COVID Can I Do It

COVID-19 has caused over two million infections and roughly 400,000 deaths throughout the world. As a novel infectious disease with high transmission rates, drastic measures have been taken to limit new infections and prevent overwhelming health care systems. While lockdowns and stay-at-home orders have kept people physically distant, people have been left without clear guidance on how they can make informed decisions on preventing the transmission of COVID-19. COVIDCanIDoIt (CCIDI) is an online, mobile-friendly tool that helps users make informed decisions to reduce risk of transmission, from not engaging in certain activities to recommendations for mitigating transmission and preventing the further spread of COVID-19. Recommendations are based on both scientific literature and the current epidemiologic data of their locality. Equipped with this tool, individuals can be empowered to make informed choices of when to engage in activities, helping us all reduce transmission and put an end to the COVID-19 pandemic.

The COVID-19 pandemic has caused immense devastation and loss of life throughout the world. So far, we have seen two million infections and over 400,000 deaths globally, with countries spending trillions in economic and healthcare costs. The world may continue to see such challenges until an effective vaccine or cure is discovered and scaled up globally. Initially, governments focused on lockdowns or stay-at-home orders to slow transmission. However,  in many countries, these initial orders are being lifted prematurely in response to widespread food insecurity, economic turmoil, and political pressure. Furthermore, many countries have developed limited public guidances, leaving many people unequipped to make informed decisions regarding their everyday activities. People are struggling to determine how risky  activities are for themselves, and some don’t have the option to refrain from activities. With the U.S. and other countries reopening, limited practical guidance, and geographical differences, there needs to be a tool to support people’s decision making on daily activities that equips people with the skills needed to reduce and/or avoid risk.

CCIDI is an online tool designed to help individuals avoid risky activities and adopt risk reduction practices to make activities safe during the COVID-19 outbreak. People can use their mobile or desktop devices to ask about any activity (such as going to the grocery store). By answering a few questions related to increased risk of COVID-19 complication including age and potential immunocompromised status, users can see their potential risk and mitigation tactics. The overall risk of engaging in an activity is shown on a five-point scale from no-risk to high-risk and recommendations on how to safely engage in the activity. The tool also breaks down the transmission risk of every activity into four common characteristics (crowding, droplets, times, and ventilation) that forms the foundation of CCIDI’s harm reduction approach. By extension, these four characteristics form an accessible blueprint that individuals can adapt and apply to activities that are unique to their lives. In addition to this core approach, CCIDI is harnessing available data and technology to both increase CCIDI’s accessibility and usefulness, including publicly-available crowding data and WhatsApp and Viber APIs to adapt the tool’s web interface into a chatbot.

CCIDI’s target population are individuals engaging in everyday activities in countries with active COVID-19 outbreaks, including key populations at greater risk of suffering severe complications from COVID-19, due to preexisting conditions or social determinants. As a result, CCIDI’s features, user-experience, and public health messaging need to be flexible enough to ensure that CCIDI is accessible and useful to individuals from diverse global communities. 

In the United States, CCIDI has assembled a Public Health Working Group composed of public health professionals with a diversity of training and experiences. Harm reduction and COVID-19 educational messaging are developed based on published scientific evidence, public health theory, and experience. The Working Group has also established a development process that actively engages with both CCIDI’s users and key populations. This process aims to not only rapidly and iteratively test the effectiveness of CCIDI’s messaging but elicit new features and messaging strategies from our contributors. 

CCIDI has also engaged Ministries of Health in the Philippines, Uganda, and Argentina and, in the United States, United States of Care, a non-profit with strong ties to State health departments, to better understand the needs and gaps that have been identified by governmental public health agencies.

Novel infectious diseases underscore the importance of individual actions in containing and preventing outbreaks. However, at the onset of outbreaks, governments have struggled to educate and empower their populations to take action, relying on mostly prescriptive interventions, like lock-downs and stay-at-home orders. The approaches are effective in the short-term but aren’t sustainable and don’t contribute to resilience against future outbreaks. CCIDI helps to bridge both these gaps. By centralizing available information and making it actionable, individuals can understand their role in an ongoing outbreak, act to reduce their individual risks, and retain these harm reduction strategies for future outbreaks.

