COVID-19 Data Dispatch

Author: Betsy Ladyzhets

  • The Omicron subvariants start coming and they don’t stop coming

    The Omicron subvariants start coming and they don’t stop coming

    A veritable alphabet soup of subvariants. Chart from the CDC, data as of October 15.

    When the CDC updated its variant prevalence estimates this week, the agency added new versions of Omicron to the dashboard. In the U.S., COVID-19 cases are now driven by: BA.5, BA.4.6, BQ.1, BQ.1.1, BF.7, BA.2.75, and BA.2.75.2. And possibly more subvariants that we aren’t tracking yet.

    As evolutionary biology expert T. Ryan Gregory pointed out on Twitter recently, Omicron’s evolution is “off the chart.” 

    Or, to parody Smash Mouth: the Omicron variants start coming and they don’t stop coming and they don’t stop coming and they don’t stop coming…

    Let’s go over the veritable alphabet soup of variants we’re dealing with right now, as well as one newer variant identified in east Asia that experts are closely watching.

    BA.5, BA.4, BA.4.6

    BA.5 is currently the dominant Omicron lineage in the U.S., causing about two-thirds of new COVID-19 cases in the week ending October 15. Along with BA.4, BA.5 split off from the original Omicron lineage and was first identified by South African scientists over the summer.

    As these two subvariants spread around the world, it quickly became clear that they could spread faster than other versions of Omicron and reinfect people who’d previously gotten sick with those prior lineages. For more details, see this post from June. BA.5 later pulled out from BA.4 as the most competitive lineage.

    BA.4.6 evolved out of BA.4. It appears to have a small advantage over BA.5, but can’t really compete with the newer subvariants we’re seeing now; according to the CDC’s estimates, it’s been causing around 10% to 12% of new cases nationwide for the last few weeks (without much growth).

    BQ.1 and BQ.1.1

    BQ.1 and its descendant BQ.1.1 are the two newest subvariants to show up in the CDC’s prevalence estimates, both causing about 5.7% of new cases nationwide in the last week. They actually evolved out of BA.5: BQ.1 is shorthand for a much longer, more unwieldy variant name that nobody wants to type out on Twitter.

    In the U.S., BQ.1 and BQ.1.1 are starting to outcompete their parent lineage, BA.5. They’ve grown from causing less than 1% of new cases to over 10% of new cases in the last month. These subvariants are also now outcompeting other strains in the U.K. and other European countries.

    As CBS News’s Alexander Tin explains, health experts are concerned that COVID-19 treatments like monoclonal antibodies might work less well against BQ.1 and BQ.1.1. We don’t have clear data on this yet, but pharmaceutical companies will test out the newer variants in the weeks to come. The Omicron bivalent boosters, at least, are expected to continue working against this lineage.

    BF.7

    BF.7 is another offshoot of BA.5 (again, this is shorthand for a longer name). I dedicated a post to it in late September, and the subvariant’s position hasn’t changed significantly since then: it seems to be a bit more transmissible than BA.5, but not so much that it is quickly outcompeting the parent lineage. BF.7 caused about 5% of new cases nationwide in the last week.

    Similarly to BQ.1 and BQ.1.1, there are some concerns that COVID-19 treatments will be less effective against BF.7 than other versions of Omicron based on the subvariant’s spike protein mutations, but we do not have clinical data at this point.

    BA.2.75 and BA.2.75.2

    BA.2.75, as you might guess from the notation, evolved out of BA.2—the same original Omicron lineage that produced BA.2.12.1 and drove surges in places like New York City over the summer. It has also remained present at fairly low levels across the U.S. recently, causing just 1.3% of new cases in the last week, according to the CDC’s estimates.

    But BA.2.75 now has its own offshoot, called BA.2.75.2, that appears to be a bit more competitive. The CDC recently started splitting BA.2.75.2 out of its parent lineage in its prevalence estimates, showing that it’s growing a bit faster (from 0.4% to 1.4% in the last month). Of course, this growth rate pales in comparison to what we’re seeing from the BA.5 sublineages described above.

