The end of the Covid-19 public health emergency will require the Centers for Disease Control and Prevention to have the information they collect to analyze the extent of illness caused by the SARS-CoV-2 virus in the future, the CDC announced Friday.
But some of the data measures the CDC will no longer collect are of lesser value now than in the early stages of the pandemic, company officials explained at a news conference Thursday ahead of Friday’s publication of two articles online at the CDC. Morbidity and Mortality Weekly Report detailing the changes.
The CDC will no longer seek to track all covid infections, an effort that became futile long ago due to ubiquitous immediate testing conducted at home. And hospitals are no longer being asked to report suspected covid cases, a move in an era of widespread availability of covid testing. .
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“We have the right knowledge for this phase of Covid-19, although our long-term knowledge will be different,” said Nirav Shah, senior deputy director at the CDC. “They will continue to provide timely data to CDC or local fitness officials, as well as the public to perceive the dynamics of Covid-19 at the network level. “
The long-standing federal public fitness emergency was first declared on January 31, 2020, the day after the World Health Organization announced that the new virus spreading outside of China is a public health emergency of international concern. The Public Fitness Emergency in the U. S. The U. S. has been renewed several times over the next 3 years, but will officially end on Thursday.
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With its demise, some powers the CDC used to force states and territories to provide certain Covid measures.
Some knowledge resources have been running out for some time; Some places no longer report as they used to. And the challenge isn’t just American: Countries around the world have been cutting back on the amount of Covid-related knowledge they collect for some time, Maria Van Kerkhove, a technician at the World Health Organization. lead in Covid-19, he told STAT in an interview.
“What we’ve tried to do is have higher quality data, even if it’s lower,” he explained. , trends in deaths. And at one point, we had. . . whereas 130 Member States provided data on hospitalisations. And I think last month it was about 50. “
As a result, the WHO’s covid hospitalization tracker now publishes monthly rather than weekly updates, he said.
In many ways, the CDC’s transition to a more concise basket of measures is just a mirror picture of the truth that the covid pandemic is in another phase.
At this point, through vaccination, infection, or both, most people have gained some degree of protective immunity; Sufficient immunity, in any case, so that, at most, an episode of covid is no longer life-threatening.
Cécile Viboud, an infectious disease epidemiologist at the National Institutes of Health’s Fogarty International Center, agreed that the desire for knowledge gathering has changed.
In an interview last month, Viboud said his group, which modeled forecasts of covid activity, switched instances to hospitalizations as the basis for its covid projections about a year ago, as counting other people in hospitals who test positive for covid is a more reliable way. metric at this point.
That’s how the CDC is now headed, with hospitals across the country reporting hospitalizations weekly than daily reports demanded lately. the local level. “
Other surveillance approaches CDC will continue to use long-term are wastewater testing (which is conducted in all regions), emergency branch visits for Covid, and positivity rate testing from a network of 450 labs that supply data to CDC on a variety of respiratory and intestinal infections.
“Our epidemiology of covid-19 after the end of the public fitness emergency will be deeper than what we have for other viruses like [respiratory syncytial virus] and influenza,” Shah said.
He cited knowledge of hospitalization as an example. For influenza, hospitalizations are estimated, counted.
Deaths are another domain in which Covid data is and will continue to be more detailed than influenza and RSV. The last two are estimated through mathematical models. But Covid deaths are counted, death certificate data.
Bob Anderson, leader of the mortality statistics branch at the CDC’s National Center for Health Statistics (NCHS), said that despite some earlier reports that medical examiners in some parts of the country failed to report covid deaths, he is sure of himself. The firm is accumulating is strong.
“By talking to U. S. medical examiners. “”A number of U. S. medical examiners, forensics and medical examiners, we don’t think it’s a widespread practice,” Anderson said in an earlier interview with STAT.
“The death certificate information is pretty smart and timely,” he said. “We don’t think we’re missing much. “
However, there is some delay in reporting knowledge of death. Some states record temporarily, with a delay of about 3 to five days, while others record their knowledge with a delay of up to 8 weeks, Anderson said. “But overall, we were getting pretty timely information. Timely enough for us to be able to execute our surveillance, death certificate-based death surveillance, with a delay of about a week.
Viboud said there’s a little more delay in reporting deaths in the NCHS system, “but not much. One or two weeks,” adding that the knowledge is “smart and excellent. “
As the CDC’s technique for Covid awareness evolves, Shah said the company is still running what he called its knowledge architecture. one of which can take weeks. Without a larger formula, the company would face the same constraints in the next emergency.
Better systems are desperately needed, agreed Sheri Lewis, a global expert on disease surveillance at the Johns Hopkins Applied Physics Laboratory. The Hopkins Group created and controlled the university’s Covid data tracker, the access data site until the tracker was consolidated in March.
“One of the most important classes learned [during the pandemic] is that we have over 2500, and this is clearly an approximation, local fitness departments collect knowledge in a non-standardized way,” Lewis told STAT last month. “And so why don’t you think about how we can do standardization in. . . Shared definitions, non-unusual categories of knowledge, so that we can have some kind of non-unusual characteristics, so to speak. That was the biggest challenge 3 years ago.
“I think the Hopkins team will say it over and over again: it must be where we were 3 years ago, where we were building the plane while we were flying. “
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