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when the united states The public health emergency ends On May 11, the US Centers for Disease Control and Prevention will have to change some of the ways it tracks covid-19 in the United States, but the agency says it won’t lose sight of the infection. since it continues to be part of American Life.
On Thursday, for the first time in three years, the CDC will stop publishing a national count of Covid-19 cases. The agency’s color-coded maps of disease transmission and burden at the county level will be retired, the CDC will no longer track variants down to the state level, and it will update its genomic surveillance estimates every two weeks instead of weekly.
“Although our data going forward will be different, it will continue to provide timely information for CDC, local health officials, as well as for the public to understand the dynamics of Covid-19,” said CDC Principal Deputy Director Dr. Dr Nirav Shah.
“In short, we’ll still be able to tell it’s snowing, even though we’re no longer counting every snowflake.”
Instead of tracking Covid-19 cases, the agency will track the burden and spread of the disease primarily through hospitalizations and deaths.
The decision to stop publishing a national case count is largely symbolic. The number of COVID-19 cases known to public health officials has long been underestimated. The percentage of cases detected has only fallen further as people turn to rapid home tests for a diagnosis. At some points in the pandemic, experts estimated that the true number of cases was more than 14 times higher than the official counts.
Other metrics that people are used to seeing on the CDC’s Covid data tracker will also disappear. like cnn previously reportedThe CDC will stop publishing detailed, color-coded Covid-19 transmission levels and community-level maps of Covid-19 that have been linked to recommendations on when to wear masks, when it’s a good idea for people to get tested for prevent the spread of disease and when to avoid large indoor public gatherings.
When the public health emergency ends, more states are expected to stop reporting Covid-19 cases to the CDC. Iowa, for example, it has already stopped. So the CDC says it won’t be feasible to keep a national count or update their maps.
Instead, future recommendations for precautions like mask wearing will be tied to hospitalization levels.
Covid-19 will retain its designation as a nationally notifiable disease, but that’s just a recommendation, says Dr. Brendan Jackson, who leads the CDC’s COVID-19 response. He has no authority for the required reports. When the public health emergency is over, it will be a state-by-state decision to share those numbers, Jackson said Thursday.
The CDC says it will still post the case counts it gets from the states, but that will be in a different section of its website and the numbers won’t be totaled.
Some experts say they are disappointed to see the CDC have to revert to an older, fragmented system of having to ask states to share data.
“We are going back to a system where the CDC independently negotiates all these data sharing agreements with the states and making it more voluntary,” said Beth Blauer, associate vice chancellor for public sector innovation at Johns Hopkins University.
“I think having states do all of this independently doesn’t make a lot of sense because it doesn’t help us understand, as a whole, the impact that the disease is having on our communities,” Blauer said.
He also said that it will be very difficult to scale this system back up if another major immediate public health threat emerges.
Starting next week, vaccination counts will be discretionary. Jackson said that most, but not all, of the 64 jurisdictions that report to the CDC have signed data use agreements to share their vaccine administration numbers. They may not share as much or as frequently as in the past about who is getting vaccinated, which may limit the nation’s ability to detect widespread racial, ethnic, or socioeconomic disparities for future vaccination campaigns. Starting in June, the CDC says, it will update its vaccination data monthly.
Laboratories will no longer be required to submit test data to the CDC, hampering the ability to understand test positivity rates, a metric that, early in the pandemic, helped public health officials know if they were doing enough testing or if transmission in a community was going up or down. Positivity rates were used in transmission maps, but also for CDC variant tracking.
CDC will still get some lab test data from another system called the National Enteric and Respiratory Virus Surveillance System, a network of about 450 labs that help it track diseases like influenza and respiratory syncytial virus, or RSV.
Variant tracking will continue, but CDC will need to adjust some of the metrics it uses to model the proportions of variants. State level estimates of varying proportions will disappear, but regional levels will remain. These will be updated twice a month instead of weekly like now.
The way the CDC will collect data on deaths will also change. Instead of pulling numbers from the state website and getting direct reports from states, which counted deaths based on the date they were reported, the CDC will switch to a national system that counts deaths based on death certificate data. The agency says this system has become much more timely and will be a more stable way of counting Covid-19 deaths in the future. It will also add a new metric to its death report: the percentage of all reported deaths that week that are caused by Covid-19.
Hospitals will still have to report Covid-19 data through April 2024, but they won’t track as many metrics or send that information as often. Hospitals have shared information daily for most of the pandemic, but now that information will be weekly.
Hospitalizations and deaths are known as lagging indicators because they increase only after people have gotten sick. Studies released Friday by CDC epidemiologists show that hospitalizations may not lag cases as much as we once thought they did.
He new studiespublished in the CDC’s Morbidity and Mortality Weekly Report, shows that COVID-19 hospitalizations lagged one day behind increases in reported cases and four days behind increases in ER visits. .
The research also shows that the new system the CDC will use to track deaths will show trends 13 days earlier than data collected from states, the system that is being discontinued.
With case levels low in most of the country, the need for this kind of insight has disappeared, or scientists have found other ways to get the information, such as sewage testing, which begins ramping up about a week before that the test data reflects a rebound in the spread. Wastewater testing is available in some locations, but not all areas have this capability.
The CDC will also maintain surveillance of travelers, tests sewage in airplanes in an effort to detect new incoming threats.
The CDC will also maintain what it calls sentinel systems: smaller, but nationally representative, networks of hospitals and laboratories that will feed more detailed data. This is the same way the agency tracks patterns in other respiratory illnesses, such as the flu and RSV. The CDC says that recent investments in these sentinel systems will help it keep its eyes on Covid-19.
Instead, it will use hospitalizations and ER visits as the primary ways it tracks for Covid-19 and as the basis for its recommendations. When hospitalization rates in an area are high, for example, people will be encouraged to wear masks, Jackson said.
CDC Director Dr. Rochelle Walensky acknowledged some of these data changes at a Senate committee hearing this week, though she stressed that the CDC was not “changing course” in its work on COVID-19. .
“As the public health emergency will end next week, I just want to reiterate that we at the CDC are not changing the course in which we are working to resolve this public health emergency,” Walensky said at a Senate Committee hearing. on Education in Health, Work and Pensions.
“It is the case at the end of the public health emergency, we will have less of a window in terms of data,” he said. “We will not get lab reports. We will not get case reports. So we’ll lose some of that.”
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