(Durham, NC) – Since late January, Biospatial has been helping its federal, state, and local partners identify and follow-up on potential cases of what was then known as the 2019 novel coronavirus. Biospatial developed search criteria based on existing Influenza-Like Illness and Respiratory syndromes with inclusion and exclusion criteria for searching free text fields of EMS reports. The initial search criteria focused on travel to China and the Wuhan Province. Within the platform, those records could then easily be reviewed. The search criteria were shared with our partners for their biosurveillance use.
In early March, Biospatial released the COVID-19 syndrome. Development of the syndrome was again based on our Influenza-Like Illness and Respiratory syndromes. With information from our Federal partners, the geographical areas were extended to include China, Iran, and Italy. The syndrome also triggers for confirmed patient contact with a person who has travelled to one of these regions or who has tested positive for COVID-19. In addition to identifying potential cases, custom alerting can be used for notification of cases in selected geographical areas, down to the county level.
While EMS providers are often not able to document a confirmed diagnosis of COVID-19 in their reports, the careful documentation by providers is useful to identify suspect cases. The patient care reports are often submitted to and classified by Biospatial within hours of the patient contact. The timely nature of the data enables rapid notification of suspect cases so that local health care agencies and state health departments can conduct investigations. Agencies can also backtrack confirmed cases that were transported by EMS to identify the geographical area where the patient contact originated, allowing the ability to track for possible additional cases.
Biospatial is committed to its partners to help with this public health emergency. Biospatial staff have fielded multiple calls and have participated in webinars with partners to discuss how the platform can best serve their missions. User input has also contributed to the development of version 2 of the COVID-19 syndrome which will be released soon. The updated version will incorporate feedback from our user community, discussions led by the NEMSIS Technical Assistance Center, guidance from the CDC, and evolving trends in documentation of COVID-19 in prehospital patient care reports. Specifically:
• Documented provider impressions and symptoms will now contribute to the patient symptoms component of the classifier, as an alternative to matching on the Biospatial Influenza-like Illness and Respiratory syndromes. Indication of travel to an affected region or patient contact are still required for a positive match.
• Expansion of the affected regions to include additional high incidence countries in the European Region beyond Italy (Spain, France, Germany, Switzerland, etc.) as reported by the World Health Organization (WHO).
• Narrative or chief complaint documentation of a confirmed or potential COVID-19 case will create a positive match. Matching phrases will include provider impression options implemented by ePCR vendors, for example, “COVID-19 – Confirmed by testing”.