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Cloud-Based Architecture for Effective Surveillance and Diagnosis of COVID-19

Shweta Singh1, Aditya Bhardwaj2*, Ishan Budhiraja2†, Umesh Gupta2‡ and Indrajeet Gupta2§

1 Department of Computer Science and Engineering, KIET Group of Institutions, Delhi-NCR, Ghaziabad, India

2 School of Computer Science Engineering and Technology, Bennett University, Greater Noida, India

Abstract

Coronavirus disease 2019 (COVID-19) has spread in multiple countries and caused major worldwide concern. The continual increase in the number of COVID-19 cases is overwhelming the world economy and has become a serious concern to global health. It is supposed to as an absolute to severe acute respiratory syndrome (SARS), formally known as beta-coronavirus, which was termed as COVID-19 through World Health Organization (WHO). Even with its deadly recurrence, several actions have been taken to diagnose and treat the disease as fast as possible. Rigorous quarantine efforts and global containment are being performed. Apart from this, the incidence of pandemics, similar to COVID-19, had been into existence a few decades back. Various techniques and technologies are being introduced previously, by various authors, to tackle the pandemic. Health authorities, worldwide, concluded with surveillance and tracking of individuals, while others opted for application-based techniques to keep track of the infected individuals, etc. The study proposed a cloud-based network to manage pandemic situations like COVID-19. With this proposed scenario and detailed survey, government authorities and researchers (worldwide) can opt for appropriate ways to control its recurrence; and will help to stop further propagation using dynamic surveillance.

Keywords: Pandemic, COVID-19, cloud-based network, surveillance

4.1 Introduction

A disease is termed as pandemic when it spreads beyond the boundaries of a country and affects people severely to a large extent, hence leading to killings of many. People had been victim to the numerous deadly infectious diseases from past centuries [1]. Few infectious diseases went out of time and did not affect at much higher extent to the countries all around the world. World has been a victim to few infectious diseases from past centuries such as, The Black Death (1330), Spanish flu (1918), HIV/AIDS (1981), The Antonine plague (165 AD), Ebola (21st Century), Tuberculosis, Asian flu (1957), Smallpox (1633), Camp fever, plague of Athens (430 BC), COVID-19 (2019), etc. [1, 2]. Every pandemic leaves the country with numerous political, economic, and social disruptions.

Hence, it becomes equally impossible and more complex to manage the circumstances during any pandemic, as almost every sector of growth is affected at a wider extent. Several precautionary and preventive measures have been followed by countries to manage and stop further propagation of a pandemic. To some extent, the techniques fulfill the criteria, but lacks in providing more reliable and effective techniques to manage the circumstances during a pandemic. Every country is working beyond limits to safeguard the world from the deadly propagation of the disease. With every new era, new technology-based solutions are being provided.

Various authors have proposed technology-based solutions to manage the propagation of disease and safeguard the people. Few authors proposed an android application-based surveillance and detection of infected individuals in an area. Few previous solutions are based on Artificial Intelligence (AI) [3] based architectures that can detect and diagnose using Drone technology [4]. Others provided the review of various block-chain-based technologies [5] that can be utilized to detect the infected person more effectively. But technologies proposed so far lacks in one or the other way. Hence, in this study we explored how cloud-based technology could be used to provide solution of pandemic situation like COVID-19 [6, 7]. In this paper, a framework of cloud-based technology has been implemented that will help various government authorities to diagnose and track the individuals in more efficient manner. An individual will be able to coordinate for the resources via web service utilizing through cloud-based architecture.

The main contributions of this chapter are as follows:

  • Proposed cloud-based network to provide solution of pandemic situation like COVID-19.
  • Explored factor to perform data analysis of the proposed approach.
  • Conducted reliability and validity test for factors analysis in proposed solution.

Furthermore, the chapter is structured in following sections, as: Section 4.2 describes different technologies that has been implemented worldwide to manage circumstances during any pandemic. Section 4.3 describes the proposed Cloud-based network to manage the circumstances for future pandemics similar to COVID-19. Section 4.4 describes survey findings by drawing attention to different factors and outcomes of implementing proposed cloud-based technology in various diagnosis & treatment activities; Section 4.5 includes conclusion and future scope that will help in developing such technology for better sustenance.

