on COVID-19 contact tracing technology — it’s very interesting and informative. Thank you!

[Wah Wah Lwin]

This tool played a critical role in COVID-19 contact tracing!

[Lokachet Tanasugarn]

This is an interesting angle indeed! Anyhow, do you think there is any limitation of this technology that we should be aware of for contact tracing?

[Wai Phyo Aung]

Dear Ko Aung,

Thanks for sharing it, I also learned that point from the article. It is really interesting and effective technology to track contact tracing.

[Wah Wah Lwin]

I would choose social media platforms that played an important role COVID-19 response by serving as tools for rapid communication, public engagement, and real-time data monitoring. As described by Budd et al. (2020), social media platforms enabled health authorities to share timely updates, preventive measures, and risk communication messages directly with the public. These platforms work by allowing users to exchange information and interact instantly, creating a two-way communication channel that helps address public concerns and tackle misinformation. Social media data can also be analyzed using machine learning and natural language processing to track public sentiment, identify misinformation trends, and detect early signs of outbreaks. For example, during the early stages of COVID-19, patterns in social media activity provided early warnings of increasing infection rates even before official reports emerged. Despite challenges related to misinformation and data privacy, social media platforms are important for delivering health messages, promoting behavioral change, and strengthening community engagement.

[Siriluk Dungdawadueng]

Hi Wah Wah, thank you for sharing your opinion. I totally agree with your point about the use of social media platforms, as they serve as effective tools for rapid communication and allow the public to access real-time information. During the COVID-19 outbreak, I also observed how public health authorities used various social media platforms to communicate updates. Dashboards displaying daily case numbers, hospitalizations, and deaths were regularly shared, helping people stay informed. I also found it interesting to see flowcharts from different countries’ health departments that promoted preventive measures and clear public guidance. Thank you!

[Lokachet Tanasugarn]

Social media platform is indeed a new landscape for disease control strategy. I like the fact that you mentioned about “tackling misinformation” since we seems to have too many unreliable sources of information on social media. Any particular example from those platforms to fight back the misinformation?

[Wah Wah Lwin]

To my knowledge, during the COVID-19 era, Facebook sought to minimize the spread of misinformation by using automated systems to detect and remove suspicious content that repeatedly shared information not aligned with updates, news, and guidelines from the World Health Organization (WHO). In addition, to promote accurate information and public education, Facebook boosted posts from trusted health organizations such as the WHO, ensuring that reliable updates on COVID-19 trends, notifications, and precautions appeared in users’ news feeds. I think other platforms, such as YouTube, use similar technology to minimize misinformation. However, it is sometimes difficult to determine which sources of information are truly reliable and what criteria social media platforms use to check and balance the delivery of accurate information to users. This can be complicated further by potential influences from political interests and decision-makers. For example, political leaders are nowadays using social media platforms to gain public trust.

[Salin Sirinam]

I still find that some platforms continue to spread misinformation about COVID-19 even today, especially in open chat groups that started during the pandemic and have now turned into anti-vaccine communities. I have seen efforts from both the government and health influencers trying to tackle this news by sharing correct information online to counter false claims. I think what we can do is to keep spreading reliable information on the same platforms and make people stronger in digital and media literacy, which will help tackling this problem in the long run.

[Wah Wah Lwin]

Hi K’ Salin! Yup, I agree with your point. Continuous delivering of correct information is crucial for the long-run. At the same time, educating people is the complimentary to tackle the misinformation issues.

[Wai Phyo Aung]

Dear Ama Wah,

I totally agree and got your point. We also rely on social media announced post during C-19 period from Ministry of Health.

[Siriluk Dungdawadueng]

One digital technology from the article that I found most interesting is digital contact tracing using Bluetooth-enabled smartphone apps, such as TraceTogether in Singapore.

These apps automatically record when two users are near each other by exchanging anonymous Bluetooth signals. If someone later tests positive for COVID-19, the system can quickly alert all recent contacts so they can self-isolate or get tested. This reduces the delay and human error found in manual contact tracing, helping to stop the spread of the virus more effectively.

