key: cord-323826-nxst9poy
authors: Amir-Behghadami, Mehrdad; Gholizadeh, Masoumeh
title: Electronic screening through community engagement: A national strategic plan to find COVID-19 patients and reduce clinical intervention delays
date: 2020-05-04
journal: Infection control and hospital epidemiology
DOI: 10.1017/ice.2020.188
sha: 
doc_id: 323826
cord_uid: nxst9poy

nan

to cope with a sudden outbreak of COVID-19, the community needs to be screened, and whether the infection has occurred and the dynamics of when it is contagious need to be understood more fully.

The Iranian Ministry of Health and Medical Education designed and has been implementing an electronic national screening system (https://salamat.gov.ir/) using a modern information network technology. 10 After logging information (eg, national code, date of birth, phone number) into the system, Iranian residents answer some questions about COVID-19 symptoms, immunosuppression, and some chronic diseases, as well as the presence of others suspected of having COVID-19 disease among their relatives. Those suspected of having the disease receive a message regarding their health status, and healthcare providers then call them and guide them. Also, the their residences are disinfected and other family members are quarantined if required. If they do not improve within 3 days, they are referred to the emergency department of a hospital. Some screening-related information is provided in Table 1 .

This self-screening plan has been successful through government implementation and community engagement. During the pandemic, many efforts have been made to find effective and efficient solutions for the initial management of COVID-19 globally. One of the significant factors, which is been emphasized today, is the important role of community engagement in the management and screening of infected patients. People's attitudes toward the disease and understanding of its consequences if left untreated have played an important role in encouraging their participation in self-screening through designed website. The government has allocated >17,000 health houses and >9,000 comprehensive health centers in urban, suburban, and rural areas throughout the country to support the plan. These centers, as community health centers, play an important role in these efforts; they are responsible for delivering integrated care services to the population in geographically defined areas. 11 In addition, this plan is consistent with the overall goal of developing health systems, strengthening their capacity to meet the needs of the community, and achieving universal health coverage.

In conclusion, a successful electronic screening system was developed and introduced to combat the COVID-19 pandemic in Iran. On one hand, this system helps in the initial identification of patients with COVID-19 infections and prevents any delay in clinical interventions. On the other hand, it prevents nonemergency referrals to emergency departments of hospitals. Implementing a simple strategy can be effective for the health system in dealing with this pandemic. Therefore, sharing our successful experience, which was the result of good cooperation and cohesion between the government and community, may be helpful for authorities in other countries. Based on available data, we considered patients with death outcome, as well as those admitted to ICU or under mechanical ventilation, as more severe cases. The information in this chart is based on hospitalized cases, and outpatients are not included in this calculation. Inclusion of outpatients and asymptomatic cases would decrease the proportion of severe cases. c To increase the sample size, the analysis of death cases was performed using the data from the previous week. Reference: Daily Situation Report on COVID-19, Ministry of Health and Medical Education, IR Iran.

The extent of transmission of novel coronavirus in Wuhan, China, 2020

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

A case of 2019 novel coronavirus in a pregnant woman with preterm delivery

The importance of designing and implementing a participatory surveillance system: an approach to early detection and prevention of novel coronavirus (2019-nCov)

Novel coronavirus (2019-nCoV) situation report -38. World Health Organization website

COVID-19) situation report -82. World Health Organization website

Iranian Ministry of Health and Medical Education website

Mapping the incidence of the COVID-19 hotspot in Iran-implications for travellers

Home-to-home program to be launched to combat COVID-19. Tehran Times website

Effectiveness of the health complex model in Iranian primary health care reform: the study protocol

Acknowledgments.Financial support. No financial support was provided relevant to this article.Conflicts of interest. All authors report no conflicts of interest relevant to this article.