CCIDI emerged from the lack of practical information for people trying to navigate stay-at-home guidance and a maze of contradicting scientific information. During the initial stages of the outbreak, public health guidance didn’t address the risk of everyday life. Even now, as new guidance from national, state, and local public health authorities emerge, much of it is directed toward specific economic sectors, making them difficult to interpret and generalize. To make matters worse, guidance continues to take a prescriptive approach rather than equipping individuals with information to make decisions and are hosted as dense text-heavy web pages. CCIDI recognizes that, while important, these guidance are failing individuals. 

The innovation of CCIDI is also its central premise: the concerns and questions of individuals are critical to a community’s response to an outbreak and resilience to future outbreaks. CCIDI seeks to answer the questions that people are asking and equip individuals with practical skills to slow the spread. For our team, that means listening to individuals both in developing content and the tool’s user experience. Our team is leveraging both traditional public health approaches and new technologies as part of a mixed-methods, user-driven process to develop and communicate public health messages. So instead of a wall of text, CCIDI users are presented with a clear risk scale and actionable recommendations. Helpful tools are built right in, like a visualization of points-of-interest popularity, so that individuals have insight into crowding right next to a reminder to avoid indoor spaces at busy times.

CCIDI is an open-source, harm reduction web tool that provides users with clear risk reduction recommendations to prevent COVID-19 transmission. At its core, CCIDI relies on evidence synthesis processes and harm reduction messaging to empower users to reduce their individual transmission risk. The data and content generated from these processes are hosted on Google Firebase and developed using VueJS.  

Beyond this foundation, CCIDI’s collaborative approach and open-source development process has enabled the integration of numerous innovative technologies. CCIDI’s international collaborators are in the process of harnessing WhatsApp and Viber APIs to adapt the tool’s web interface into a chatbot. This would enable users with data constraints to access CCIDI. Another example is CCIDI’s use of open-source packages to scrape Google Maps popularity data CCIDI and inform users when locations have increased foot traffic. This allows users to plan for when they can visit a location with the least amount of people present.

CCIDI is also leveraging technology to better understand users’ needs. CCIDI is analyzing  large social media datasets to identify contentious or concerning activities. A collaboration with natural language processing scientists applying sentiment analysis to published articles on everyday activities to better understand messaging discordance or concordance between popular media and CCIDI’s risk ratings. 

CCIDI’s mission is to empower individuals to make informed choices to prevent further transmission. To that end, the CCIDI constantly experiments with technologies to understand how they can improve CCIDI’s accessibility and utility. The result is the integration of many technologies that come together seamlessly.

Harm reduction is integral to modern public health interventions, including for HIV epidemic control and drug use. Extensive literature underscores the real-world effectiveness of harm reduction strategies that embrace education and empowerment affected individuals. Furthermore, independent of CCIDI’s development, public health experts have publicly endorsed harm reduction strategies for responding to the current COVID-19. In May 2020, Dr. Julia Marcus published two articles in the Atlantic Magazine that succinctly summarizes the need for a “manual on how to have a life in a pandemic”. The CCIDI team agrees, and, since its inception in March 2020, in the early stages of the COVID-19 outbreak, CCIDI has been striving to do just that.  

In our video, you will find a walkthrough of how our platform empowers users to better understand their COVID-19 risk during daily activities: CCIDI Product Demo

Academic Literature:

https://www.ncjrs.gov/App/Publications/abstract.aspx?ID=252863

https://d1wqtxts1xzle7.cloudfront.net/41821289/A_review_of_the_efficacy_and_effectivene20160131-9433-pkn9b1.pdf?1454276568=&response-content-disposition=inline%3B+filename%3DA_review_of_the_efficacy_and_effectivene.pdf&Expires=1592278147&Signature=XgOmBsKSiZlBc8p6qBxX6VqcEuYM6a3E10lPRYYGxYZs~qNlYSY4qDLaLi9MjTq9pJHJGBOT7xGqbbwgz2CxnEA3eNGTokzRT2vOn2pgYuM1txgv6gl-G5k7K2ahxV~HPlLYo~bziom5zBfCak0-b5-6NQ5p1AHcXIbyt8-nw7rRsyMWVgp1woPAR5D5y8Mom5PdExSAGQavSIX3bROkD2uDn5YAqTzRz8k1Tz3VkIEAiDkdVWSerXX9bSnb9e7spU9Y1mSelWp6iQncNAT4kC6NRrSZfLpzlkF1rP-0seHl6ERPIx4~ZpkLnOH~ogOs5D8VZFZ7y8UToRj~zwzr1A__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA

