When the World Health Organization declared a pandemic in early March, there was immediately a need for information and data on the COVID-19 response. In those early weeks, the main question revolved around contact tracing: how many contacts were being traced, how many were being quarantined, and where and how can we get this information.
Before the pandemic, WHO Philippines had already been working with software developers doing apps for monitoring and recording tuberculosis (TB) cases when the pandemic was declared. So they began to explore doing a digital platform that would address information management needs for the COVID-19 response. When technical experts from WHO Philippines presented the app concept to the Department of Health (DOH), the latter was eager to support its development.
The case and contact reporting platform was expected to expand the capacity of the previous COVID-19 information system and supplement other self-reporting, user-driven contract tracing systems. Since its implementation in June 2020, the mobile application has allowed real-time monitoring and helped identify bottlenecks and delays in patient services. Among the tasks it automates are tracking testing specimens, communicating test results, and monitor quarantined contacts.
“The availability of timely and complete information from health facilities for suspected, probable and confirmed COVID-19 cases and tracking down of their close contacts is crucial to save lives and contact tracing is an essential part of the COVID-19 response to trace, test, isolate and quarantine,” said DOH Undersecretary Maria Rosario Vergeire during a consultation with WHO on COVID-Kaya last May 2020.
On 3 June 2020, the Philippine Government’s Inter-Agency Task Force (IATF) that was leading the COVID-19 response formally announced via Resolution No. 43 that it has adopted COVID-KAYA as “the convergent Epidemiological Surveillance system for COVID-19” in all healthcare and testing facilities.
Overcoming Challenges
According to WHO technical experts, managing expectations for such a rapid rollout of a big system was difficult. And while there was already a base system that was initially developed (for TB) and it only needed to be tailored to fit pandemic surveillance needs, there was no time for larger-scale testing or do much troubleshooting. Only two weeks were given for software development and one week for pilot testing in Paranaque (National Capital Region) and Davao cities (Mindanao). On daily calls with WHO and DOH officers, contact tracers in regional and local health offices tested the system by encoding their existing Contact Information Forms (CIFs) or doing manual input of data in real time.
COVID-KAYA was then rolled out nationwide after the testing. However, because the DOH-Epidemiology Bureau (EB) already had an information system (as well as StaySafe.PH and other local contact tracing apps) that was being used in their satellite offices all over the country, it soon became apparent that these systems must be integrated.
To address these, another IATF resolution in June 2020 delineated the functions of both StaySafe.PH app and COVID-KAYA, which are officially collection and storage of data, respectively. Essentially, Resolution No. 45 established COVID-KAYA as the central repository of all data related to the pandemic response. All data from the StaySafe app was required for migration to COVID-Kaya.
This migration took longer than anybody had anticipated. For weeks, the system kept collecting new information every day even as migration was being done. Additionally, those who had become used to using the old system had to be given basic training on how to use COVID-KAYA. It also didn’t help that many local government units (LGUs) had their own formatting system in place. Manual correction and cleaning had to be done during data migration.
The system was further given a boost after the two major telecommunications companies of the Philippines, Smart-PLDT and Globe, both granted connectivity boost and free access to the COVID-Kaya app for all registered health workers. All app users connected to both telecom networks do not incur data charges.
Today, 4 months after its rollout, the COVID-KAYA system as over 2 million rows of data and is used by both private and public sectors in the Philippines to write reports and inform local strategies in combatting the pandemic, particularly for surveillance and contact tracing activities. It has indeed become the central repository of COVID-19 data in the country.
Positive contribution to the Philippine pandemic response
COVID-KAYA stores data from all confirmed COVID-19 cases and their close contacts, which meant around 2 million individual records. This comprehensive data has been instrumental in providing data for the government to make evidence-based decisions and actions.
The DOH COVID tracker that publishes daily case numbers and statistics across the nation takes its reports directly from the database. This makes the system not only useful for surveillance and contact tracing but also for monitoring utilization of hospital and treatment facility beds and equipment as well as calculation of positivity rates, case fatality rates and overall demographics of the affected population.
“Ideally, we should have developed such a system even before the pandemic,” said Dr. Rajendra Prasad Yadav, of WHO Philippines. Dr. Yadav was one of the WHO technical experts who participated in the development of COVID-KAYA.
He added that with diseases like TB, polio and other highly infectious diseases, a strong digital surveillance would have a huge impact on identifying infection sources and isolating them to prevent further transmission. As such, COVID-KAYA is already being recommended for further improvement and transitioned into a more general surveillance system that could be useful for other diseases and in readiness for future epidemics.
The COVID KAYA app was developed by the DOH Epidemiology Bureau and the World Health Organization (WHO) with funding from the European Union. Since the start of the outbreak, the EU has supported several WHO initiatives in the Philippines, including lab licensing accreditation and quality assurance management and health personnel training and development.
Nearly ten months into the pandemic response in the country, Dr. Rabindra Abeyasinghe, WHO Representative to the Philippines says: “As the country expands and strengthens testing and contact tracing, isolation and treatment are more effective and pave the way towards better and faster rebuilding of the economy as well as a healthy future for all Filipinos.”