In my opinion, this technology had a significant impact during the pandemic. It showed how data and connectivity can strengthen public-health responses when used responsibly. Although challenges like privacy concerns and limited user adoption remain, I believe digital contact tracing has changed the way societies think about using technology for collective health protection.

[Wah Wah Lwin]

Agreed!Hope such tool would be useful for future pandenmic.

[Wai Phyo Aung]

After reading the article, I learned about the importance of surveillance in responding pandemic disease COVID-19. The technology plays a pivotal role in surveillance. In the article, It highlighted the usages of technology in
1) digital epidemiological surveillance (web-based online syndromic , 2) Rapid case identification (febrile checking symptoms), 3) Interruption of community transmission (Digital contact tracing) , 4) Public communication (social media platform) and 5) Clinical care (teleconferencing). Among them,
Interruption of community transmission is my mind blowing tools. It works via smart phone based on low-power Bluetooth technology. In controlling of fast transmissible diseases, contact tracing and breaking the chain of transmission is key intervention to response. The technology can track the contact of positive patient by tracking the Bluetooth exposure range. It will alert to contact person to follow quarantine or test when his/her contact is becoming positive. It also can map the geo-point of the cases and additional measurement like lock-down, quarantine, medical service and other necessity services can provide to that place.

[Myo Oo]

Many thanks for sharing, Ahko. I like your idea of breaking the chain of transmission as a key intervention to outbreak response.

[Sirithep Pl]

Hi everyone,

In my opinion, one of the digital tools that I like most highlighted in the article is the digital contact tracing (Bluetooth or GPS-enabled smartphone contact-tracing app).

How it works:
These apps use Bluetooth signals or GPS to detect when two smartphones are near each other. When two users come into close contact, their phones exchange anonymous identifier keys (not personal data). If a user later tests positive for COVID-19, they can update their status in the app.
These applications are dependent on the system architecture:
– In a centralized system, contact data is sent to a central server for matching and notification.
– In a decentralized system, only the infected person’s key is uploaded; matching occurs locally on other users’ devices, which preserves privacy.
People who have been in close proximity receive a notification and are advised to self-isolate or get tested.

Why is it important:
– Rapid scale and speed – the application can instantly identify and notify contacts..
– Supports outbreak control – When widely adopted, these apps can help reduce the effective number of infected individuals and interrupt transmission chains.

However, the effectiveness of the application depends on widespread adoption and public trust.

[Soe Wai Yan]

During COVID-19, some researchers and governments around the world used anonymized mobile phone location data to track how people moved and whether lockdowns or travel restrictions were effective. These data that were collected from telecom operators and apps can show the aggregated patterns of population mobility rather than individual identities.
In Myanmar, this type of technology was used during the pandemic. The UN Development Programme (UNDP) and Telenor Myanmar collaborated in 2020 to analyze anonymized mobile mobility data to support the government’s COVID-19 response. These data helped public health authorities and researchers understand how people were moving between regions, especially during lockdown periods or religious holidays when internal travel increased.
Because Myanmar has very high mobile ownership, this tool provided a realistic, data-driven picture of population movement even in the absence of widespread testing or digital contact tracing apps. It allowed policymakers to better target stay-at-home orders, border control and resource allocation to areas at higher risk of transmission.

Why it was important:
It helped to monitor compliance with lockdowns and travel restrictions.
It gave the real-time insight into urban/rural migration patterns during outbreaks.
It worked even in a context with limited internet access or low digital literacy, since it used existing telecom infrastructure.

[Yin Moe Khaing]

That’s a great example of how innovative data sources can strengthen public health surveillance, especially during emergencies like COVID-19. Using anonymized mobile phone location data was an effective and ethical way to understand population mobility without compromising individual privacy.

[Salin Sirinam]

I choose social media platforms as a tool that I found having a strong impact on COVID-19 surveillance and response. Through social media, people can quickly become aware of an emerging disease and its characteristics by accessing information shared by public health authorities and their communities. For example, these platforms help spread awareness of symptoms and signs of COVID-19, when to seek testing, how to access vaccines, and updates on preventive measures. They also support real-time communication faster than traditional systems, although some people may still be left behind due to digital inequalities.