 Popular Media:

https://www.theatlantic.com/ideas/archive/2020/05/quarantine-fatigue-real-and-shaming-people-wont-help/611482/

https://www.theatlantic.com/ideas/archive/2020/05/no-one-telling-americans-how-reopen-their-lives/612172/

Individuals transmit infectious diseases, and individual choices can significantly contribute to the trajectory of infectious disease outbreaks. Recognizing this, the ultimate goal of CCIDI is to educate and empower enough individuals to reduce their transmission risk to make a tangible contribution to containing the COVID-19 outbreak. 

To educate and empower individuals, CCIDI’s user-experience, key messages, and interactive tools need to be effective and inclusive. CCIDI has formed three distinct working groups of experienced professionals to develop the tool. 

The Public Health Working Group has engaged in an overhaul of CCIDI’s approach. Based on feedback from existing users and a synthesis of expert testimony and available literature, the Working Group is focused on helping individuals understand the characteristics of everyday activities that contribute to risk. The Working Group centering equity in CCIDI by engaging communities vulnerable to COVID-19, like Black and Brown communities and those living in assisted living facilities. Mixed-methods approaches including surveys, key informant interviews, and focus groups will be used to assess COVID-19 health literacy outcomes. Social listening and sentiment analysis will also be applied to assess CCIDI’s concordance and relevance to national audiences.      

The UX/UI and Developers Working Groups are improving the user experience of CCIDI’s web tool. First, the Working Groups are engaging with stakeholders, like international and institutional partners, to assess current deficits of the web tool and establish shared objectives. The Working Groups will then iteratively develop and test proposed changes with stakeholders. Testing will also be conducted with volunteer contributors recruited by the Public Health Working Group.

To reach enough individuals to make a tangible contribution, CCIDI is focused on engaging partners with strong ties to local agencies who may be able to endorse and publicize the tool to their populations. CCIDI is also working to earn media coverage by drawing attention on social media and by authoring opinion and commentary pieces. Finally, CCIDI has demonstrated success in driving user engagement by partnering with social media influencers, like WashingtonianProbs (61.5K followers), the George Washington University Milken Institute School of Public Health, and others, and our team plans to continue this activity.

In the past week, we have had 4,929 total unique users globally with 72% of US users engaged for an average of one minute. The page received 74,000 views over the past week. In one year, we look to have 150,000 unique users, with over one million unique users using the tool over the next five years or until a vaccine or cure is discovered.

COVID-19 represents one of the greatest global challenges of modern history. Almost every person on this planet has been impacted by the pandemic, whether through economic downturn, forced lockdown or isolation or have been sick and lost their lives. COVID-19 requires every member of humanity to do what is needed to prevent further spread and protect the most vulnerable. Within the next year, we look to expand COVID Can I Do It to 3 countries and the European Union working with local partners to adapt the tool to fit the local context and be most impactful to the community. We will also aim to have 80% of users repeat tool usage and expand our audience through five distinct social media campaigns in the next year.

 Our hope is through the use of this tool, in partnership with global efforts, we will see the end of the COVID-19 pandemic well within five years. Over the next several months and up until a functional vaccine exists, COVID Can I Do It will help individuals recognize the risks associated with activities and help reduce the transmission of the virus. The goal will be to continue to exponentially grow use of the COVID-19 tool.

In five years, after the COVID-19 pandemic has ended, we can look to adapt the tool to fit other pressing public health challenges and can be altered to address future emerging pandemic threats.