    XBB

    XBB is the latest international subvariant of concern, identified this week in several east Asian countries. It has spread particularly quickly in Singapore, as described in this article by David Axe at the Daily Beast.

    Like BA.2.75, XBB descended from Omicron BA.2—though it’s gone through more rounds of spike protein mutation; this is why experts are calling it XBB, rather than a long string attached to BA.2. Data so far indicate its growth advantage over BA.5 is similar to what we’re seeing from BQ.1.1. XBB has also raised concerns about treatment and vaccine efficacy, since the bivalent boosters were developed from BA.4 and BA.5. 

    The CDC and other health agencies have yet to identify XBB in the U.S.; experts are closely watching how this new subvariant might be able to compete with our current variations on BA.5.

    Overall takeaways

    Overall, both in the U.S. and around the world, we’re seeing a lot of competition between these subvariants. All of them have small growth advantages over BA.5—which is currently dominant in the U.S.—but none are so different that they’re completely pulling ahead.

    As I wrote last weekend, many experts are anticipating a surge this fall and winter, driven by both new subvariants and less-cautious beavior. We likely won’t see a huge spike at the level of last winter’s massive Omicron surge, but this season will still have plenty of infections (and reinfections).

    We will need more data on how all these newer variants respond to vaccines and treatments, especially the antiviral Paxlovid. But it’s at least promising that many of the circulating variants right now evolved from BA.5, against which our bivalent boosters were specifically designed. It’s a great time to get that booster!

    More variant data

  • National numbers, October 16

    National numbers, October 16

    After a small uptick in vaccinations thanks to the new boosters, vaccinations are already slowing again. Chart via the CDC, data as of October 12.

    In the past week (October 8 through 14), the U.S. reported about 270,000 new COVID-19 cases, according to the CDC. This amounts to:

    • An average of 39,000 new cases each day
    • 83 total new cases for every 100,000 Americans
    • 12% fewer new cases than last week (October 1-7)

    In the past week, the U.S. also reported about 23,000 new COVID-19 patients admitted to hospitals. This amounts to:

    • An average of 3,300 new admissions each day
    • 7.0 total admissions for every 100,000 Americans
    • 4% fewer new admissions than last week

    Additionally, the U.S. reported:

    • 2,300 new COVID-19 deaths (330 per day)
    • 12% of new cases are caused by Omicron BA.4.6; 11% by BQ.1 and BQ.1.1; 5% by BF.7;  3% by BA.2.75 and BA.2.75.2 (as of October 15)
    • An average of 400,000 vaccinations per day

    While official case numbers remain low compared to past fall seasons—both national cases and hospital admissions dropped again this week—signals of a coming fall surge are accumulating from wastewater and local data.

    According to Biobot’s dashboard, the coronavirus continues to spread in the Northeast at higher levels than the rest of the country with a new uptick this week. In places like Franklin County, Massachusetts, Fairfield County, Connecticut, and Middlesex County, New Jersey, coronavirus levels are higher now than they have been at any point in the last six months.

    Similar patterns are starting to show up in clinical data: Northeast states including Vermont, Maine, Connecticut, New Hampshire, Massachusetts, New York, and New Jersey reported increased COVID-19 patients this past week, according to the October 13 Community Profile Report.

    Along with colder weather and behavior patterns, new Omicron lineages could contribute to the increased transmission—if they aren’t contributing already. BQ.1 and BQ.1.1, two sublineages from BA.5, are now causing about 11% of new cases nationwide, according to the CDC’s most recent variant prevalence update. In the northeast, their prevalence is approaching to 20%. (More on the new subvariants in the next post.)

    As many of the sublineages now circulating are descended from BA.5 or BA.4, the bivalent booster shots designed to protect against these variants should still help protect against newer strains. In fact, the FDA and CDC recently expanded eligibility for these new shots to younger age groups, going down to kids ages five to eleven.

    But uptake of the new boosters remains low—in part because public communication has been so limited, many Americans don’t know they qualify for these shots. Only 15 million people have received the boosters as of October 12, a tiny fraction of the eligible population.

    more national numbers

  • COVID source callout: CDC shifts to weekly updates

    This week, the CDC announced a big change to its COVID-19 data reporting: instead of updating case and death numbers daily, the figures will be updated weekly. The change comes into effect on October 20.

