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Metrics & monitoring
A checklist for establishing routine monitoring and assessment metrics of your contact tracing program

Checklist

1. Process indicators

    Identify key process indicators: (*key indicators)
      Speed of contact tracing
        *Percentage of new cases reported within 24 hours of specimen collection
        *Percentage of cases interviewed and isolated within 24 hours of case report
        *Percentage of contacts notified and quarantined within 24 hours of elicitation
        Proportion of contacts with symptoms evaluated within 24 hours of onset of symptoms
      Completeness of case investigation
        Daily percentage of cases whose status has been monitored (i.e. checked for temperature, symptoms, and isolation status)
        Proportion of cases with no contacts elicited
      Completeness of contact tracing
        Percentage of cases reached out of cases identified
        Percentage of contacts reached out of contacts elicited from cases
        Daily percentage of contacts whose status is monitored (i.e. checked for temperature, symptoms, and quarantine status)
      Completeness of testing
        *Of new symptomatic cases, number tested and interviewed within 3 days of onset of symptoms
        Percentage of contacts connected to clinical care and/or testing out of those who develop symptoms

2. Outcome indicators

    Identify key outcome indicators: (*key indicators)
      Overall
        *Percentage of new cases arising among contacts identified by program and under quarantine at the time of onset of their symptoms or, if asymptomatic, at first positive test with immediate initiation of isolation. i.e., as proportion increases, it means we’re getting better at capturing and containing exposure before it spreads further
        *Percentage of new cases unlinked to a source of infection
        Number needed to interview: number of cases interviewed in order to result in one contact quarantined
      Adherence to isolation or quarantine
        Percentage of contacts who complete their full quarantine period
        Percentage of cases who complete their full isolation period
MONITORING FOR IMPROVING ADHERENCE
    By tracking noncompliance rates and reasons, health departments can address challenges and improve compliance.
    Data collection should not have a negative impact on cases or contacts in isolation or quarantine. Their personal information should not be disseminated or published, except when imperative for public health purposes. This privacy also helps avoid stigmatizing individuals or groups.

3. Quality improvement and quality assurance indicators

4. Equity considerations in reporting

    Collect data for tracking and reporting on program equity. Ensure data is collected from cases and contacts in the contact tracing system to be able to stratify by relevant variables, such as:
      Geography (county, city, neighborhood, ZIP code, or other meaningful geographic category)
      Race/ethnicity
      Age
      Language preference

5. Dashboard

    Develop a dashboard aligned with IT system and consider how to align the dashboard with case reporting and case surveillance systems:
      Key outcome and process indicators
      Total and current cases by status (awaiting outreach; outreach underway; monitoring and support; closed)
        By gender, age group, race/ethnicity
        By county, neighborhood, ZIP code, or other meaningful geographic category
      Reasons for closure of case (isolation completed; lost to follow-up; referred to local health department; hospitalized; declined; was never reached; died)
      Median number of contacts per case (for cases with at least one contact)
        Percentage by risk category (if risk categories are being used)
        Percentage by type (individual case; mass gathering; group setting; facility with healthcare delivery)
      Number/percentage of cases with no identifying information
      Total and current contacts by status (awaiting outreach; outreach underway; monitoring and support; closed)
      Reasons for closure of contacts (quarantine completed; lost to follow-up; referred to local health department; hospitalized; diagnosed with COVID-19; declined; was never reached; died)
      Percentage of total and current contacts by risk level (if risk levels are being used)
      Staffing indicators
        Percentage of positions currently recruited, hired, onboarded, trained by title
        Any performance standards, i.e. monitoring calls, etc.
      Technology/digital app indicators and data flow indicators, depending on if and how technology is used
      Telemedicine and connections to social support indicators
      Communication and marketing indicators

6. Targets

Implementation tools

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LIVING DOCUMENT This playbook is a dynamic, “living” document. Global knowledge pertaining to COVID-19 is rapidly evolving. Feedback and suggestions can be sent to [email protected].
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Contents
Checklist
1. Process indicators
2. Outcome indicators
3. Quality improvement and quality assurance indicators
4. Equity considerations in reporting
5. Dashboard
6. Targets
Implementation tools