4.2 Related Work

From lockdown practices to the technology-based surveillance of the people, various methodologies have been implemented by the countries all around the world. In [8], authors have provided the framework to assist the people online through IoT and blockchain-based architecture [9, 10]. The author has proposed a four-layer architecture to detect the infected people using smartphones. To detect the symptoms based on readings received via sensors, IoT-enabled technology is utilized, and to secure the transfer of information, blockchain-based technology is facilitated.

In [11], author proposed a systemic review of the mobile applications that have been utilized for information gathering and detection of the disease during pandemic in past two years. Thereafter, an analysis of the mobile applications has been done based on certain set of features and quality factors, such as functionality, reliability of the information provided by the application, etc. In [12], authors have discussed about various AI based techniques [13] that can help combat with the deadly propagation of the disease. The authors have provided the detailed description on importance of AI in combating with the pandemic through drone-based technology in various ways related to the prevention, testing, treatment, etc. In [14], authors have proposed an AI-based model to diagnose the disease using radiology images [15]. The authors have proposed COVID-19 Detection Neural Network (COVNet) model to detect and diagnose the community that has acquired the infection from somewhere. Based on the CT-Scan and X-Ray images received, a model will predict about the status of the health of an individual.

In [16], authors proposed a Neural Network (NN) [17] model that will detect the infected people based on an abnormality in the respiratory patterns of an individual. The model proposed by the authors relies on the set of 05 factors, namely, Susceptible, Exposed, Infectious, and Recovered or Removed (SEIR). A classifier model has been utilized to classify the patterns for the estimation of the infection to an individual. In [18], author has provided the detailed explanation and description of various AI-based models that have been proposed by various researchers all around the world. Based on the parameters, such as accuracy, sensitivity, and specificity of every proposed algorithm, the author has concluded the existing models need to be modified for more accurate results, so that difficulties related to transparency and interpretability can be rectified.

In [19] and [20], authors have proposed a model to detect the level of infection in an individual using smartphone. An individual need to record an audio of the cough and using an additional apparatus, body temperature will be measured and saved. And based on the measurement of both cough and temperature of an individual, a decision will be taken whether a person is infected or not. In [21], authors have provided the detailed description of various blockchain-based technologies to detect and deal with the pandemic. Authors have concluded that technologies such as cloud computing [22, 23], AI, big data along with blockchain technology can effectively work in a scenario to handle the spread of any deadly infection in near future.

In [24], authors have proposed a surveillance model based on IoT and Edge technologies [25]. The model works on real-time values received via set of sensors through an IoT-enabled gadget. The authors have proposed a five-stage architecture that will work through a dedicated android application and based on the current health state of an individual, a suspect can be grabbed to safeguard others in his surroundings. The author has implemented an alarm monitoring system for other people who stay nearby an infected person.

Hence, it can be summarized that when it comes to manage the data and resources at a larger extent, cloud-computing is the widely used technology. Cloud-based technology is utilized around the world due to its set of salient features, such as improved agility, performance, increased productivity, security [26], etc.

4.2.1 Proposed Cloud-Based Network for Management of COVID-19

This section represents the proposed cloud-based network to effectively detect and diagnose during pandemic like COVID-19. Figure 4.1 describes the proposed scenario where cloud-based technology is utilized as the basis of more effective and reliable surveillance for the disease.

As shown in Figure 4.1 for the proposed cloud-based network, state of a country is being partitioned into separate regions that will stay connected via web service. For each state there will be a centralized data storage center for resources and equipment that may be required in future. One cen-tralized committee of doctors and security authorities will also be made, so that they can manage the data at a centralized region. Every region will be equipped with group of users, that may have few infected people, a regional repository of data storage, resources, and equipment required, along with the dedicated team of doctors and security authorities at regional level. Every regional committee is hereby responsible to update the centralized committee for the status of the regional health. Following steps are to be followed to implement a more reliable and efficient cloud-based surveillance architecture:

  1. The architecture is based on cloud-enabled technology, which is operated and managed through any web service.
  2. Through this architecture better diagnosis and surveillance methods can be attained.
  3. States of the country is to be partitioned into various regions, and for each region, separate data storage & resource centers are to be maintained, for both medical & security authorities.
    “A schematic illustration of the proposed cloud-based network for management of COVID-19.”

