COVID-19 has caused a public health crisis unlike any other in recent memory, but three years into the pandemic, there are signs that governments and public health authorities are ready to start putting the urgency of the threat in the past. On May 5, the World Health Organization (WHO) declared that COVID-19 is no longer a “public health emergency of international concern,” and is now “an established and ongoing health issue.” The WHO based its decision on decreasing deaths and hospitalizations from COVID-19 globally, as well as growing immunity against SARS-CoV-2 from both vaccines and infections.
In the U.S., President Joe Biden is moving ahead with plans to end the country’s public health and national emergencies on May 11, which will mean that a number of measures to help curb the spread of disease will end.
These decisions do not mean that the COVID-19 pandemic is over, but that it is moving into a more manageable phase. In the U.S., it will mean an end to things like free tests and vaccines, which were provided by the federal government (and will continue to be until they run out). To get and pay for these, people will now use insurance coverage or, for those who are uninsured, public health services.
The way that the U.S. tracks and monitors COVID-19 will also change. “We lived through an historic moment that compelled the federal government to mobilize massive amounts of support to respond to COVID-19,” says Jen Kates, director of global health & HIV at the non-profit Kaiser Family Foundation. “When the public health emergency ends, we’re going back to the regular system, and not all of our challenges have been solved.”
Here’s how COVID-19 data will change once the public health emergency ends on May 11.
What will change:
Color-coded maps will go away
The U.S. Centers for Disease Control and Prevention (CDC) will stop tracking COVID-19 community levels: a tally of PCR-confirmed cases, down to the county level, that states were required to report to the CDC. That aggregated information allowed the agency to provide people with an easy-to-understand, color-based metric for determining if cases are low (green), moderate (yellow), or high (red) where they live. This system helped individuals, as well as organizations like schools and hospitals make decisions about whether to recommend behavior changes like mask-wearing.
After May 11, states and jurisdictions will no longer be required to report cases to the CDC, so the data the agency will receive won’t allow them to accurately capture the burden of COVID-19 cases in any given county.
Hospitalization data will replace it
The CDC will now rely on hospital admissions data, which hospitals will continue to report to the CDC. Hospitalizations are “the main driver of community levels of COVID-19,” said Dr. Brendan Jackson, lead of the CDC’s COVID-19 response, during a briefing. In a May 5 report, CDC scientists conducted analyses comparing hospital admission data and its correlation to community levels of infections and found a 99% concordance between the two. “We will still be able to tell that it’s snowing, even though we are no longer counting every snowflake,” said Dr. Nirav Shah, CDC’s principal deputy director.
But instead of reporting admissions daily, as hospitals do now, they will do so weekly.
Other systems, such as wastewater surveillance, will help to provide a window into how cases of COVID-19 might be ebbing and flowing in different communities. The CDC’s National Wastewater Surveillance System, which launched in 2020, involves collecting wastewater and analyzing it for the presence of SARS-CoV-2 in hundreds of sites covering 140 million people (about 40% of the U.S. population). “Wastewater allows us to get insights into not just COVID-19, but other infectious diseases as well,” said Shah. “It is one of those early sentinel markers that we use to understand where things are going, and we intend to continue the investment CDC made in this system.”
PCR lab tests will no longer be tracked
After May 11, we’ll also no longer have insight into “percent positivity,” or the percent of COVID-19 tests that are positive in a given area. That’s because in order to calculate that measure, CDC needs to have data from all lab test results, including negative ones, to determine what percent of the total are positive. But after May 11, most labs will no longer be required to report negative test results.
The CDC will now rely on labs voluntarily reporting data
Although the CDC has agreements with some labs to continue reporting negative results, the agency is moving to include COVID-19 in its National Respiratory and Enteric Virus Surveillance System, a network of 450 labs around the country that test and voluntarily report results for respiratory diseases. The network does not include all labs testing for COVID-19, but it’s a representative sample that will continue to give CDC a heads up on when, and where, more COVID-19 cases might be emerging.
In addition, the agency will also draw data from its National Syndromic Surveillance Program, which collects emergency-department data from 6,300 health facilities in all 50 states, the District of Columbia, and Guam. The network covers about 75% of all emergency visits in the U.S., and weekly assessments of how many people test positive for COVID-19 during visits can provide early hints about whether cases are creeping upward.
What will stay the same:
Vaccination data will still be tracked on the CDC’s COVID-19 Data Tracker. Nearly all of the 64 states and jurisdictions (such as the Marshall and Virgin Islands) that work with the CDC have signed data-use agreements in which they will continue to supply information on how many vaccinations they have administered.
The CDC will also continue to monitor for COVID-19 vaccine side effects through its VAERS system. The V-safe system, which was created specifically to monitor for COVID-19 vaccine side effects through a smartphone app, will no longer accept new reports, but CDC plans to launch a new version of V-safe later this year.
COVID-19 deaths will also continue to appear on the COVID-19 Data Tracker, but in a more accurate way, according to Jackson. Until now, deaths were recorded by the date on which they were reported, which allowed for some lag and inaccuracies in matching them up to spikes in cases. The CDC will shift to reporting deaths from COVID-19 based on death certificates, which record the date of death, a more timely metric.
The CDC will still conduct genomic sequencing of positive samples—both from people within the U.S. and from travelers who come from abroad and test positive—to monitor for new variants. Samples from the National Wastewater Surveillance System are also genetically sequenced, and together, these sources are early indicators of new variants that might be causing infections in the U.S.
The CDC plans to launch a new COVID-19 Data Tracker website incorporating these changes on May 11 that will be updated weekly to keep the public informed about changing COVID-19 trends.
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Contributor: Alice Park