As COVID-19 case counts and deaths continue to rise in the United States and around the world, we’re beginning to learn more about how it is impacting nations, businesses, and even our own neighborhoods. We’re also beginning to see just how important strong public buy-in is to the success of life-saving public health interventions—such as social distancing—to contain the spread of the virus. The initial public health response has focused on collective action and impact, but it’s no surprise that individuals are experiencing fear and stress about how the disease could affect them specifically.
Counteracting that fear and stress with the best available evidence was what drove me and my colleagues at Mathematica to create 19 and Me during a recent hackathon.
Our team of data scientists, software developers, and epidemiologists wanted to empower people to make sense of the vast amount of information and to make evidence-based decisions. We set out to give individuals a rough estimate of their risk—or, more precisely, the risk of people with similar characteristics as them—of contracting COVID-19. We also wanted to visualize how behaviors, such as practicing social distancing, handwashing, and wearing personal protective equipment, can change people’s risk level.
Many important aspects of this disease remain unknown or uncertain, and the app might not account for some information specific to you, your health status, and your behaviors that would be necessary to most accurately quantify your individual risk score. But our guiding philosophy is that an imperfect estimate, based on the best scientific evidence currently available, is better than no estimate. We believe people make better decisions when empowered neither with fear nor complacency, but with accurate data.
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Mathematica Inc. (“Mathematica” or “we”) has developed this Tool which provides you with an estimation of your personal susceptibility or risk of contracting COVID 19 based on the information you input into the Tool. You may use the Tool for personal and informational purposes. Any other use of the tool is governed by the MIT License
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19 and Me combines information about users with available case data and epidemiological research to empower them to make data-driven decisions that matter for their health and safety. The app is divided into three sections:
- About you. This section collects user input about geographic location, age, and biological sex. Because privacy is such a concern, these data are only used to run the individualized analysis and aren’t collected or stored. Interestingly, most of the public data on COVID-19 cases, such as the Johns Hopkins University Center for Systems Science and Engineering and the New York Times database, are available only at the county level. That might work well for researchers and news outlets, but most people are used to entering their ZIP code to see personalized results. So we built a ZIP-code-to-county crosswalk using a publicly available Application Programming Interface (API) from the U.S. Department of Housing and Urban Development. The app asks for age and biological sex because the risk of hospitalization and severe health outcomes from contracting COVID-19 also depends on these factors. We used the latest epidemiological evidence from the Chinese Center for Disease Control and Prevention (CDC), the U.S. CDC, and peer-reviewed articles to estimate how age and biological sex affect risk.
- Preexisting conditions. The next step asks users if they already have flu-like symptoms and what kind of underlying medical complications they might have. For people with flu-like symptoms and for those without them, our algorithm has different methods to calculate the probability of someone having COVID-19. The underlying medical complications are important because they also determine the risks of developing a severe case of COVID-19, being hospitalized, and dying. Similarly, we estimated risk using the latest epidemiological evidence from the Chinese CDC, U.S. CDC, and peer-reviewed articles.
- Your behavior. Although many risk factors for COVID-19, such as place of residence, age, biological sex, and underlying medical conditions, cannot be easily modified, there are things we all can do to mitigate our own risks. In this section of the app, users can estimate the number of people they and their household members come into close contact with on a weekly basis. This input will feed into the calculation of the probability of contracting COVID-19. The U.S. CDC has recommended additional risk mitigation measures, such as hand washing and wearing personal protective equipment. Users can select checkboxes for these behaviors in the app to see how adopting these behaviors can reduce risk.
We wanted to design the risk score like a credit score, a semi-quantitative metric that can be used to inform actions. Although we cannot provide individuals with a precise sense of their risk, we can indicate the general risk level for people living in the same community who are the same age, sex, and health status, and have similar behaviors. We centered the score around 50. If the risk score is between 1 and 30, users get a message saying the level of risk for people with similar characteristics and behavior is currently low but encouraging them to review the CDC planning guidance to make sure they are prepared. If the risk score is between 30 and 70, users are directed to the CDC resources on how to protect themselves and others from COVID-19. If the risk score is above 70, the message lets them know the risk score is serious and encourages them to avoid exposure, practice good hygiene, and read additional CDC resources on disease prevention.
We did an alpha launch of the app on April 2. Now we’re trying to spread the word and encourage more people to use it. Without effective treatment or a vaccine in sight, we are likely to be living with the virus for the near future. We hope 19 and Me can help people stay informed and levelheaded while we all navigate this long and winding road together. We have already received great questions and a lot of feedback about user-friendliness, which we’ve summarized into an FAQ page in the app.
This pandemic is quickly evolving, and we want 19 and Me to do the same. If you have suggestions, know of data sets that could lead to improvements, or want to suggest additional features, please let us know or visit us on GitHub.