    Figure 4.1 Proposed cloud-based network for management of COVID-19.

  4. Individuals at each region will be allowed to find relevant information about COVID-19 as and when required through a particular web service.
  5. Weekly survey pings will be sent to every individual in particular regional area, so that health–related updates are reached at time to the responsible authorities.
  6. Similarly, centralized data & resource centers will be maintained along with the centralized control of medical and security authorities.
  7. With this, centralized diagnosis & surveillance centers will be maintained, so that all regional committees can send updates for better management of recurrence of this pandemic.
  8. Every individual is required to operate a kind of web service, and for that, their location and Bluetooth should always remain active.
  9. The services of Identity (ID) tracing will help authorities to trace an infected person and will help other individuals to avoid visiting to those infected zones.
  10. Along with this, special authority should be given to every medical store in various regions, so that they can send update on time-to-time, to the responsible authorities is any individual buy’s medications required in their zone.
  11. Though this cloud-based technology, further propagation of COVID-19 can be backed up to some level, as it is secure, efficient, faster, and requirement of time. Figure 4.2 shows working steps for the proposed cloud-based network for management of COVID-19.

Figures 4.1 and 4.2 conclude the overall architecture that is to be followed in proposing scenario to tackle with the propagation of pandemic similar to COVID-19 through cloud-based technology. Figure 4.2 states the overall blueprint of all the features of the proposed scenario. From the Figure 4.2, the summary of the proposed scenario can be concluded in just 05 steps. Whereas Figure 4.1 describes a detailed architecture for cloud-based technology (how cloud-based technology is to be utilized to gain maximum to prevent further propagation). From Figure 4.2, it can be concluded that regional and centralized distribution of resources and equipment will help the individuals to meet their needs during an adverse situation. Hence, maintaining data storage and other relevant information at sub-regional and centralized region will help the government authorities to better coordinate in the extreme conditions.

A schematic illustration of working steps for the proposed cloud-based network.

Figure 4.2 Working steps for the proposed cloud-based network.

4.3 Research Methodology

The existing treatment programs and diagnosis phenomenon of the “Novel Coronavirus” has not been defined clearly [27]. Hence, it becomes necessary to introduce improved technology-based practices that will help in better surveillance and diagnosis during future pandemic. There are less efficient and effective solutions provided by various authors to manage suspicious patients and lacks in appropriate treatment methods. To better interact and to overcome the treatment difficulties, a cloud-based assistance is required that provides a frontline to interact the medical experts. With this, suspicious patients will be monitored in a timely manner and misdiagnosis can be avoided this way.

The present area of study relies on the following specific objectives:

  1. To validate the above proposed cloud-based architecture to manage the circumstances in future pandemics, a survey has been performed.
  2. To generate the factors which contributes for surveillance and diagnosis practices for future pandemics.
  3. To consider the list of generated factors for data analysis and find the most impacting factor out of them and justify their inter-connectivity to stop its propagation in a more sophisticated manner.
  4. The survey has been conducted based on the circumstances seen so far during COVID-19.
  5. Since world is moving towards an era of Smart Things [28], hence Internet-based solutions will be best suited for the coming century.

From above literature study and data analysis, a set of following impacting factors are conceived:

  1. Ease of using technology
  2. Smart gadgets
  3. Ease of using Internet
  4. Applications as travel guides
  5. Reliability on applications
  6. Efficiency of applications
  7. Awareness about COVID-19
  8. Awareness about protective & preventive measures
  9. COVID-19 declared as pandemic
  10. Initiative by government
  11. Satisfaction from government
  12. Guidelines issued by government
  13. Role of technology in managing COVID-19

4.3.1 Sample Size and Target

The investigation is performed on suspects in North-East Delhi region. The target sample size at initial was set to 430 out of which approximately 398 respondents validated with appropriate responses. To achieve subjectivity of this study, an analysis is to be performed, that explains the impact of COVID-19 on majority, and how technology can help in avoiding misdiagnosis procedures. Since their survey is being done during COVID-19, hence, the questionnaire was prepared related to the pandemics similar to COVID-19. We have restricted our study to certain parameters in due consideration of technological issues due to time and resource constraints. A convenient sampling method was utilized so that people were surveyed as per convenience.