However, because of their huge impact, if not carefully managed, social media can also become a source of misinformation, such as from antivax people, or false treatment information. I think this is a big challenge today, and health authorities need to be more aware and proactive in monitoring and correcting such information.

[Yin Moe Khaing]

I completely agree that social media platforms have become powerful tools for disease surveillance and public health communication, especially during COVID-19. They allow rapid information sharing between health authorities and the public, helping people understand symptoms, prevention, and vaccination updates in real time.

[Yin Moe Khaing]

I have selected Digital Contact Tracing Apps as the technology that I find most compelling due to its direct role in interrupting community transmission at scale. Digital contact tracing automates the process of identifying individuals who have been in contact with a confirmed case, offering scale and speed that is difficult to replicate using traditional methods.
How it works:
1. These smartphone applications typically leverage low-power Bluetooth technology to operate.
2. When User A and User B come into contact, their phones exchange an anonymous identifier key via Bluetooth, recording this as a contact event. These detected keys, recording contact events, are usually saved on the device for a limited time.
3. If User A tests positive for COVID-19, they update their status in the app.
4. Depending on the architecture, either User A’s contact records are sent to a central server (centralized system) or only User A’s anonymous key is sent (decentralized system).
5. User B’s app receives this information and, if a match is found with their on-phone contact records, User B is alerted of contact with a confirmed case and advised to quarantine and/or get tested.
This digital approach helps to reduce reliance on human recall, which is particularly beneficial in densely populated areas with mobile populations.
The primary importance of digital contact tracing is its role in interrupting community transmission. Following the identification and isolation of a case, rapid tracing and quarantining of contacts is crucial to prevent the further spread of the virus.
However, the effectiveness of these apps is heavily dependent on widespread adoption by the population, requiring a large proportion of users to download and comply with the advice for the strategy to be effective in reducing the effective reproduction number (R) to less than 1. Furthermore, while offering significant benefits, digital tracing apps raise considerable challenges, especially regarding legal, ethical, and privacy barriers, and require careful implementation to build public trust. Several international frameworks have emerged to address privacy concerns, advocating for decentralized systems over centralized ones, for instance.

[Hteik Htar Tin]

Thanks for sharing about digital contact tracing, Sayama Khaing. It is easier to trace the contact by traditional methods and can also give awareness to the community immediately. As you mentioned, the privacy of users may be violated if there is no security guarding measures for data sharing.

[Jenny Bituin]

Thank you for your detailed explanation on how digital contact tracing apps work. Although as you mentioned, these apps are only effective in contact tracing if a large number of people download and use them.

[Myo Thiha]

One digital technology from the article that I find particularly interesting is web-based epidemic intelligence tools and online syndromic surveillance driven by machine learning.

How it works: These tools collect data from many digital sources and conduct pre-processing and filtering. Machine learning is used to detect signals in this data by identifying symptom-related search queries, recognizing clusters of news and social media posts about respiratory symptoms, and forecasting trends. The outputs are shown on dashboards to help public health decisions.

How important it is: A Digital signal can provide an early warning and alert of rising transmission than a formal report. Once the infrastructure is set up, these tools can continuously monitor a large volume of data across the globe with low incremental cost compared to traditional surveillance systems that have delays. These tools enable public health authorities to make decisions for effective interventions.
But some limitations remain.

[Myo Oo]

I agree with you. Web-based tools and machine learning are very useful for detecting outbreaks early.

