COVID-19 Data Dispatch

Tag: Biden

  • What the public health emergency’s end means for COVID-19 data

    This past Monday, the White House announced that the federal public health emergency for COVID-19 will end in May. While this decision might be an accurate reflection of how most of the U.S. is treating COVID-19 right now, it has massive implications for Americans’ access to tests, treatments, vaccines—and data.

    I wrote about the potential data issues last September, in anticipation of this emergency ending. Here are the highlights from that post:

    • Outside of a public health emergency, the CDC has limited authority to collect data from state and local health agencies. And even during the emergency, the CDC’s authority has been minimal enough that national datasets for some key COVID-19 metrics (like breakthrough cases and wastewater surveillance) have been very spotty.
    • When the federal emergency ends, the Department of Health and Human Services (HHS) may lose its ability to require reporting of some key data, including: PCR test results (from states), hospital capacity information and COVID-19 patient numbers (from individual hospitals), COVID-19 cases and deaths in nursing homes.
    • It’s possible that the HHS and/or CDC will negotiate new data reporting requirements with states and other entities that don’t rely on the public health emergency. They have about three months to do this. I haven’t seen much news on that yet, but I’ll keep an eye out and share updates as I find them.
    • Regardless, I expect that reporting COVID-19 numbers to federal data systems will become even more voluntary than it already is for health agencies, hospitals, congregate facilities, and other settings. We will likely have to rely more on targeted surveillance systems (which compile data from a subset of healthcare facilities) rather than comprehensive national datasets, similar to our current surveillance systems for the flu and other endemic diseases.

    At the same time, the public health emergency’s end will lead to changes in the distribution of vaccines, tests, and treatments. The Kaiser Family Foundation has a helpful explanation of exactly what’s changing. Here are the highlights:

    • Vaccines will remain free to all as long as the stockpile of doses purchased by the federal government lasts. However, the ending emergency will likely impact the government’s ability to buy more vaccines—including future boosters that might be targeted to new variants. Vaccine manufacturers are planning to raise their prices, and cost will become a burden for uninsured and underinsured people.
    • At-home, rapid tests will no longer be covered by traditional Medicare, while Medicare Advantage coverage will vary by plan. Most private insurance providers will likely still cover the tests, but prices may go up (similarly to the prices for vaccines).
    • PCR tests are also likely no longer going to be covered by a lot of insurance plans and/or are going to get more expensive. Notably, Medicaid will continue covering both at-home and PCR tests through September 2024.
    • Treatments (primarily Paxlovid right now) will remain free for doses purchased by the federal government, similar to the situation with vaccines. After the federally-purchased supply runs out, however, we will similarly see rising costs and dwindling access.

    KFF also has produced a detailed report about how the end of the federal emergency will impact healthcare coverage more broadly.

    In short, the end of the public health emergency will make it harder for Americans to get tested, receive treatments, and stay up to date with COVID-19 vaccines. The testing access changes, in particular, will lead to official case numbers becoming even less accurate, as fewer people seek out tests. At the same time, Americans will lose access to the data we need to know how much of a threat COVID-19 presents in the first place.

    It’s also worth noting that, on the same day the White House announced the end of its emergency declaration, the World Health Organization announced the opposite: the global public health emergency is continuing, though it may end later in 2023. As Americans largely ignore COVID-19, millions of people around the world are unvaccinated, facing new surges, dealing with new variants, etc.

    COVID-19 clearly remains a looming threat at the global level. In the U.S., we technically have the best vaccines and treatments to deal with the disease—but these tools are going underutilized, and the Biden administration’s decision this week will only make it harder for people to get them. Maybe we shouldn’t have to rely on an emergency declaration to get basic data and access to health measures in the first place.

    More federal data

  • COVID source callout: Misinformation from the White House

    You might have seen this statistic from President Biden or other White House officials: “COVID deaths are down nearly 90%.” The statistic is misleading and incorrect, to the point that I’d consider it misinformation—especially right now, as the U.S. faces a largely-ignored surge.

    Let me explain where this number comes from. The White House is comparing average daily deaths from COVID-19 in recent weeks to this metric during the peak of the winter 2020-2021 surge, when Biden took office.

    On January 20, 2021, the day of Biden’s inauguration, about 3,200 people were dying from COVID-19 each day, according to CDC data. This past week, as Biden battled COVID-19, about 400 people were dying each day. The percent change between 3,200 and 400 is about 88%, or “nearly 90%.”