Interfacing with users to deliver high quality and evidence-based information during these uncertain times has presented a multitude of technical, socio-cultural, and market-based challenges. The initiatives of harm reduction and user empowerment are based in a cross-sectoral approach between public health and social impact design to impart behavior changes. COVID-19 erupted into a global scientific and public health landscape ill-equipped to digest and respond with the expediency required to mitigate the disease. Technically, it has been challenging to find strong sources for our internal qualitative public health task force to use for risk assessment due to the lack of field-awareness. Another technical challenge has been finding references that speak to specific needs of all communities of CCIDI users. The erosion of domestic public trust in health agencies has fractured relationships with sources of health literacy dissemination. The cultural challenges that have emerged for CCIDI have required increased trust and agency development among our users. In order to meet user needs, there is a social imperative to increase public awareness about the potential role of public health as a positive mediator of disease. CCIDI has been met with market barriers to establish the role of public health within a health literacy technology landscape that is under-explored.

 The technical challenges of creating valid risk scores in absence of peer-reviewed literature or public health agency guidance has created an opportunity for our cohort of expert epidemiologists to answer societal information needs via our platform. The technical challenges encountered with the lack of information has clarified the need for a cohort of epidemiologists specialized in harm reduction education to scale to meet the needs of communities. CCIDI has overcome this barrier through networking with leading epidemiologists to provide expert feedback on internal risk assessments. In the next phase of our growth, we will be partnering with key public health stakeholders across domestic and international audiences to improve our information collection and dissemination. The erosion of public trust in established forms of health literacy has challenged the promise of technology-based education tools. Frequently, profitable channels are also exploitive of unaware users. CCIDI aims to overcome these cultural factors through producing and developing all features through an open-source data initiative. We have established strong guidelines on not collecting any user information to preserve trust and make our platform one that is accessible to all queries. Lack of awareness of the positive impacts of public health have been a large detriment to successful health literacy campaigns. CCIDI aims to partner with local public health departments and state-level regulatory agencies to disseminate accessible information ahead of the anticipated second wave of outbreaks this fall.

CCIDI is entirely volunteer-driven and includes members across USA, Uganda, and Philippines. Our co-founders are Jarjieh Fang and Gayatri Sanku. We presently have 21 members across our public health development taskforce, international engagement, software developer team, and UI/UX graphic design teams.

CCIDI emerged from a collaboration of cross-sectoral leaders to provide the public health knowledge and online platform to users. The public health challenge that the pandemic has brought has required leaders who are well-versed in public health intervention design, immunology, software development and international social impact. Our volunteers answer to this challenge through their experience, bringing years of experience from their professional careers in government, industry, academia and non-profit sectors. The public health development task-force is composed of epidemiologists and qualitative public health researchers equipped with diverse graduate training in public health. Our public relations team and international expansion team has recruited teams of medical students and social media strategists. To bring our educational assets to users, our software development team has enabled our platform with an iterative design approach from the first weeks of program design. The UI/UX and graphic design teams have experience in health communications and brand strategy. Our co-founders have worked together and with international partners to develop successful public health proposals at the WHO and United Nations Biological Weapons Convention. Their experience in creating strategic public health partnerships have been essential to the success of CCIDI and the integration of our taskforces to achieve our mission for users. More information on our team may be found on our “Learn More” page. 

CCIDI maintains partnerships with experts affiliated with numerous organizations. In the United States, faculty members from ICAP at Columbia University and the Georgetown University Global Health Initiative serve as expert advisers to CCIDI. They provide input on risk scoring and evidence synthesis methodologies as well as on design and user experience. In the Philippines  CCIDI content development and deployment are advised by faculty members from St Luke's Medical Center College of Medicine - William H. Quasha Memorial. In Uganda, advisors are affiliated with the Makerere University College of Health Sciences, the Makerere University Lung Institute, and the Ministry of Health. CCIDI also maintains a panel of volunteer clinicians that review activity risk ratings and serve as an external validation to internal risk-rating processes. 

CCIDI is also in the process of developing a relationship with United States of Care. Following a review and presentation of CCIDI, U.S. of Care expressed interest in sharing CCIDI with its State and local public health partners. Their team also provided feedback and suggestions for future features. 