[Kevin Zam]

One digital technology I like most apart from contact tracing app from Budd et al. (2020) is the chatbot used in the COVID-19 public health response. Chatbots are computer programs that can talk with people through websites, apps, or messaging platforms. They use artificial intelligence to answer questions, give advice, and guide people on what to do if they have symptoms.
During the COVID-19 pandemic, chatbots were used by the World Health Organization (WHO) and many national health agencies to provide accurate and timely information to the public. They helped people check their symptoms, learn about testing and vaccination, and avoid misinformation.
This technology is very important because it allows health authorities to reach millions of people quickly, even when healthcare workers are busy or when movement restrictions are in place. Chatbots are available 24 hours a day and can respond in different languages, making them a useful and low-cost tool for improving public communication and surveillance during health emergencies

[Wah Wah Lwin]

Hi Kevin! Yup, Chatbots are really helpful for automated information sharing, and it’s convenient way to communicate with the users who need prompt responses. Also, we can collect the data from the system faster and analyze the users’ behavior, from there, we could refine/improve strategies in health emergencies for better public communication.

[Hteik Htar Tin]

I like the data visualization tools for decision support in COVID 19 surveillance and response. In COVID 19 pandemic period, enormous big data were collected through nationwide surveillance sites. If the public health professionals cannot use the information technology for presenting the result of those data analysis, the responses for prevention will be delayed. To make an important decision for public health intervention, the decision makers must clearly see the epidemiological trend of infection. In COVID-19 dashboards, time-series charts and geographic maps were focused to display and it helped to understand the region-level statistics to case-level coordinate data. After that, the policymakers and public gave much attention to watch the data dashboard in real-time. Some dashboard can show contact tracing, status of patients and social distancing directives. Those dashboard data are streaming through mass media like TV channels as daily practice to raise the community awareness. Data is just data if we cannot extract information form it. And it is not information hierarchy if we cannot share the knowledge from the information. So, data sharing through visualization works to inform and educate the public by effective communication way.

[Jenny Bituin]

I agree, using dashboards are an effective in relaying key updates and information to the public.

[Nang Phyoe Thiri]

One technology I like most is telemedicine.

How it works: Telemedicine lets doctors and healthcare workers check on patients remotely using video calls, phone calls, or secure messages. Patients can tell their symptoms, share some health info, and get advice without going to the clinic. Many telemedicine systems connect with electronic health records so the doctor can see your history and follow up easily.

Importance: Telemedicine is very helpful during pandemics like COVID-19 because it reduces the risk of overcrowding in hospital and reduce disease transmission while ensuring continuity of care for both covid and non-covid patients. It plays a crucial role in ensuring accessible, inclusive and equity of healthcare services.
It also supports the successful implementation of outbreak response principle in case detection, contain infection clusters and interrupt community transmission.

[Jenny Bituin]

The technology from the article that I liked the most is the use of mobility data to evaluate COVID-19 interventions.

How it works
Smartphones were used to collect aggregated location data via GPS, cellular network and Wi-Fi.

Why it is important
Mobility data collected from smartphones was used to:
• Monitor real-time population flows during COVID-19
• Identify potential transmission hotspots
• Give insight into the effectiveness of public-health interventions, such as travel restrictions, on actual human behavior

Examples of how mobility data was used to enhance COVID-19 surveillance and response
• In China, daily aggregated origin-destination data from Baidu are used to evaluate the effect of travel restrictions and quarantine measures on COVID-19 transmission
• In Italy, analysis of location data of smartphone users revealed that in the week after the announcement of lockdown, total trips between Italian provinces was reduced to an estimate of 50%
• Google released publicly downloadable dataset on weekly mobility reports with sub-national granularity, including breakdown by journey type and destination (such as workplaces and parks)
• Apple also released a dataset similar to Google, with daily figures for mobility and assumed method of transport

Disadvantages of using Mobility Data
• Access to data is a major challenge
• Ethical and privacy concerns
• Datasets are limited
• No long-term commitment in place for data-sharing with technology and telecom companies
• No standardization of datasets between providers
• Not all countries or regions are included in datasets

[Myo Oo]

I would choose the use of Bluetooth-enabled smartphone apps for digital contact tracing. These apps work by Bluetooth signals emitting from nearby mobile phones to record contact events. When a user reports testing COVID-19 positive, the app uploads information to the central server and then, notifies to the relevant users by using the anonymous identifier of the users.
This technology is important because it can help to detect the contact events of the COVID-19 patients and possible COVID-19 contacts faster than manual methods. It also can reach many people quickly to reduce community transmission.

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