REMOTE Study: Longitudinal Monitoring of the Incidence of SARS-CoV-2 Infection and Immunity Levels in Long-term Care Facilities

Approximately 11% of COVID-19 cases and 73% of all COVID-19 deaths in Canada have been in long-term care (LTC) homes, affecting both their residents and staff. With the rapid vaccination of the residents and staff in LTC facilities, the questions now are how to effectively monitor their risk of infection, and to quantitatively evaluate the protection levels and strategies for better implementing post-vaccination care to the residents. Technically, none of the commercially available rapid tests and wearable devices have been effectively utilized in Canada for longitudinal monitoring of SARS-CoV-2 markers and host immune response in LTC residents and staff, as these technologies are inefficient, lengthy, costly, not digital, often invasive, and require skilled personnel to operate. We propose to fill this critical gap in effective self-testing of infection and immunity levels through a unique vital signs and immunity level monitoring system integrated with a machine-learning harnessed web-app (REMOTE). Once pilot-tested and implemented, the digital REMOTE technology will enable accurate and non-invasive monitoring of LTC residents and staff through simultaneous longitudinal monitoring of 1) vital signs using smartwatches and 2) risk of viral infection and protection levels using digital saliva testing kits. With the partnership with Brenda Strafford Foundation, our project will benefit to protecting at-risk LTC residents while helping them remain socially and emotionally connected. It will represent an opportunity to provide evidence-informed recommendations for the development of standards for staffing and infection monitoring, prevention, and control in LTC homes. The outcomes of this research in the short term will provide enhanced uptake of accurate rapid tests and digital technologies by LTC staff and residents, and in the longer term, will build the basic infrastructure for a shift in home-based medicine and remote monitoring of diseases.