    Under the new schedule, data updates will be cut off on Wednesdays, though it’s unclear if the CDC will actually update its dashboard on Wednesdays or if this will happen on a day later in the week.

    According to the CDC’s data FAQ page, this change was made “to allow for additional reporting flexibility, reduce the reporting burden on states and jurisdictions, and maximize surveillance resources.” To me, this makes a lot of sense: as case data become increasingly less reliable (thanks to increased at-home testing, closing PCR sites, etc.), daily updates can be more misleading than they are valuable. Most states are not reporting daily data either.

    Also, much as it pains me to say this, the CDC’s COVID-19 dashboard is very likely not getting the views and attention that it received one or two years ago. If this change frees up agency data scientists to work on new tracking mechanisms that will be more useful, that seems like a fair trade-off to me. But it’s still a bummer to see the daily data go, especially at a time when we really need information to track a potential fall surge.

    Worth noting: the HHS Community Profile Reports are updating on a weekly cadence now as well.

    more source spotlights

  • Sources and updates, October 9

    • Household Pulse Survey updates, expands Long COVID data: This week, the CDC and Census released an update of their Household Pulse Survey results on how Long COVID is impacting Americans. In addition to more recent data on Long COVID prevalence, the update includes new information on how adults with the condition find it limiting their day-to-day activities. The data shows that, out of all adults currently experiencing Long COVID symptoms, over 80% have some activity limitations and 25% have “significant” activity limitations. (For more context on this dataset, see my post from June.)
    • NIH shares update on RECOVER study: Speaking of Long COVID, the National Institutes of Health’s Directors Blog shared a post this week with updates on its flagship RECOVER study to learn more about the condition. Major updates include: RECOVER’s current recruitment goal is 17,000 adults and 18,000 children; the NIH recently awarded more than 40 grants to research projects examining the condition’s underlying biology; and RECOVER is utilizing electronic health records to track patients over time. While this is all valuable progress, patient advocates have expressed concerns about limited involvement by post-viral chronic illness experts in RECOVER so far.
    • Paxlovid is going under-utilized, study finds: A new report from the health records company Epic Research provides evidence that Paxlovid reduces severe COVID-19 outcomes: patients over age 50 who received the antiviral drug were about three times less likely to be hospitalized, compared with those who didn’t. The study also found, however, that eligible Americans aren’t taking advantage of this treatment. Out of about 570,000 people who “could have received Paxlovid” between March and August 2022, only 146,000 (about one in four) actually got prescriptions. Paxlovid needs to be better advertised and easier to access.
    • New COVID-19 pill added to Medicines Patent Pool: And a new COVID-19 treatment option is becoming available internationally. Shionogi, a Japanese pharmaceutical company, recently signed an agreement with the Medicines Patent Pool, an international public health organization that facilitates increased drug access in low- and middle-income countries. The agreement allows other drug companies to make Shoinogi’s antiviral COVID-19 pill, called ensitrelvir fumaric acid, which has seen some promising results in clinical trials so far. Paxlovid and Molnupiravir (Merck’s antiviral pill) are already licensed by the pool.
    • Patient access to electronic health records expands: This past Thursday, new federal rules took effect requiring healthcare companies to “give patients unfettered access to their full health records in digital format,” as STAT News reporter Casey Ross put it. This is a major milestone for the democratization of health data, as patient records have historically been locked in a labyrinth of private databases—though more public education is needed to help people actually take advantage of the new rules. Personally, I hope this is a first step towards more record-sharing between health institutions, which could be a key step for more comprehensive analysis in the future.
    All featured sources

  • Several respiratory viruses might spread widely this fall; here’s how we should track them

    Several respiratory viruses might spread widely this fall; here’s how we should track them

    The SCAN wastewater network is tracking flu, RSV, and other viruses in wastewater along with the coronavirus.

    As you might have guessed from the last couple weeks of National numbers posts, I am anticipating that the U.S. will see a new COVID-19 surge this fall, along with potential surges of the flu and other respiratory diseases. And I’m not the only person making this prediction: in the last couple of weeks, this potential surge has been a major theme in news publications and health experts’ Twitter threads.