    But it’s misleading to just compare daily averages, as Biden has presided over several COVID-19 surges since he took office: the Delta surge last summer and fall, the first Omicron surge in the winter, and the Omicron subvariant surge this spring and summer. In fact, the number of COVID-19 deaths that occurred in the last year (July 2021 to July 2022) is pretty close to what it was in the prior year, and that’s not even accounting for thousands of excess deaths linked to the pandemic.

    While Biden’s administration has contributed to COVID-19 vaccines, treatments, testing, and other safety measures, it’s far from eliminating our collective risk from the coronavirus. Always question when you see a percent change without context!

    more source spotlights
  • Biden’s new COVID-19 plan excludes data

    Biden’s new COVID-19 plan excludes data

    No mention of data reporting or infrastructure here. Screenshot taken from whitehouse.gov on September 12.

    On Thursday, President Joe Biden unveiled a major new plan to bring the U.S. out of the pandemic. If you missed the speech, you can read through the plan’s details online.

    Key points include vaccination requirements for large employers, federal workers, and federal contractors; booster shots (if the FDA and CDC approve them); and making rapid tests more accessible for the average American. Much of the plan aligns with safety strategies that COVID-19 experts have been recommending for months—or, in the case of rapid testing access, over a year.

    But I and other data nerd friends were quick to notice that one major topic is missing: data collection. Numerous reports and investigations have demonstrated how the U.S.’s underfunded state and local public health agencies were completely unprepared to collect and report COVID-19 metrics, hindering our response to the pandemic. (This POLITICO investigation is one recent example of such a story.) Local data collection has gotten even worse during the latest surge, as many states cut back on their COVID-19 reporting and the federal government has failed to comprehensively track breakthrough cases.

    As a result, one might expect Biden’s plan to take steps towards improving COVID-19 data collection in the U.S. Perhaps the plan could have provided funding to local public health agencies, tied to a requirement that they report certain COVID-19 metrics on a daily basis. Perhaps it could have included increased tracking for breakthrough cases, or increased genomic sequencing to identify the next variant that inevitably becomes a concern after Delta.

    Instead, the plan’s only mention of “data” is a line about how well the vaccines work: “recent data indicates there is only 1 confirmed positive case per 5,000 fully vaccinated Americans per week.”

    Without prioritizing data, the Biden administration is failing to prepare the U.S.—both for future phases of this pandemic and for future public health crises.

    more federal data
  • The federal government starts acting like a federal government

    The federal government starts acting like a federal government

    A slide from the January 27 White House COVID-19 briefing, featuring the Biden team’s new commitment to provide states with three weeks’ lead time into their vaccine supply.

    Good afternoon only to the reporters on last Wednesday’s White House COVID-19 press call who told Dr. Anthony Fauci that he was on mute.

    And yes, you read that right: the White House is doing regular COVID-19 press calls again! With Dr. Fauci! Who is now President Biden’s Chief Medical Advisor on COVID-19! And CDC Director Dr. Rochelle Walensky! And chair of Biden’s health equity task force Dr. Marcella Nunez-Smith!

    Okay, that’s enough exclamation points. The briefings, which will be held three times a week, provide data-driven updates on the state of the pandemic and allow journalists to ask hard questions of the Biden administration’s response. In addition to the scientific experts, briefings so far have featured White House advisors/COVID-19 coordinators Jeff Zients and Andy Slavitt, who can speak to the more logistical aspects of the administration’s actions.

    This is, essentially, what a responsible federal government should have been doing since January 2020. But after a year of the Trump administration’s confusion, lack of coordination, and outright lies, it’s refreshing to watch a White House COVID-19 briefing in which every statement doesn’t need to be rigorously fact-checked in real-time.

    Besides the press briefings, here are a couple of moves the Biden team made this week that underscore the new administration’s commitment to better (and more transparent) COVID-19 data:

    • Publicly releasing the COVID-19 State Profile Reports: Since last spring, the White House COVID-19 Task Force has regularly compiled detailed reports to help national and state leaders respond to the pandemic. The reports include COVID-19 data for states, counties, and cities, along with specific assessments on where governors and state public health officials should focus their efforts in order to control the virus’ spread. In late December, the data behind these reports were released to the public; here’s a CDD post with more info on that release. Biden’s COVID-19 Task Force has kept the data releases going, and this week, they also shared the PDF reports themselves. What’s more, new White House COVID-19 Data Director Cyrus Shahpar made this release his first Tweet on his new official account—and he thanked public advocates for these data, such as the Center for Public Integrity’s Liz Essley Whyte and COVID Exit Strategy’s Ryan Panchadsaram. The release indicates a new commitment to data transparency that we did not see from Trump’s White House for the majority of his tenure.
    • Updating the CDC’s COVID-19 dashboard: The CDC has been building out a COVID-19 tracker since the spring, featuring data on cases, testing, vulnerable populations, and (since December) vaccination. But it got a major upgrade this week: the dashboard now has a curated landing page and a sidebar menu that makes it much easier for users to see all the available data. This dashboard also now includes those State Profile Reports I mentioned above, making it easy for users to find information about their regions. And, under the “Your Community” label, you’ll also find an interactive COVID-19 vulnerability index: select your county, and the map will show you how susceptible you are to the pandemic based on your community’s current infection rate, testing, population demographics, health disparities, and more.
    • More lead time for vaccine distribution: Last week, I discussed how unpredictable vaccine shipments from the federal government were making it difficult for states—and by extension, local public health departments and individual providers—to coordinate their dose administration. Biden’s team improved the situation this week by giving states their shipment numbers three weeks in advance. The extended lead time will allow vaccine providers to plan out appointments and coordinate other logistics in order to ensure all doses are used. Both the CDC’s Pfizer and Moderna distribution datasets were most recently updated on January 26, with allocation numbers for January 25 and February 1.
    • Stepping up the genomic surveillance: In both of this week’s White House COVID-19 briefings, CDC Director Rochelle Walensky announced that the agency is actively looking for new SARS-CoV-2 variants by working with local and international partners. She gave some specifics in Friday’s briefing: “We are now asking for surveillance from every single state,” she said, requiring states to sequence 750 strains each week. Collaborations with both commercial labs and research universities will take the surveillance to thousands of strains per week. As Sarah Braner wrote earlier in January, such surveillance is key to understanding how prevalent the new—and more contagious—coronavirus strains are in the U.S., as well as to detecting future strains that may become a threat in the coming months.

    It looks like the CDC may be on its way to adapting its current dashboard into the Nationwide Pandemic Dashboard that Biden promised in his transition plan. But I, for one, am trying not to get too comfortable. The statements still need to be fact-checked, and the hard questions need to be asked. Biden’s team is making the bare minimum look nice—albeit with a few Zoom glitches.

    As I look forward into my coverage of the Biden administration’s COVID-19 response, and its healthcare policies more broadly, I’m thinking about this quote from Chris La Tray in his most recent newsletter issue, “Same as it Ever Was”:

    “I’m already sick of all the white liberal people humping each other’s legs every time Biden does something that is simply his damn job. “It’s so nice to have a president that….” Blech. Puke. There is copious lingering accountability to be addressed and Joe goddamn Biden is neck deep in it. We are not going back to anything that resembles the last 40 years of his political career, our only way is forward.”

    Our only way is forward. To end this pandemic, to prepare for the next one.

    Related posts

    • Can Biden clean up America’s COVID-19 data?

      Can Biden clean up America’s COVID-19 data?

      President Biden signing executive orders related to COVID-19 on January 21. Screenshot via the White House’s livestream.

      Shortly after President Joe Biden’s inauguration, the official White House website got a makeover. It now hosts the president’s priorities and COVID-19 plan—including a promise to create a “Nationwide Pandemic Dashboard.”

      I wrote about this promise in November, when it first appeared on Biden’s transition plan website. The promise hasn’t changed since then:

      Create the Nationwide Pandemic Dashboard that Americans can check in real-time to help them gauge whether local transmission is actively occurring in their zip codes. This information is critical to helping all individuals, but especially older Americans and others at high risk, understand what level of precaution to take.

      We don’t have a clear timeline for this dashboard yet, of course, much less details on what it will include. But the foundation was laid this week: Biden released a detailed national COVID-19 plan and signed 30 executive orders—three of which are directly related to tracking the pandemic.

      In the coming weeks, I’ll be closely watching to see how the Biden administration follows through on these plans. Will the new administration build on the strengths of existing federal and state data systems, or will it tear down old systems and sow unnecessary confusion?