The research more relies on evaluating the impact of eight different factors found that can play a vital role to overcome the pandemic in a country. Total count of thirteen factors was taken at initial for the data analysis, but further analysis methods reduced them to eight factors. Data collected through questionnaire is primary in nature, which will further act as basis of report formulation. Though, authors agree to certain constraints that may restrict the study as more descriptive in nature to a certain point than being exploratory.

Pilot Testing

To attain the lucidity in questionnaire and the reliability of variables, several pretesting methods [29] need to be performed. These pre-testing surveys are performed so that questions that are hard to understand or confusing can be easily rectified, and questionnaire is to be non-confusing. Under study, a count of 70 pre-test surveys was preferred from a non-probability sample respondent.

4.3.1.1 Sampling Procedures

Research relies on a survey technique to gather information via questionnaires distributed to various suspects in North-East Delhi region. These suspects were mixed who were aged between 12 years and above. An appropriate sampling technique was utilized while investigation. These 440 participants were distributed properly prepared questionnaire that contained COVID-19 and questions related to the technology-based solutions. The questionnaire method was containing 65 items. Our survey technique bifurcated questionnaire items to 13 different factor loads relevant to manage the propagation of COVID-19.

4.3.1.2 Response Rate

A count of 440 questionnaires was circulated out of which 396 satisfactory responses are received. Though a satisfactory response rate of 90% is attained, rest mentioned issues such as lack of interest, busy schedules, or other personal reasons. While the data analysis was going on, no invalid responses were considered.

4.3.1.3 Instrument and Measures

While designing the questionnaire, various factors like smart gadgets, reliability on applications, advantage of technology in managing COVID-19, etc., (total count of 13 factor dimensions) were taken into consideration. The overall process has resulted in mainly 65 items in questionnaire consisting of both generalized and proposed scenario related questions.

Data Analysis

Exploratory Factor Analysis (EFA) [30, 31] was performed to cut-off the count of proposed items to some level. It is a two-way approach mainly. In the initial stage, to satisfy the level of reliability and validity of the conception, an individual measurement model must be examined. Furthermore, with second stage, the procedure of factor analysis is performed, and respondents answered to items according to their own excuses.

4.3.2 Reliability and Validity Test

An IBM SPSS Statistics software (22.0) [32, 33] is used to perform reliability test on 65 items in questionnaire. Table 4.1 depicts the alpha coefficients calculated for each factor involved. To improve the scales, those adapted from previous studies, Cronbach’s alpha coefficient [34] and EFA were applied. On considering the multi-dimensionality intended for the factors, coefficient alpha was evaluated regarding every factor. Reliability test [35] for analysis about cloud-based network in managing pandemic similar to COVID-19 was done on set of 13 factors, separately. Survey findings stated that minimum 5 items should be included for which separate alpha coeffi-cients are to be assigned.

As recommended by testing research theory (Nunnally & Bernstein, 1994) [36], a cut-off level is to be fixed at 0.7. Thus, eliminating the factors, those are unsatisfactory in level of reliability. Optimized item-to-total correlation [37] is facilitated that helps to choose which item is to be removed. Multiple recompiling for alpha values is performed further, which helped to cut-off the list of items to some extent. Further, on investigating opti-mized item-to-total correlations at times, all irrelevant items are deleted. This multiple elimination practice helps in improving corresponding alpha values. After recurrence to a lot of times, count of 40 items for 8 constructs (to which, 65 items for 13 constructs were initially proposed) are found most relevant.

