People walk past a COVID-19 testing site in Times Square on May 12, 2022 in New York City.
Liao Pan | China News Service | Getty Images
Centers for Disease Control and Prevention will have less data to track the spread COVID-19 And new variants in the US after the public health emergency ended on Thursday.
CDC principal deputy director Dr. Nirav Shah told reporters during a call, “The end of the public health emergency means that the CDC will have less authority to collect certain types of public health data — which means that for us Less data will be available.” Thursday.
Shah acknowledged that disease surveillance in the US during the pandemic was inadequate and needed improvement.
“Our ability to detect and monitor disease threats should be better in the future than in the past,” he said. “And the capability to detect and monitor should be built into our baseline and not depend on emergency declarations,” Shah said.
The US, unlike other wealthy countries, has a fragmented health care system in which authority to decide which disease data gets reported rests largely with corporations, the 50 states, tribes and territories – not the CDC. .
Dr. James Lawler, an infectious disease specialist at the University of Nebraska Medical Center, said this fragmented system is the result of a lack of will to reform — not a technical challenge.
“How ridiculous is it that in 2023, I can tell you where my UPS packages are at any time and not have visibility into my health care data,” said Lawler, who advised the Bush and Obama administrations on biodefense. and pandemic preparedness.
“Health care is the third rail in politics and nobody wants to touch it,” he said.
a more fragmented system
Laboratories certified by the Centers for Medicare and Medicaid Services are no longer required to report COVID test results to the CDC. Congress required these labs in March 2020 to send results to the federal government, but that mandate was tied to a public health emergency.
Dr. Brendan Jackson, head of the agency’s COVID response team, said some states will stop reporting cases to the CDC altogether.
Since April 2020, Covid has been classified as a National Notable Disease. This means new cases must be reported to the CDC, but notification by states to the federal government is a recommendation — not a mandate.
“Each individual state or other jurisdiction has its own rules or regulations that determine what is reportable,” Jackson said. “In some jurisdictions or some states those authorizations will go away with the end of the public health emergency,” he said.
Jackson said the CDC would transfer its archive of positive Covid tests to a voluntary network of more than 450 labs.
Covid case data in the US became unreliable several months ago because so many people are getting tested at home – if at all. These test results are not taken into account in the CDC data because there is no reporting requirement.
The World Health Organization has repeatedly warned that the dramatic drop in testing worldwide is making it difficult to track new Covid variants.
Although the CDC will continue to track Covid variants domestically and among international travelers entering the US, it will reduce how often the agency is required to report this data.
“There’s definitely been a decline in the amount of testing that’s going on and the number of samples that can be submitted for genomic sequence, so we need to scale back on the frequency of how often we’re reporting on them,” Jackson said. Might be possible.”
According to the CDC, variant data will be reported twice a month instead of weekly going forward.
Spotty reporting of case data also means the CDC no longer reports the virus broadcast at the county level After the public health emergency is over. Health-care facilities used this data to know when to get masks and nursing homes relied on it for testing for admissions.
Jackson said the CDC will update its recommendations for these facilities as they learn how to prevent further infections.
The agency will also phase it out covid community levelThey provide local recommendations to the general public about mask-wearing and other precautions based on the number of cases and hospitalizations due to the virus in individual counties.
Jackson said the community level would be replaced by a new system that relies solely on hospitalization.
Other Monitoring Methods
Public health officials are focusing on tracking severe disease through hospitalizations and deaths rather than cases, as the availability of vaccines has reduced the risk of infection and prevented so many people from catching Covid. Immunity to an extent.
Shah said that even after the public health emergency is over, the CDC will still have methods for monitoring COVID. Jackson said hospitals would have to report Covid admissions by 2024. The CDC will primarily rely on this information as well as sewage surveillance, which covers about 140 million Americans. Hospital data will be reported weekly rather than daily going forward.
The CDC will continue to report COVID deaths, although the system will move to the National Vital Statistics System. Jackson said this should improve the reporting of death statistics.
“We’ll still be able to tell it’s snowing even if we’re not counting every snowfall,” Shah said.
But health law expert Lawrence Gostin said the CDC would easily lose the ability to collect data once the public health emergency is over. The problem, Gostin said, is that unlike most other wealthy countries in the world, the US doesn’t have a national health care system.
CDC is currently negotiating data-use agreements with states, tribes, and territories to maintain access to COVID vaccine administration data. Jackson said these talks could take weeks to months to complete.
“This is no way to run a world-class surveillance system. It is porous, it is unreliable, it is inadequate for the job.” Gostin said.
This information is critical to successful vaccination campaigns because it can reveal the disparities in getting the shot across race, age and geography. This allows public health officials to focus on ensuring that unvaccinated vulnerable populations get their vaccines.
Jackson said most of the 64 states, including 50 state and other local authorities, have signed data-use agreements on vaccine administration. He said the CDC will also continue its separate national immunization surveys, which provide information on race and ethnicity.
Congress has been reluctant to mandate reporting to the CDC because of doubts about what the federal government will do with the data, Gostin said.
“This is public health information,” Gostin said. “The CDC is bound by confidentiality laws and public health officials in all peer countries have these authorizations and nothing goes wrong — the government doesn’t use it for bad things,” he said.