To identify potential cases and ensure timely management of symptoms, syndromic surveillance is conducted at the household level. An eight-tier mechanism entails detection, management and follow-up.

Anecdotal reports, which we refer to as the ‘word of mouth’ approach, is the primary source of data on potential cases. When community members report a potential case, our network of community health workers coordinate a household visit with the consent of the individual showing symptoms.

At the household level, health workers collect data on a digital platform using a structured questionnaire. The predetermined algorithm confirms suspected cases and assigns risk levels. The data is uploaded to the case data dashboard, while the health worker connects with a doctor via our dedicated telemedicine service. The doctor determines the severity of symptoms, prescribes medication and recommends testing when necessary. Irrespective of the risks of the suspected case, health workers advise on quarantine and isolation protocols.

Health workers and telemedicine doctors conduct follow-ups on regular intervals and facilitate hospital referrals when symptoms escalate. Suspected case data accumulated on the dashboard is used to facilitate decision making of government agencies.