    Yes, most of the U.S.’s major COVID-19 indicators appear to be at low levels right now (at least compared to earlier in the Omicron era). But rising numbers in Europe, as well as trends from some parts of the Northeast, provide reasons to worry. Here’s why it’s worth worrying, and some thoughts on better tracking these viruses in the future.

    Why experts anticipate a fall surge

    One likely reason for a fall surge, as writer Ewen Callaway explains in Nature, is an influx of new subvariants that have continued to evolve off of Omicron. While there are several lineages on the rise in various countries, researchers are finding that they tend to have similar mutations and capacities for reinfecting people, Callaway reports. Scientists call this “convergent evolution.”

    From the story:

    SARS-CoV-2-watchers are tracking an unprecedented menagerie of variants from a number of branches of the Omicron family tree, says Tom Peacock, a virologist at Imperial College London. Despite these variants’ distinct ancestries, they carry many of the same mutations to the SARS-CoV-2 spike protein (the part of the virus that immune systems target). “Clearly, there’s an optimal way for a variant to look going into this season,” says Peacock.

    The new bivalent booster shots will help reduce severe disease from these newer Omicron iterations. But Americans are currently getting boosted in such small numbers that the shots might not help alleviate healthcare systems as much as experts might’ve hoped. And that brings me to another surge driver: behavior.

    More than at any point in the pandemic, Americans are acting like COVID-19 is not worth a simple mask in public or test before a gathering—even though the coronavirus is still very capable of sending people to the hospital or giving them long-term symptoms. Indoor gatherings, holiday travel, fully opened schools, and all the behaviors that come with them will inevitably lead to outbreaks that are poorly tracked by our increasingly-less-resourced public health system (and that are largely ignored by leaders who encouraged the unsafe behavior).

    Katherine Wu summarized this situation well in a recent article for the Atlantic, writing: 

    So we can call this winter “post-pandemic” if we want. But given the policy failures and institutional dysfunctions that have accumulated over the past three years, it won’t be anything like a pre-pandemic winter, either. The more we resist that reality, the worse it will become. If we treat this winter as normal, it will be anything but.

    At the same time, the behaviors contributing to more COVID-19 spread will also help other respiratory viruses. Experts are anticipating that the U.S. could have a bad flu winter, based on trends from the Southern hemisphere—which faces the flu a few months before we do. (For journalists interested in following flu patterns this fall and winter, the Association of Health Care Journalists has a new tipsheet on the subject.)

    In addition to COVID-19 and the flu, the U.S. is seeing increased transmission of other respiratory viruses particularly primed to spread among children, such as RSV, rhinoviruses and enteroviruses. Pediatricians and hospital directors told USA TODAY’s Adrianna Rodriguez that they’re seeing more sick kids, earlier in the school year than they would typically expect. Kids have less immunity to these viruses after limited spread in the last two winters, while minimal health precautions are making it easier for the viruses to infect more people.

    Expanding COVID-19 surveillance to other viruses

    In short, we could see a lot of respiratory virus cases in the next few months. These trends have got me thinking about how, in an ideal world, the U.S. public health system might expand our existing COVID-19 surveillance to better track all of the viruses that wreak havoc on our bodies during colder weather. (As I pointed out last month, our flu tracking is pretty terrible right now.)

    Here are a few suggestions:

