November 16, 2020 (New York) – Eight months into the pandemic, the United States is facing a record surge of COVID-19 cases with more cases in more places than ever, more hospitalizations, and increasing deaths, and continues to lag in controlling the virus with a coordinated national response. Today, Dr. Tom Frieden, former CDC Director and President and CEO of Resolve to Save Lives, an initiative of Vital Strategies, and his team have released their second comprehensive review of COVID-19 information available to the public at the state level, mapping states’ progress toward reporting key COVID-19 indicators and providing actionable steps for improvement.
The report shows important gains in the availability of information necessary to track and control COVID-19 in the United States: 54% of essential data points are now being monitored and reported publicly (up from 40% in an initial review conducted by Resolve to Save Lives in July of this year). But troubling gaps persist, particularly for important indicators on contact tracing, health care worker infections, and the use of masks.
“Many state and county-level health departments have put enormous time and effort to increase the quality, timeliness and relevance of the COVID-19 data they share,” said Dr. Tom Frieden. “But the improvements are not uniform, and most states still fall short. What we see is a patchwork of solutions, brought about by the absence of national coordination and support. ”
“Tracking COVID-19 in the United States: Progress and Pitfalls” evaluates state-level dashboards for all 50 states, Washington, D.C. and Puerto Rico on their reporting of essential indicators that would dramatically improve the ability of people in the United States to understand both their own risk and how well each state and county is doing to reduce that risk. Better reporting would help provide more services and prevention to the communities most affected by COVID-19, including Black, Latinx, Native American/American Indian, and other groups that have been disproportionately affected. As a companion to the review, Resolve to Save Lives developed an interactive, digital map to showcase changes in indicator availability at the state level.
Dashboards from Minnesota, Oregon, Utah and Washington, D.C. received the highest scores. Nine states (Arkansas, New Mexico, Washington, D.C., Washington, Hawaii, Minnesota, Oregon, and South Carolina) improved by 20 or more percentage points since the July assessment. Of note, the report focuses on public availability of data rather than the overall effectiveness of the state response; several states, including New York and Maine, have excellent overall responses, but gaps in public availability of data.
The report also highlights data availability on emerging hot topics: rapid testing with antigen-based technologies, risk-alert systems, travel-related measures, schools, and vaccines.
The researchers at Resolve conducted a thorough search of state-level government information on COVID-19, including data dashboards from Departments of Health and Education, Governors’ offices, and reopening plans. Data points that could not be located in this process were not considered accessible to the public, and thus not considered in the assessment.
To control COVID-19 effectively, it is important that everyone have clear access to relevant, uniform data across jurisdictions. Adoption of the essential indicators would also increase the information available on disparities in COVID-19 cases, deaths, and the quality of the governmental response for different ages, races, ethnicities, and locations.
Limited but encouraging improvements show that the U.S. can do better. The average COVID-19 data dashboard scored 31% (up from 21% in July). For the first time, for each of the 15 essential indicators, there is at least one state whose reporting meets the gold standard. Reporting on outbreaks in congregate facilities (including long-term care facilities, correctional facilities and homeless shelters) test positivity, and occupancy proportions of ICU beds showed the greatest improvement.
Failure to break down numbers by age and race/ethnicity over time hides important trends. Essential indicators, such as cases, tests, hospitalizations and deaths are not stratified by subgroup or over time in many states. This means there is critical information missing on how different communities and demographics are being disproportionately impacted, limiting public awareness, accountability, and progress.
Reporting on case investigation and contact tracing remains unacceptably poor. There are two crucially important indicators: How long it takes to get infectious people isolated, and what proportion of cases arise from among quarantined contacts. No state fully meets criteria for reporting on the time from when a test is performed (specimen collection) to when people confirmed to be infected are isolated. Only two dashboards (Oklahoma and Washington, D.C.) fully meet criteria for reporting on the crucially important indicator of the percentage of their new cases that come from quarantined contacts. These gaps hamstring the public’s ability to understand the performance of local contact tracing efforts, limit sharing of best practices between states, and delay life-saving improvements. Although contact tracing may need to be scaled back in the context of explosive spread of the virus, case investigation and contact tracing services need continuous improvement to enable more of society to open sooner and safer.
In many places, data critical to decisions on opening and closing schools for in-person learning is missing. Nearly half of states do not publicly report any data on school-associated COVID-19 cases. Some states provide comprehensive data on cases among students and staff. As examples of best practices, New York and Ohio both provide searchable databases of school-specific data.
With the emergence of rapid antigen testing, tracking tests performed and their results has become increasingly complex, and reporting has not kept up. Most (58%) state dashboards do not differentiate between faster, less accurate antigen tests, and molecular (PCR) tests. Failure to report the results of antigen testing may leave communities unaware to local transmission and outbreaks that have not been confirmed by molecular testing.
The report emphasizes basic best practices for data sharing including:
- Reporting data the same day it is collected to inform timely risk assessment and action
- Linking to county data dashboards so the public can easily see what is happening in their county and neighboring counties, ideally with zip-code look-up
- Enabling download of data.
Resolve to Save Lives plans to repeat the assessment in January, and add an assessment of the ease of use of dashboards at that time. In addition, in the coming weeks, Resolve will provide tools and examples of well-designed dashboards, in addition to the examples provided in the report.
Read the full report here: https://preventepidemics.org/covid19/resources/indicators/
Consult the interactive map here: https://preventepidemics.org/covid19/indicators/map
Steven Chlapecka, Resolve to Save Lives, [email protected], +1.917.623.0246
Christina Honeysett, Vital Strategies: [email protected]; +1.914.424.3356
Erin Sykes, Resolve to Save Lives: [email protected]; +1.646.612.0001
About Dr. Tom Frieden
Dr. Tom Frieden is former director of the US Centers for Disease Control and Prevention and former commissioner of the New York City Health Department. He is currently president and CEO of Resolve to Save Lives, a global health initiative. Resolve is part of Vital Strategies, and works with countries to prevent 100 million deaths from heart disease and to make the world safer from epidemics. Follow Dr. Frieden on Twitter @DrTomFrieden.
About Resolve to Save Lives
Resolve to Save Lives, an initiative of Vital Strategies, aims to prevent at least 100 million deaths from cardiovascular disease and epidemics. Through its Prevent Epidemics program, Resolve to Save Lives has rapidly leveraged existing networks to partner with countries throughout Africa and beyond to combat COVID-19. Resolve is led by Dr. Tom Frieden, former director of the U.S. Centers for Disease Control and Prevention, and is part of the global health organization Vital Strategies. To find out more visit: https://www.resolvetosavelives.org or Twitter @ResolveTSL.
Resolve to Save Lives created a website called PreventEpidemics.org that shows how prepared each country is for an epidemic, including COVID-19. This site is also a resource for current coronavirus statistics and resources.
About Vital Strategies
Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. We work with governments and civil society in 73 countries to design and implement evidence-based strategies that tackle their most pressing public health problems. Our goal is to see governments adopt promising interventions at scale as rapidly as possible. To find out more, please visit www.vitalstrategies.org or Twitter @VitalStrat.