World

WHO launched a tool to track outbreaks in real-time in 2019. Then came COVID-19

Here’s a look at how Go.Data has been used, and how the lessons from those experiences are helping countries better prepare for future outbreaks.

In the early days of the Ebola outbreak in the Democratic Republic of the Congo (DRC) in 2018, contact tracer Léa Kanyere spent much of her day dealing with paperwork.

“We used to use paper, filling out a form each day for every contact. Then at the end of the day, we took the papers to our supervisors, who alerted the doctor if one of the contacts had signs of Ebola. It took a long time.”

For years, epidemiologists on the front lines of outbreak responses have worked with pen and paper to track and analyze data. This vital information about cases, contacts, laboratory results and hospitalization outcomes was collected on paper or in spreadsheets, then manually combined and shared with decision-makers. The time lag meant that decisions about response actions were based on old information, and field teams were constantly playing catch-up.

A new system emerges

By 2016, a number of different tools existed to support field data collection, but the experience of Ebola in West Africa made it clear that they were not sufficient. This prompted WHO to collaborate with the Global Outbreak Alert and Response Network (GOARN) to develop a better system.

The result was Go.Data – a multi-language, mobile-friendly software tool that can collect data on cases and contacts and track how a disease spreads between people in real time – helping responders to take action immediately. It is easy to configure and use, can work online and offline, and can be adapted and customized to fit the needs of different disease outbreaks.

Go.Data was first used in 2019 in response to an outbreak of diphtheria among refugees in Cox’s Bazar, Bangladesh and Ebola in the Democratic Republic of the Congo and Uganda.

For Léa Kanyere in DRC, switching from a paper-based system to Go.Data helped make the Ebola outbreak response more efficient and effective. It also made her and her colleagues feel more secure, and put contacts at ease.

“It’s much more discreet and easier than carrying around a lot of paper forms,” says Kanyere’s supervisor, Josué Nebese Kaseme.

Go.Data in the COVID-19 era

The rollout of Go.Data went into hyperdrive at the beginning of 2020, when the volume and complexity of data and information generated by the COVID-19 pandemic left countries scrambling to update old contact-tracing and outbreak data management systems.

“From a system that was Excel and paper and intelligent people who remember all the cases, we had to develop something new,” said Dr Christian von Plessen, Senior Advisor for the Directorate-General for Health in Vaud, Switzerland.

In their search for tools fit for the digital era, many countries, regions and institutions turned to WHO. WHO and GOARN partners provided them with Go.Data. The software is freely available, and its components were chosen carefully to rely on existing open-source software to avoid dependencies on licensed products.

“That [Go.Data] is free of conflicts of interest and promoted by the WHO is very important,” said Teknautas Pere Godoy, President of the Spanish Society of Epidemiology, in an interview with Spanish news outlet AS. “In public health the data are very sensitive, and you cannot use just anything.”

In February 2020 the Go.Data team at WHO received the first few requests for support. Then came a deluge. By 2022, WHO and GOARN partners have supported Go.Data projects in 65 countries and territories.

To cope with COVID-19, and based on user feedback, Go.Data was continuously enhanced throughout 2020 and 2021, with adaptations to handle significantly larger volumes of data: millions of records of person data and relationship nodes versus thousands.

WHO also rolled out online courses for the new users and, when possible, facilitated in-person training sessions, including in Argentina, Bangladesh, Mexico and Viet Nam.

“The Go.Data project is collaborative, involving multiple departments in WHO headquarters, regional and country offices and GOARN partner institutions; it is versatile, with quick adaptation to the country-specific environment and needs, and it is innovative and fit-for-purpose. This is why we were able to rapidly adjust to the increased demands for assistance,” says Armand Bejtullahu, the Go.Data project leader at WHO and one of the chief architects of the tool.

Getting ahead of the outbreak

For epidemiologists, the visual representation of the transmission chain created by the Go.Data allows them to understand more easily how the disease spreads: which activities, environments and types of interaction are associated with high or low transmission rates. This means they can tailor response interventions to quickly interrupt further transmission.

"It is very rich because it allows us to see and evaluate the dynamics of the outbreaks," said Analía Rearte, Argentina’s National Director of Epidemiology.

In South Africa’s Free State province, health teams knew that COVID-19 was more likely to spread in places where people gather, such as in factories and at boarding schools.

“As soon as cases started to show on the Go.Data platform, we would send a testing unit that same day and aim to isolate the cases,” says COVID-19 Case Investigations Manager Dr Thato Lion.

In mid-2021, her team saw a cluster of cases emerging at a school in Bloemfontein. The testing unit that was dispatched to the school identified 84 students with COVID-19. They were quickly isolated and provided with care, helping prevent the outbreak from spreading further.

“It was so important that we could move quickly,” she said.

An evolving tool

WHO and partners continue to enhance Go.Data, largely based on feedback from countries that have used it.

The more Go.Data is used, the more it is strengthened, as the growing Go.Data community shares feedback and local adaptations.The core team behind the platform maintains a Go.Data Community of Practice and the Go.Data Docs site on WHO Github. These open-source resources allow the wider community of technicians and developers to easily access solutions, adapt them to their own context or contribute upgrades.

Several WHO forums have facilitated experience sharing across countries. The Argentine and Ukrainian Go.Data teams, for example, have had several meetings to share experiences.

Beyond COVID-19

Today, Go.Data is an established tool with a track record for flexible use in outbreak response in countries and institutions across the world.

After gaining experience using Go.Data to respond to COVID-19, many countries have already started using the tool to monitor other outbreaks – such as measles in Brazil.

This year the Go.Data team will shift from a reactive to a proactive approach. Their strategy will focus on preparedness, embedding the platform into national training programmes and making the software universally available as a fully open-source product. This activity will be conducted under the forthcoming Open Source Programme Office within the new WHO Hub for Pandemic and Epidemic Intelligence in Berlin. This approach will promote further ownership and equitable access to Go.Data, while ensuring sustainability and integration within existing health information infrastructures.

"Every year, governments in many countries need to respond to several new or recurrent outbreaks, sometimes with limited resources, and almost always without advance notice of what is coming,” says Sara Hollis, an epidemiologist in Emergency Event Response for WHO. “If the tools and systems for contact tracing are already in place, you can act quickly and decisively as soon as the signal is received.”

Learn more

Read the 2021 Go.Data Annual Report

**Visit the Go.Data *webpage

*Learn about GOARN