    • Expand wastewater surveillance to other respiratory viruses. Some pilot programs, such as the SCAN network based at Stanford and Emory Universities, have already started to monitor the flu, RSV, and other viruses in wastewater. But we need this type of tracking on a much broader scale, and we need it to be funded by the CDC and other major health institutions. (Biobot and the CDC’s expansion into monkeypox surveillance is a good first step here.)
    • Make multipurpose PCR tests widely available. My favorite place to get a COVID-19 test is one of the NYC health department’s express PCR sites. These public labs conduct PCR analysis on-site, so I get my test results in a few hours. And the results don’t just include COVID-19: the lab also tests for flu and RSV, so I can immediately rule out several explanations as to why my throat might be sore. We need many more labs doing this type of multi-virus testing.
    • Conduct population surveys for multiple respiratory diseases. I frequently reference the work of epidemiologist Denis Nash and his team at the City University of New York, who have surveyed New Yorkers and nationally to understand true COVID-19 infection rates. This type of work should be expanded to other diseases, in order to develop better, closer-to-real-time estimates of multiple conditions.
    • Add more diseases to hospital surveillance systems. Did you know that the HHS’s hospital utilization dataset includes hospitalizations for flu? While facilities have the opportunity to submit their flu patient numbers through the same system that they report on COVID-19 patients, flu reporting is optional—and therefore not very useful for analysis. A future iteration of the HHS’s hospital surveillance system should include mandatory flu reporting as well as other diseases, so that we can track severe cases more closely.
    • Incorporate respiratory virus tracking into school systems. For the first couple of pandemic-era semesters, many K-12 school systems maintained detailed records of their COVID-19 cases. This process has largely disappeared along with other COVID-19 measures—and while it lasted, it was incredibly burdensome for the school officials doing the tracking (many of them already-overworked school nurses). Still, in a future with more resources devoted to health in public schools, I’d like to see them become sites for tracking a variety of diseases and health conditions. The more collaboration between public schools and public health, the better.

    If you know of researchers or organizations working on any of these surveillance mechanisms—or anything I haven’t included on this list—please reach out! I am always on the lookout for solutions story ideas.

    More on testing

  • National numbers, October 9

    National numbers, October 9

    Regional wastewater data from Biobot suggest the Northeast currently has much higher coronavirus transmission levels than the rest of the country.

    In the past week (October 1 through 7), the U.S. reported about 300,000 new COVID-19 cases, according to the CDC. This amounts to:

    • An average of 42,000 new cases each day
    • 89 total new cases for every 100,000 Americans
    • 10% fewer new cases than last week (September 24-30)

    In the past week, the U.S. also reported about 23,000 new COVID-19 patients admitted to hospitals. This amounts to:

    • An average of 3,300 new admissions each day
    • 7.1 total admissions for every 100,000 Americans
    • 5% fewer new admissions than last week

    Additionally, the U.S. reported:

    • 2,400 new COVID-19 deaths (350 per day)
    • 79% of new cases are caused by Omicron BA.5; 14% by BA.4.6; 5% by BF.7;  2% by BA.2.75 (as of October 8)
    • An average of 400,000 vaccinations per day (CDC link)

    Following a pattern from the last couple of months, national COVID-19 cases and hospitalizations continued to trend slightly downward this week—though local indicators suggest we may experience a fall surge soon.

    Biobot’s wastewater dashboard reports that coronavirus transmission has plateaued at a high level in the Northeast, and at lower levels in the Midwest, West, and South. More locally, several counties that Biobot monitors in Massachusetts, New Jersey, and nearby states are seeing increased viral levels in their wastewater; two prominent examples are Boston and Hartford, Connecticut.

    Official COVID-19 cases are heavily underreported right now (by a factor of ten times or more); if we had a better testing infrastructure, they might match more closely to wastewater trends.

    Even so, data from the HHS’s October 6 Community Profile Report show that several Northeast states reported among the highest case rates this week. Rhode Island, New Jersey, New York, and Massachusetts all reported 150 or more cases per 100,000 people in the week ending October 5. Kentucky and Puerto Rico reported even more cases, at rates over 200 per 100,000.

    At the moment, we’re not seeing enough of the newer Omicron subvariants (BF.7, BA.2.75, etc.) to blame the transmission increases on them. Cold weather (driving people to gather indoors) and waning immunity from past cases and vaccinations are more likely culprits, as Katelyn Jetelina noted in a recent Your Local Epidemiologist post.

    Jetelina also pointed out that fall waves are starting in Western European countries, including Germany and the U.K. The U.S. has followed trends in these countries throughout the pandemic, and it seems likely that the same thing will happen this fall—especially considering that the U.S. and European nations have similarly dismissive attitudes towards safety measures right now.

