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CDC struggles to track Covid cases as Omicron looms

As the world experiences new, more transmissible Covid-19 variants, scientists and health officials in the U.S. are still struggling to gather accurate and timely domestic data to help inform policy decisions to safeguard Americans.

Continuing gaps in the CDC’s data collection program, which almost two years into the pandemic still relies on state health departments who use a mix of often incompatible and outdated state systems to identify cases, impedes the nation’s understanding of where and how fast the virus is spreading, according to more than a dozen state and federal officials involved in tracking cases.

The fact that the data gaps have been apparent since the start of the pandemic makes the lack of substantial improvement particularly galling to many infectious disease specialists.

“I think we’ve done a horrible job from day one in data tracking for the pandemic,” said Eric Topol, a professor of molecular medicine at Scripps Research and former advisory board member of the Covid Tracking Project, a team that worked to collect and synthesize local Covid-19 during the peak of the pandemic. “We’re not tracking all the things that we need to to get a handle on what’s going on. It is embarrassing.”

Meanwhile, other Western countries have tapped into their modern health systems that can easily track patient data and seamlessly share epidemiologic information across a broad spectrum of health care facilities and public health departments. Because of the lack of accurate and timely domestic data, Biden health officials over the last eight months have increasingly relied on international sources to respond to domestic surges in part because they believe the information is more reliable, the officials said.

The administration’s dependence on international data underscores the extent to which the U.S. public health data infrastructure is still failing to produce real-time data on not only the spread of the virus but also the degree to which the virus evades the vaccine and the degree to which it impacts various American populations. It also raises questions about whether the American public health system, supported by state health departments, will be able to sustain itself under the inevitable deluge of Omicron cases that will pop up across the U.S. in the coming months.

With the emergence of Omicron, public health officials across the country told WEBICNEWS that the current level of investment by the federal government to improve the country’s data systems is not enough to overhaul their existing surveillance systems to a degree that they can handle another massive surge or another pandemic like Covid-19.

In an interview with WEBICNEWS, Dan Jernigan, the deputy director of the CDC’s Public Health Science and Surveillance office, acknowledged that the CDC had not yet secured additional future funding to improve state data collection — funding supplemental to the money it earmarks for data modernization annually.

“It will be very important that we identify ways to have sustainable support for these non-categorical activities like data modernization,” Jernigan said. “That’s something that we look to our partners in Congress to identify how best to support the ongoing need for maintaining a good data infrastructure.”

Lacking comprehensive domestic data, U.S. scientists and health officials have in recent months examined information from Israel, the United Kingdom and India to understand how the Delta and Omicron variants are transmitted, how they impact both the vaccinated and unvaccinated communities and which public health policies work best at stopping their spread.

Two top Biden health officials said they often look overseas for answers because the newer variants have spread more quickly in other regions of the world first and data from those areas are critical in helping the U.S. prepare for future surges.

Anthony Fauci, the president’s chief medical adviser, told WEBICNEWS the administration is primarily using South Africa data to study the transmissibility of the Omicron variant as well as its infectious nature.

“There’s a lot of data that’s coming in from a lot of different places. It’s coming in from the U.K., it’s coming in from Israel, it’s coming in a lot from South Africa, which is ahead of the rest of the world in the experience they’re having with Omicron,” Fauci said. “We’ve gotten virus either in the live virus form or in the pseudo virus form. But we don’t have enough of this in the United States to be able to bank on our own clinical experience which is in contrast to the South Africans who are in real time experiencing the clinical impact of Omicron.”

But even as the Delta variant spread across the U.S. over the summer and the country gathered more information about cases and hospitalizations, the administration continued to rely on data from other countries, according to the two senior health officials and another individual with direct knowledge of the matter.

In interagency health and high-level White House meetings, health and White House Covid-19 officials have lamented that U.S. epidemiological data is lacking in speed and accuracy and have advocated that the administration use data collected by international allies while considering policies on vaccinations and booster shots, those sources said.

“We’re relying on everyone else’s data. We should be providing data to the world and we are not,” said Zeke Emanuel, a bioethicist and former member of President Biden’s transition Covid-19 advisory board. “We started [the pandemic] with a serious problem of not enough data and bad data infrastructure. We have not made the structural investments we need. The ideal is that we have real time data. And we don’t have that. We’re not even close to that.”

Health advocates, scientists, doctors and health officials have long highlighted the importance of improving U.S. public health data systems and ensuring they more accurately predict and manage the spread of diseases and viruses. But with diminishing federal funding, state health officials said they have struggled to make the necessary improvements to their data systems — improvements that would withstand the crush of a pandemic. When Covid-19 emerged in the U.S., those data systems failed.

State and local public health departments and the CDC have tried to gather information on Covid-19 cases, investigate outbreaks and translate epidemiological data to the public as quickly as possible. But outdated data systems that require significant manual data entry, slow laboratory reporting and a dwindling local public health workforce have hampered those efforts.

Jernigan, of the CDC’s surveillance office, said the agency has allocated billions of dollars in funding to provide upgrades to those systems.

“What we’re focusing on is really changing how the data gets collected, changing where that data lands, like what kind of platform you put that data into, and then really changing the way that CDC gets the data and uses that data … to help make the work better and make investigations faster,” Jernigan said.

The CDC has allocated funding to states and public health labs across the country to ramp up genomic sequencing efforts. That effort seems to be paying off. With the outbreak of the Omicron variant in the U.S. this month, state health departments in Washington and New York received samples and detected the variant in less than 48 hours — a far shorter period of time than the weeks it took some labs during the height of the pandemic.

And in August, days after a WEBICNEWS investigation revealed pandemic data gaps, the CDC announced it was using $29 million to create a new data forecasting center that will speed the delivery of critical public health data to federal decision makers.

The agency also ramped up its efforts to support states in improving their data systems and hire new, skilled employees to manage those systems by providing health departments with significant new funding, he said. State health officials from Wyoming, Arkansas, Vermont and the state of Washington all said they are finally working with teams that have the technical knowledge and depth to be able to make all the necessary changes needed to prepare for the next pandemic.

Specifically, those officials said, they are working with Jernigan and his team to find ways to create new platforms through which health care facilities, physicians and state health departments can electronically share patient case information, allowing health officials to quickly open new case investigations for specific viruses and diseases.

But it could take several years to implement, state officials said, which will require a level of federal funding that matches that which they’ve been receiving during the pandemic. The big question is whether Congress will make the necessary funds available to the CDC for disbursement. Without additional investment, local officials worry the funding will disappear in the coming year, reversing some of the progress they have made in fixing the country’s public health data problems.

“We have been a hole in public health and under invested in over the decades, we cannot delude ourselves to think that one time investments will be enough to regain the footing for public health across the country,” said Umair Shah, secretary for health in the state of Washington. “We must have strategic, smart, sustainable funding. Whether it’s Covid-19 today, or whether it’s the next emergency or pandemic tomorrow, we have to have significantly better capacity across the system otherwise we’re going to repeat what we saw previously.”


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