This week the Public Health Emergency (PHE) for COVID-19 is ending in the U.S. This means many things, but one major shift will be the data—the dashboards and updates we’ve grown accustomed to. Why the change? The public health system in the U.S. is complicated. But, essentially it’s decentralized. In other words, the federal government (i.e., CDC or HHS) is not the “center” of the public health universe. Public health is local. What “local” means
“ Cultural differences between red and blue counties also likely contributed to COVID deaths. “You’re affected by your neighbors,” says Neil Sehgal, a public health professor at the University of Maryland and co-author of a recent study of the association between COVID mortality and county-level voting. Sehgal and his colleagues found that through October 2021, majority-Republican counties experienced 72.9 additional deaths per 100,000 people relative to majority-Democratic counties. To the researchers’ surprise, however, vaccine uptake explained only 10 percent of the difference. The finding suggests that differences in COVID outcomes are driven by a combination of factors, including the likelihood of, say, engaging in unmasked social events or in-person dining, Sehgal says. By February 2022 the COVID death rate in all counties Donald Trump won in the 2020 presidential election was substantially higher than in counties that Joe Biden won—326 deaths per 100,000 people versus 258. “COVID was probably the most dramatic example I’ve seen in my career of the influence of policy choices on health outcomes,” Woolf says.”
Insightful and appreciated, even for this old, non-medical, lay person who appreciates reading qualified information. It’s why I’m a paid subscriber who values trusted sources. Keep up the great work!
If it’s in your wheelhouse would you consider an in-depth article sometime on research for antiviral treatments? I am in my mid 60s, and have what is nicknamed a “patchwork heart“, which makes me very high risk. Should I contract Covid or even apparently the current flu strain. Packs love it is off the list of options for me, and remdisivir seems like a crapshoot. therefore I remain isolated, going into my almost 4th year. If I didn’t want to be a burden to my daughter, I would just take my chances and frankly, I would almost take going out with Covid to the specter of more isolation. Luckily, though it is summer and more sunlight and outdoor gatherings will be refreshing. the frustrating part is knowing that there are no antivirals that could help people like me. And I’m very curious if there is any increased effort to get more nimble with treatments than there is with vaccines. I am, of course fully Vaxxed and probably over boosted… Thank you for all your hard work, we will continue to slog and celebrate those who don’t have to be cooped up anymore.
Would you consider a future post offering guidance on how best to adapt our indivdual responses with the wastewater and hospitalization data (plus the best ways to find that info)? You have been so helpful walking us through your process for interpreting case counts and percent positives. I would love to have a similar plan for these new metrics. Thank you, as always.
Public health is a major failure of the Biden administration. All that covid aid money and now back to the past with poor data reporting infrastructure.
Over 65 and still masking in indoor public spaces.
As a 60-something healthy person with a 68-year old low risk spouse, we have been trying to stay as safe as possible by masking indoors, even in uncrowded spaces. We got our bivalent boosters back in September and just don't want to get Covid. I would love to hear more about where you think we should be focusing our attention now that the country and world are ending the PHE. Would love your recommendations or suggestions for reading material now that so many people have had the disease and/or the vaccine, but it is still here and killing people.
Thank you again. This is important information that so few folks are aware of. The false impression that the CDC is all encompassing and has far reaching powers is common. Same with EPA.
Thank you very much for the Big Picture analysis Public Health.& data flows One comment on the CA system specifically County public Health Departments in the Bay Area who managed the AIDs crisis. County reps know each other by first name & still meet informally once a month. Dr Silverman still goes to international conferences in his mid 80's. We benefited greatly from their coordination in the Pandemic
Wastewater is a preferred metric over hospitalizations because (I’m assuming) wastewater increases 2-3 weeks before hospitalizations, making it a better leading indicator?
I'm not so sure about wastewater not going away. I live in dc, and fortunately I can see that on biobot since it's still not showing up on DC's dashboards. But one of my neighboring counties, Arlington county, hasn't updated wastewater since March 29th.
There is one very important reason why it makes sense to ease off on publicly available reporting when actual prevalence is low: the potential for de-anonymization. This is a serious issue with all aggregate data, but it can be particularly problematic when it's health information, that could very well point to chronic underlying conditions.
As far as test positivity rates go - isn't it safe to assume that the same labs that report TPR of other viruses to NREVSS will simply add covid to their list? I feel like it might actually be useful to see covid reported along side its cousins.
My primary care provider, Martin’s Point, which has the contract for providing health care for retired veterans if they so choose in much of Maine, Vermont and upstate New York follows federal mandates on masking, so today’s will the last day for masks at all their primary care health care centers.
I'd love to see some of the unspent government COVID funds go towards modernizing our national and state data infrastructure. This would help on a much broader level and allow us to respond even quicker the next time a pathogen arises.
It feels satisfying to be on this side of the mountain, even though the hiking is still rough.
National/federal public health powers are a Hamiltonian success story. It’s sad to see them dismantled and hamstrung in many red states.