4.3.3 Exploratory Factor Analysis

Unlikely to factor analysis, an appropriate methodology is utilized to determine the dimensionality of 65 items scale. EFA is used basically to cut-off the count of items in questionnaire, and to evaluate validity for the construct. The very famous, Kaiser-Meyer-Olkin (KMO) and Bartlett’s Test [38, 39] are opted by most researchers to validate the robustness for each factor analysis and sampling adequacy procedures [40]. Table 4.2 depicts KMO calculate of sample adequacy as (0.855) which is approximately 1. Moreover, while applying Bartlett’s Test of Sphericity, a considerable value (p = 0.000) is received i.e., approximately 0.05 (such that p-value <0.5). Hence, it can be stated that sample and factors extracted are now more optimized and satisfactory.

Table 4.1 Reliability test for factors in relevance to Cloud-based solution to manage future pandemics similar to COVID-19.

S. no.Factors consideredCronbach’s AlphaCalculated Alpha coefficients for factors namely 2, 3, 4, 5, 7, 11, 12, 13 has met the considerable range of reliability that lies in between 0.713 and 0.876. Though, factors like 1, 6, 8, 9 and 10 didn’t met the minimum reliability with loads as 0.612, 0.667 , 0.634, 0.539 and 0.685. Thus, these indicate inadequate level of reliability in relation to role of cloud-based network in managing pandemic. To achieve constancy, unsatisfactory factors were removed, and was restricted to further load the factors with minimum of 0.7.
1Ease of using technology0.612
2Smart gadgets0.785
3Ease of using Internet0.876
4Applications as travel guides0.830
5Reliability on applications0.713
6Efficiency of applications0.667
7Awareness about COVID-190.773
8Awareness about protective & preventive measures0.634
9COVID-19 declared as pandemic0.539
10Initiative by government0.685
11Satisfaction from government0.747
12Guidelines issued by government0.834
13Role of technology in managing COVID-190.801

Table 4.2 KMO and Bartlett’s test.

TestAdequacy
Kaiser-Meyer-Olkin measure of sampling adequacy0.855
Bartlett’s Test of SphericityChi-Square10752.627
Significant Value0.000

4.4 Survey Findings

Tables 4.1 and 4.2 depicts the optimized count of total factors (8 factors) after applying reliability tests on set of factors. Figures 4.3 and 4.4 conclude the results drawn after a survey is done on factors related to the circumstance of the COVID-19 epidemic and awareness in public regarding technological solutions. The factors that are most relevant to findings related to advantages of technology for better diagnosis and surveillance are, smart gadgets, ease of using Internet, applications as travel guides, reliability on applications, awareness about COVID-19, satisfaction from government, guidelines issued by government, and Role of technology in managing COVID-19.

Figure 4.3 describes the factors that most essential this survey, after analysis is performed. It is found that factor named Ease of using Internet has received greatest loading factor. This means that people make maximum work out of Internet-based services. Second most appropriate factor found is Applications as travel guides that contribute much for security authorities, as users of such applications agree to its prescribed terms & conditions of usage. That is, they are ready to share their location related information, as and when required by the government. This feature will help authorities to trace the infected person, and to update the people nearby to him.

A schematic illustration of an open-source factor analysis for analyzed 13 factors using Cronbach’s alpha.

Figure 4.3 An open-source factor analysis for analyzed 13 factors using Cronbach’s alpha.

A schematic illustration of survey summary to validate the proposed scenario of cloud-enabled network.

Figure 4.4 Survey summary to validate the proposed scenario of cloud-enabled network.

Figure 4.4 concludes the summary report as per the items distributed to various respondents. It can be stated clearly from the Figure 4.4, that respondents have validated the proposed cloud-based scenario. According to the above figure, 84.9% of total respondents agree to make their most of the work done via Internet and with the ease of using smart gadgets. Similarly, 94.3% of the total respondents find web and related services as appropriate ways to find information and being updated. Also, 100% stated that more preventive measures should be introduced that can be utilized via Internet-enabled elements. Hence, it can be concluded from survey findings that majority of respondents agree that cloud-based technology should be encouraged for better diagnosis and surveillance related activities, by the government, for the sake of every individual.

It is found from both the surveys and factor analysis method, most appropriate factor to be considered is role of technology in managing COVID-19. Technology is playing a vital role in almost every aspect worldwide, as it has numbers of advantages over traditional methods of finding solutions to any problem. Further, this the study carried out in this paper can be extended with container-based virtualization [41, 42].

