The COronavirus Pandemic Epidemiology (COPE) Consortium: A Call to Action

Abstract

The rapid pace of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) pandemic presents challenges to the real-time collection of population-scale data to inform near-term public health needs as well as future investigations. We established the COronavirus Pandemic Epidemiology (COPE) consortium to address this unprecedented crisis on behalf of the epidemiology research community. As a central component of this initiative, we have developed a COVID Symptom Study (previously known as the COVID Symptom Tracker) mobile application as a common data collection tool for epidemiologic cohort studies with active study participants. This mobile application collects information on risk factors, daily symptoms, and outcomes through a user-friendly interface that minimizes participant burden. Combined with our efforts within the general population, data collected from nearly 3 million participants in the United States and United Kingdom are being used to address critical needs in the emergency response, including identifying potential hot spots of disease and clinically actionable risk factors. The linkage of symptom data collected in the app with information and biospecimens already collected in epidemiology cohorts will position us to address key questions related to diet, lifestyle, environmental, and socioeconomic factors on susceptibility to COVID-19, clinical outcomes related to infection, and long-term physical, mental health, and financial sequalae. We call upon additional epidemiology cohorts to join this collective effort to strengthen our impact on the current health crisis and generate a new model for a collaborative and nimble research infrastructure that will lead to more rapid translation of our work for the betterment of public health.

Figure 1.

The COVID Symptom Study smartphone application. After providing informed consent and registering, participants are asked basic demographic information, baseline health questions, and whether they are experiencing any potential COVID-19 symptoms or have received testing or treatment for COVID-19. There is a specific module of questions for health care workers related to possible COVID-19 exposures and PPE use. Participants are requested to return to the app daily to log how they are feeling, even when they are well or symptoms have resolved. If they report feeling unwell, they are asked about specific symptoms. Finally, participants see an estimate of COVID-19 cases in their area and how many people in their county are reporting via the app. There is an option to share the app with others. The application is available for Android and Apple iOS operating systems.

Figure 2.

COVID Symptom Study app use, reported symptoms, and testing rates by state in the United States. More than 150,000 unique individuals have downloaded the application and shared clinical and demographic information, as well as daily symptoms and high-intensity occupational exposures across the United States (blue map). Population density of those presenting with any symptoms varied according to states with widespread reports of fatigue, cough, and diarrhea, followed by anosmia and relatively infrequently, fever (inlay). Reported testing rates vary between states, with all states reporting testing rates lower than 10%. This example of real-time visualization of data captured by the COVID Symptom Study may assist public health and government officials in reallocating resources, identifying areas with unmet testing needs, and detecting emerging hot spots earlier. Alaska is omitted from maps where there were not enough contributors.