Even in a post-vaccine America, death rates in red states were 38% higher than in blue states.
https://abcnews.go.com/amp/Health/red-blue-america-glaring-divide-covid-19-death/story?id=83649085
And this from Scientific American:
“ Cultural differences between red and blue counties also likely contributed to COVID deaths. “You’re affected by your neighbors,” says Neil Sehgal, a public health professor at the University of Maryland and co-author of a recent study of the association between COVID mortality and county-level voting. Sehgal and his colleagues found that through October 2021, majority-Republican counties experienced 72.9 additional deaths per 100,000 people relative to majority-Democratic counties. To the researchers’ surprise, however, vaccine uptake explained only 10 percent of the difference. The finding suggests that differences in COVID outcomes are driven by a combination of factors, including the likelihood of, say, engaging in unmasked social events or in-person dining, Sehgal says. By February 2022 the COVID death rate in all counties Donald Trump won in the 2020 presidential election was substantially higher than in counties that Joe Biden won—326 deaths per 100,000 people versus 258. “COVID was probably the most dramatic example I’ve seen in my career of the influence of policy choices on health outcomes,” Woolf says.”
https://www.scientificamerican.com/article/people-in-republican-counties-have-higher-death-rates-than-those-in-democratic-counties/?amp=true
Science-minded, centralized leadership and public-minded, community spirit actually matter. A lot. Not just for Covid.
Insightful and appreciated, even for this old, non-medical, lay person who appreciates reading qualified information. It’s why I’m a paid subscriber who values trusted sources. Keep up the great work!
If it’s in your wheelhouse would you consider an in-depth article sometime on research for antiviral treatments? I am in my mid 60s, and have what is nicknamed a “patchwork heart“, which makes me very high risk. Should I contract Covid or even apparently the current flu strain. Packs love it is off the list of options for me, and remdisivir seems like a crapshoot. therefore I remain isolated, going into my almost 4th year. If I didn’t want to be a burden to my daughter, I would just take my chances and frankly, I would almost take going out with Covid to the specter of more isolation. Luckily, though it is summer and more sunlight and outdoor gatherings will be refreshing. the frustrating part is knowing that there are no antivirals that could help people like me. And I’m very curious if there is any increased effort to get more nimble with treatments than there is with vaccines. I am, of course fully Vaxxed and probably over boosted… Thank you for all your hard work, we will continue to slog and celebrate those who don’t have to be cooped up anymore.
Would you consider a future post offering guidance on how best to adapt our indivdual responses with the wastewater and hospitalization data (plus the best ways to find that info)? You have been so helpful walking us through your process for interpreting case counts and percent positives. I would love to have a similar plan for these new metrics. Thank you, as always.
Public health is a major failure of the Biden administration. All that covid aid money and now back to the past with poor data reporting infrastructure.
Over 65 and still masking in indoor public spaces.
As a 60-something healthy person with a 68-year old low risk spouse, we have been trying to stay as safe as possible by masking indoors, even in uncrowded spaces. We got our bivalent boosters back in September and just don't want to get Covid. I would love to hear more about where you think we should be focusing our attention now that the country and world are ending the PHE. Would love your recommendations or suggestions for reading material now that so many people have had the disease and/or the vaccine, but it is still here and killing people.
Thank you again. This is important information that so few folks are aware of. The false impression that the CDC is all encompassing and has far reaching powers is common. Same with EPA.
Hey, have you read Zelikow’s Covid report? Good work, even though it will be ignored.
Thank you very much for the Big Picture analysis Public Health.& data flows One comment on the CA system specifically County public Health Departments in the Bay Area who managed the AIDs crisis. County reps know each other by first name & still meet informally once a month. Dr Silverman still goes to international conferences in his mid 80's. We benefited greatly from their coordination in the Pandemic
Wastewater is a preferred metric over hospitalizations because (I’m assuming) wastewater increases 2-3 weeks before hospitalizations, making it a better leading indicator?
I'm not so sure about wastewater not going away. I live in dc, and fortunately I can see that on biobot since it's still not showing up on DC's dashboards. But one of my neighboring counties, Arlington county, hasn't updated wastewater since March 29th.
Being flexible and patient. Easier said than done!
There is one very important reason why it makes sense to ease off on publicly available reporting when actual prevalence is low: the potential for de-anonymization. This is a serious issue with all aggregate data, but it can be particularly problematic when it's health information, that could very well point to chronic underlying conditions.
As far as test positivity rates go - isn't it safe to assume that the same labs that report TPR of other viruses to NREVSS will simply add covid to their list? I feel like it might actually be useful to see covid reported along side its cousins.
My primary care provider, Martin’s Point, which has the contract for providing health care for retired veterans if they so choose in much of Maine, Vermont and upstate New York follows federal mandates on masking, so today’s will the last day for masks at all their primary care health care centers.
It's appalling that the only place in NYS reporting waste water in the link you shared is Nassau County. It's quite literally insane.
I'd love to see some of the unspent government COVID funds go towards modernizing our national and state data infrastructure. This would help on a much broader level and allow us to respond even quicker the next time a pathogen arises.