    Again, the best way to protect yourself as we prepare for a potential surge is to get an Omicron-specific, bivalent booster shot. Uptake of these shots continues to be quite low in the U.S. so far: as of October 5, just 11.5 million Americans have received them, representing about 5% of the eligible population.

    more national numbers

  • COVID source shout-out: Bloomberg’s vaccine tracker

    Last week, the team behind Bloomberg’s COVID-19 vaccine tracker announced that the dashboard will stop updating on October 5.

    Drew Armstrong, senior health care editor and leader of the tracking effort, provided the motivations for this decision in an update post. New rounds of booster shots around the world, including bivalent shots in some countries, have made it harder to track and present data: “There are more categories of data to collect and fewer simple comparisons among the more than 100 countries we’ve been tracking,” Armstrong wrote.

    Armstrong also explained that the vaccine tracker has been a huge lift for Bloomberg, and the company is only able to put so many resources into a dashboard that really should be provided by government or academic institutions. (The COVID Tracking Project’s leaders said something similar when that project stopped data collection in spring 2021.)

    While I’m sad to see this tracker go, I understand the decision and remain very grateful for all the work that’s gone into it since vaccination campaigns started in winter 2020. Congratulations to all of the Bloomberg journalists who contributed to this valuable resource!

    more source spotlights

  • Sources and updates, October 2

    • Johns Hopkins dashboard creator wins public service award: Lauren Gardner, an engineering professor at Johns Hopkins University, was recently awarded the 2022 Lasker-Bloomberg Public Service Award (a major prize in biomedical research) in recognition of her work on JHU’s global COVID-19 dashboard. This dashboard was one of the world’s first and most popular sources for tracking how the pandemic spread. Unlike many other projects, it has continued fairly consistently since early 2020, and continues to be a great resource for national and international data. Congratulations to Gardner and the other folks at JHU!
    • CDC releases updated chronic disease and risk factor data: This week, the CDC published a new iteration of its Behavioral Risk Factor Surveillance System (BRFSS), a major data source providing information on chronic conditions, health behaviors, access to healthcare, and more. The surveillance system uses surveys of over 400,000 American adults, conducted annually in all 50 states and several territories. While these aren’t COVID-specific data, the datasets can be a really helpful source for examining populations more vulnerable to COVID-19 in different parts of the country.
    • Increased respiratory illnesses in children: Another CDC update: researchers from the agency published a new study in the Morbidity and Mortality Weekly Report reporting increased cases of respiratory illness in kids this past summer. Strains of rhinovirus and enterovirus that haven’t circulated much in the last two years are back in 2022 and could cause problems this fall—especially as schools continue to operate in-person with relatively few public health measures—the CDC report suggests. For more context, see this recent newsletter by Katelyn Jetelina and Caitlin Rivers.
    • Biobot and CDC expand wastewater tracking to monkeypox: Biobot, the leading COVID-19 wastewater surveillance company, is expanding its work with the CDC to include monkeypox surveillance. As part of the CDC’s National Wastewater Surveillance System (NWSS), Biobot will coordinate data collection and analysis for both COVID-19 and monkeypox through at least January 2023. “We hope this can demonstrate the flexibility and versatility of this technology for governments across the country,” Biobot president and cofounder Newsha Ghaeli said in a press release.
    • Launch of the Data Liberation Project: This is not COVID- or even health-specific, but I wanted to give a quick shout-out to the Data Liberation Project, a new effort by Jeremy Singer-Vine (widely known in data journalism circles as the author of the Data Is Plural newsletter). The new project is “an initiative to identify, obtain, reformat, clean, document, publish, and disseminate government datasets of public interest.” I hope to see some COVID-19 datasets liberated through this project!

    All featured sources
  • The U.S. needs to step up its booster shot campaign

    The U.S. needs to step up its booster shot campaign

    About half of U.S. adults haven’t heard much about the updated COVID-19 booster shots, according to a recent survey done by the Kaiser Family Foundation.

    New, Omicron-specific booster shots are publicly available for all American adults who’ve been previously vaccinated. This is the first time our shots actually match the dominant coronavirus variant (BA.5), and possibly the last time that the shots will be covered for free by the federal government.