4.4.1 Outcomes of the Proposed Scenario

The key points that contribute to providing better services through technology can be stated as:

4.4.1.1 Online Monitoring

Cloud-based technology is best in identifying, monitoring, and guiding better diagnosis and surveillance online.

4.4.1.2 Location Tracking

Can be best fitted to trace the infected individuals and provide appropriate treatment procedures.

4.4.1.3 Alarm Linkage

Alarms or pings can be sent to individuals as in case there is some probability of being infected in some circumstances.

4.4.1.4 Command and Control

The command to offload data at cloud data center can be easily executed. Further, the working method would also provide controlling run time data through the cloud manage servers.

4.4.1.5 Plan Management

The preset criteria of managing and timely treatment can be provided for suspected, confirmed, and suspicious cases found. This will help in attaining measures for better surveillance-related activities.

4.4.1.6 Security Privacy

In the healthcare sector, data protection and security are the primary factors for patient perspective. Nowadays, services of cloud computing are provided across the entire computing spectrum through secure data centers.

4.4.1.7 Remote Maintenance

Through remote locations, easy graded diagnosis and treatment facilities can be utilized through web service.

4.4.1.8 Online Upgrade

Automatic medical and other information will be updated to individuals via web service and other aspects, so that necessary precautions are taken in time.

4.4.1.9 Command Management

Through cloud-based network, information can be collected, and better results can be attained.

4.4.1.10 Statistical Decision

On collecting data through different practices, statistical reports can be made, and different problem identifiers, experiences, and solutions can be proposed through various experts and managers.

Factors with minimum loading factor are, such as Ease of using technology, Efficiency of applications, Awareness about protective & preventive measures, COVID-19 declared as pandemic, Initiative by government. The factors with minimum value for Cronbach’s Alpha, also contributes to managing and controlling misdiagnosis & surveillance in some way or the other.

4.4.2 Experimental Setup

This section represents the experimental setup that has been made for the proposed scenario. An individual is allowed to operate while roaming into various regions. The regions are connected through the cloud-based architecture. The individual will be allowed to gain information through web service-based architecture. Figure 4.5 represents the experimental setup for the proposed scenario.

A schematic illustration of experimental setup for the proposed cloud-based network.

Figure 4.5 Experimental setup for the proposed cloud-based network.

A schematic illustration of point-to-point throughput received via proposed cloud-based architecture.

Figure 4.6 Point-to-point throughput received via proposed cloud-based architecture.

For the experimental setup of the current scenario, two regions are taken into existence. Each region will have a group of people communication while roaming. An individual can be traced or provided with diagnosis more effectively.

To validate the performance metrics for the proposed cloud-based architecture, the simulation represents the outcome as increased throughput. Figure 4.6 represents the simulation analysis based on the performance metrics in terms of throughput.

4.5 Conclusion and Future Scope

Researchers round the world are keenly finding technological solutions to combat with the deadly pandemic. Solutions such as IoT and AI-based have been provided by various authors in different perspectives. But an area of improvement in the strategy is required for effective surveillance and diagnosis of the people all around the world. In the paper, a cloud-based architecture is proposed that contributes to providing better aspects to manage COVID-19 and finds measures to stop further propagation of this pandemic. A user is supposed to operate the services via web service. States of a country are divided into various regions and, every region is then managed through a centralized location for a particular state. Furthermore, a survey is performed on various factors that contribute to validate the proposed cloud-based scenario for effective surveillance and diagnosis methods. In this paper, a primary questionnaire was made, to which Cronbach’s Alpha factor is applied that support the substantial factors from proposed set of factors. From the overall study, it can be stated that introducing Internet-based services is given as main concern, so that they can be updated from remote locations, as and when required. The purpose behind such research is to provide intelligent diagnosis, treatment to the majority, and overcome the fear of being infected in between the people. With this technology, authorities can easily trace at remote locations and can stop further propagation by applying certain monitoring procedure.

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Notes

  1. *Corresponding author: [email protected]
  2. †Corresponding author: [email protected]
  3. ‡Corresponding author: [email protected]
  4. §Corresponding author: [email protected]
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