Bad data slows COVID-19 fight, experts say
Ali Mokdad, an epidemiologist at the University of Washington, has been trying to make sense of this summer’s COVID-19 surge. He says he can theorize only in a general way about why the virus spread and what to do about it.
“Yes, the new cases appear to be mainly young people,” he said. “Yes, they may be letting down their guard. Yes, it might make sense to close the bars.”
But as a global health expert at the university’s Institute for Health Metrics and Evaluation, he says he should be able provide much more nuanced answers.
“Why can’t we figure out what’s contributing to the recent spread? It is very simple,” Mokdad said. “No access to data.”
In a move seen as potentially obstructing access to COVID-19 information even more, the Trump administration last month ordered hospitals to stop sending data to the Centers for Disease Control and Prevention and instead send it to a private data firm under contract with the Department of Health and Human Services, whose secretary reports directly to the White House.
Skyrocketing cases, clashes among federal leaders and a hodgepodge of state data have left many Americans asking how the United States will get back to anything resembling normal life.
The answer is straightforward, Mokdad and other epidemiologists say: wearing masks, social distancing, more testing – and better data.
Epidemiologists insist that standardizing the COVID-19 data states and localities publish is essential to helping people navigate their daily lives and enabling political leaders to make sciencebased decisions the public can support.
It’s particularly critical now, they say, as parents, teachers and elected officials are deciding when to open schools and how to keep them open.
“This virus isn’t disappearing,” said Dr. William Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University’s medical school. “COVID will be here three years from now in some form. We hope we get a vaccine soon. But even when we do, people will need data to see the impact of vaccinations.”
State and local health officials say providing better data isn’t so simple. Meager budgets, stodgy technology and disjointed state and local reporting systems make standardizing data an arduous undertaking.
“It’s a nice idea,” said Oscar Alleyne, chief of programs and services at the National Association of County and City Health Officials. “But it’s not the highest priority in most jurisdictions right now.
“Local health departments are focused on what’s in front of them, and that’s the data they need to decide how to open schools without getting caught up in a whirlwind of amplifying disease.”
Still, epidemiologists point out that every other developed country battling the virus has been able to publish the kind of data average people and scientists need to track the course of the disease each day and pivot their individual behavior and public response accordingly.
The nation’s lack of federal leadership has caused it to fall behind other countries in combating the virus, said Dr. Tom Frieden, former CDC chief, at a news briefing last month.
He and other public health experts urged state and local health agencies to adopt a uniform system of reporting on testing, positive cases, hospitalizations and deaths, as well as on the effectiveness of contact tracing efforts and the percentage of people wearing masks.
Separately, researchers at Stanford University and the University of California who are trying to determine what caused California’s COVID-19 surgereported last month that the state had refused to release crucial data, citing privacy concerns and workload constraints.
Detailed case and contact-tracing data from state and county health authorities, they said, could point to more effective, targeted approaches to slowing the pandemic.
Without the data, the scientists said, little more can be done.
For the states’ part, Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists, said privacy protections and worries about publishing incomplete data are major concerns.
“It’s a matter of trying to present data in ways that get people to make behavior changes, which usually happens when people are impacted personally or when they have local information,” she said. “We want to provide data as locally as possible without violating privacy rights or confusing people. But we know we have information gaps.”
For example, she said, in some communities where very little testing is available and, therefore, very few cases are reported, people could decide that they are not at risk, when they actually are.
Public health officials and advocates argued in a new report that without uniform data, the United States will continue to lag behind the rest of the world in fighting the pandemic.
The groups included Frieden’s organization, Resolve to Save Lives, along with the Johns Hopkins Center for Health Security, the American Public Health Association, Trust for America’s Health and the Association of Schools and Programs of Public Health.
People need to know what their local health departments are doing to contain the virus and hold them accountable, said Dr. Cyrus Shahpar, who directs the epidemics prevention team at Resolve to Save Lives, an initiative of Vital Strategies, in an interview with Stateline.
Shahpar, who lives in California, said, “If there’s a bunch of fires outside, I want to know how many are contained. Right now, we know there are big fires everywhere. But we have no idea which ones are contained.
“We also need to compare cities and states. If I’m in New York state, I need to know which states to restrict travel from. I also need to know which states and cities are safe to visit.”