    So… why does it feel like almost nobody knows about them? Since the CDC and FDA authorized these shots, I’ve had multiple conversations with friends and acquaintances who had no idea they were eligible for a new booster. My own booster happened in a small, cramped room of a public hospital—a far cry from the mass vaccination sites that New York City has offered in past campaigns.

    This week, the Kaiser Family Foundation (KFF) provided some data to back up such anecdotal evidence. According to the September iteration of KFF’s Vaccine Monitor survey, about half of U.S. adults have heard only “a little” or “nothing at all” about the new boosters. That includes more than half of adults who have been previously vaccinated.

    Moreover, the KFF survey found that 40% of previously vaccinated adults (who received the full primary series) are “not sure” if the updated booster is recommended for them. Another 11% said the new booster is not recommended for them—which is not true! The CDC has recommended these boosters for everyone who previously got vaccinated.

    Booster eligibility knowledge is even lower in certain demographics, KFF found. That includes: 55% of previously vaccinated Black adults and 57% of Hispanic adults don’t know that they’re eligible for boosters. Same thing for 57% of vaccinated adults with less than a college education and 58% of those living in rural areas.

    As of September 28, only 7.6 million Americans have received an updated booster shot, the CDC reports.

    Overall, the CDC reports that about 7.6 million Americans have received an updated booster shot as of September 28, including 4.9 million who received a Pfizer shot and 2.7 million who received a Moderna shot. This represents less than 4% of all fully vaccinated adults who are eligible for the new boosters. And we don’t have demographic data yet, but I expect the patterns will fall among similar lines to what KFF’s survey found.

    “Clear and consistent messaging accompanied by strategies to deliver boosters is needed to narrow these gaps,” said public health expert Anne Sosin, sharing the KFF findings on Twitter. We need big, public campaigns for the new boosters in line with what we got for the original vaccines in 2021—or else the new shots won’t be very helpful in an inevitable fall/winter surge.

    More vaccine data

  • Orders of free at-home COVID-19 tests varied widely by state

    Orders of free at-home COVID-19 tests varied widely by state

    On September 2, 2022, the federal government stopped taking orders for free at-home COVID-19 tests. The distribution program, which launched during the first Omicron surge in early 2022, allowed households to order free tests up to three times, with either four or eight tests in each order.

    The day this program ended, I sent a public records request to the federal government asking for data on how many tests were distributed. I filed it through MuckRock’s portal, so both the original request and my correspondence with the U.S. Postal Service’s records office are publicly available.

    Last week, the USPS fulfilled my request. While I’d requested data by state, county, and/or ZIP code, the agency only sent over at-home test orders and distribution numbers by state. According to the formal response letter they sent, more granular data would (somehow) count as “commercial information” and is therefore exempt from FOIA.

    https://twitter.com/betsyladyzhets/status/1574410510476496897/

    Now, obviously, I think that far more data on the test distribution program should be publicly available. As I wrote back in January when the program started, in order to truly evaluate the success of this program, we need test distribution numbers by more specific geographies and demographic groups.

    Still, the state-by-state data are better than nothing. With these data, we can see that states with the highest volume of at-home test orders fall on the East and West coasts, with people living in the South and Midwest less likely to use the program.

    (The population data that I used to calculate these per capita rates are from the HHS Community Profile Report.)

    With the data from my FOIA request, we can see that states with higher vaccination rates also had more people taking advantage of the free COVID-19 test program. States like Vermont and Hawaii rank high up for both metrics, while states like North Dakota and Wyoming are on the lower end for both.

    At the same time, many of the states where fewer people ordered the free tests are also states that saw higher COVID-19 death rates in 2022. In Mississippi, for example, about 433 people died of COVID-19 for every 100,000 residents since the year started—the highest death rate of any state. But people in the state ordered free tests at a rate under 0.3 per capita.

    These charts basically confirm what many public health experts suspected about the free COVID-19 test program: Americans who already were more protected against COVID-19 (thanks to vaccination) were most likely to order tests. Just as we’re seeing now with the Omicron-specific booster shots, a valuable public health measure went under-utilized here.

    I invite other journalists to report on these data; if you do, please link back to my original FOIA request on MuckRock!

    More testing data