CCIDI provides value to users through education, risk mitigation, and recommendations on how to lower risk of COVID-19 transmission. Our business model differentiates customers from beneficiaries to allow free use of our platform while prioritizing value creation. These values are imparted through operationalizing key resources like our online platform equipped with evidence-based and contextualized risk mitigation information. CCIDI is managed by a consortium of leaders developing educational tools, screening news sources, providing UX testing and sourcing of new activities. Our team is cross-trained to sustain multiple channels of activities on our online platform. CCIDI users report using our platform to increase their awareness of COVID-19 risks and impart recommendations into their life. Our management team assess impact using a range of quantitative and qualitative factors. We prioritize personalized user engagement, geographic diversity of users and amount of time users spend on our site. These measures are used to prepare users domestically and abroad to walk away from our platform better educated about the risks of COVID-19 in daily activities and ways to reduce their risk. The value that CCIDI creates is directly aligned with the mission of population public health preparedness at local and national levels. 

As a volunteer-led organization/project, we leverage inexpensive collaborative tools and open-source technology to keep direct costs minimal. We generally follow the “cooperative” business model, where the implicit members are individuals, various state and regional governmental agencies, and related public-good organizations, all of whom need to provide guidance to their constituents. We are building materials and processes for volunteers to apply to grants like this one, soliciting cooperative arrangements with larger organizations, and organizing labor needs. Additionally, our stakeholders have contributed key resources for the online mobilization of our platform that we continue to employ for deployment of our services. Similar in-kind donations of skills and resources are being pursued for further mission alignment. 

CCIDI has been piloted with audiences in the United States and Uganda and has tested deployment in the Philippines. Partnering with Solve would provide platform for further dissemination of tool. Individual behavior change must be scaled in order to impact the outcome of the COVID-19 pandemic. Additionally, as a volunteer-drive organization, our infrastructure and technical resources are limited, and a partnership with Solve provides infrastructure/operational and human resources support through MIT and its partners. Cultural and social barriers experienced by CCIDI can also be mitigated through partnership within Solve's networks. We have used key elements of the social impact and revenue design frameworks to overcome these barriers within our strategic implementation plan. Scaling our growth will be well complimented with MIT Solve's resources in addressing health challenges through community health mobilization. Finally, our team firmly believes that CCIDI has the potential to be an effective tool in the arsenal of public health departments and hope becoming a Solver help to drive further refinement and scaling of CCIDI. 

Partnership is critical for CCIDI to be able to continue to disseminate its tool to others, receive critical feedback from related experts on the tool, methodology, and findings and to ensure that more people find the tool valid. Through partnerships with local, city, state, and national governments we can continue to expand the reach of the tool. Through partnerships with other public health organizations, the tool can be further refined, and improved to meet the needs of diverse populations. Cultural and social barriers experienced by CCIDI can also be mitigated through partnership within Solve's networks. We have used key elements of the social impact and revenue design frameworks to overcome these barriers within our strategic implementation plan. Finally, our partnerships with colleagues in different countries will allow the tool to be adapted to meet other local contexts, further supporting efforts to educate unique users.

Public health agencies remain the gatekeepers of COVID-19 information. CCIDI would like to develop numerous partnerships with public health agencies to tailor CCIDI to local needs and expand the reach of CCIDI. CCIDI could easily augment traditional public health campaigns and continue promoting risk reduction strategies long after press conferences.

News organizations are also a key resource for individuals. As public health agencies failed to fulfill its mandate, news organizations filled the gap. The Atlantic developed the COVID Tracking Project to compile and report COVID-19 epidemiological data. Vox has developed a guide that offers some of the practical information missing from official guidance. CCIDI seeks to partner with innovative news organizations to fill the gap in accessible harm reduction and decision support messaging. These new organizations would be able to offer hosting support, graphic design, and web design expertise while connecting CCIDI to their audiences.  

CCIDI would also like to partner with Google. CCIDI is a volunteer-led organization with limited capabilities in software development and graphic design. Partnering with Google would allow CCIDI to rapidly test and develop new features while leveraging Google’s infrastructure. A potential model might involve Google employees volunteering their time, providing both their technical expertise and intimate knowledge of Google resources. Critically, millions of people are already using Google to ask the question: Can I [X] during the pandemic? Rather than directing users to a search page of unvetted results, CCIDI could deliver evidence-based messaging developed by public health professionals in collaboration with public health agencies.