      What Biden is promising:

      • A Nationwide Pandemic Dashboard: We covered this one already. Biden’s national strategy document specifies that the federal government will track cases, testing, vaccinations, and hospital admissions—and will “make real-time information available.” The “real-time” promise here is worth highlighting, as real-time pandemic data do not actually exist; every metric from cases to vaccinations has its own lag based on reporting and data-sharing technologies. (COVID-19 deaths, in particular, may be reported weeks after they occur.) Still, the federal government is already tracking all of these metrics. The Biden team’s goal, then, is to consolidate them into an easily accessible dashboard that is widely used by everyone from county public health leaders to elementary school teachers.
      • Coordinated federal data collection: One of Biden’s executive orders, signed on January 21, requires several federal agencies to “designate a senior official” who will lead that agency’s COVID-19 data collection. The officials must both coordinate with each other and make data public. Meanwhile, the Department of Health and Human Services secretary will review the national public health data systems and figure out how to increase their efficiency and accuracy. (Xavier Becerra, Biden’s pick for HHS secretary, hasn’t been confirmed by the Senate yet; will this review need to wait until he officially starts the position?)
      • A focus on equity: Another Biden executive order promises to address the disproportionate impact that COVID-19 has had on people of color and other minority communities. The executive order specifically calls out a lack of standardized COVID-19 data on these communities, saying this data gap has “hampered efforts to ensure an equitable pandemic response.” Biden’s COVID-19 Health Equity Task Force will be required to address this data gap by coordinating with federal agencies—both expanding data collection for underserved populations right now and making recommendations to prevent this issue in future public health crises. This task is easier said than done, though; a recent STAT News article called using data to ensure vaccination equity one of the biggest challenges Biden faces as he takes office.
      • School data collection: Last week, I wrote that there was no mention of data-gathering in Biden’s K-12 COVID-19 plan. Well, maybe someone from his team reads the COVID-19 Data Dispatch, because his executive order on supporting school reopening requires data collection in two areas: data to inform safe reopening of K-12 schools, and data to understand the pandemic’s impact on students and educators. I would have liked to see a more specific promise to track COVID-19 cases, tests, and student enrollment in public schools, but this is a good start.
      • Data-based briefings: Jen Psaki, the new White House press secretary, said on Wednesday that the administration would hold regular briefings with health officials, “with data.” Ideally, such briefings should explain trends in COVID-19 data and put numbers into context for the Americans watching at home.

      The promises are, well, promising.  And I’m rooting for President Biden!  Seriously!  My job would be way easier if I could just give you all updates using one centralized dashboard each week.  But I’ve spent enough time hacking through the weeds of this country’s highly confusing, irregular data systems to know that the new president can’t just flip a switch and make a nationwide pandemic dashboard magically appear on whitehouse.gov.

      If anyone from the Biden administration is reading this, hello!  Please put me on all your press lists!  And here’s what this data reporter would, personally, like to see you focus on.

      What I want to see:

      • Don’t break what we already have: Or, build on the existing federal data systems (and dashboards) rather than creating something entirely new. Last week, Alexis Madrigal published a feature in The Atlantic advocating for the new administration to keep COVID-19 hospitalization data under its current HHS control rather than transferring this responsibility back to the CDC. I’ve covered the HHS’s hospitalization data extensively in the CDD, but this feature really paints a cohesive picture of the dataset—from its turbulent, politically charged beginnings to its current, comprehensive, trustworthy format. The story is worth a read. And on a similar note, I’ve been glad to see federal data sources like the CDC’s dashboard and the Community Profile Reports, continue to update on their usual schedules. Biden’s team should seek to improve upon these systems and make them easier to access, not start from scratch.
      • More public metadata: When the federal government has put out large data releases in recent months, responsibility has largely fallen on journalists and other outside communicators to make those releases accessible. I’ve done some of that work in this publication and at the COVID Tracking Project. But it shouldn’t really be my job—the federal agencies that put out these datasets should be releasing FAQ documents, holding press calls, and generally making themselves available to help out researchers and communicators who want to use their data.  
      • Count the rapid tests: Since August, I’ve called on the federal public health agencies to release national data on antigen tests and other types of rapid tests. A recent article in The Atlantic by Whet Moser makes clear that data for these tests are still widely unavailable. Moser writes that antigen test numbers are not reported at the federal level, and at the state level, such reporting is highly fractured and inconsistent; as a result, about three-quarters of the antigen tests that the federal government has distributed are unaccounted for in public data. The HHS should focus on tracking these tests as comprehensively as it has tracked PCR tests, and it should make the numbers publicly available.
      • Survey the genomes: Another massive challenge that the U.S. faces right now is keeping track of the SARS-CoV-2 variants that are circulating through the population, some of which may be more contagious or more life-threatening. As Sarah Braner reported two weeks ago, the majority of COVID-19 cases aren’t genomically sequenced, making it difficult for us to know how many of those cases are new strains as opposed to the regular coronavirus that we’ve all come to know and hate over the past year. Biden’s health and science leadership should make it a priority to step up the nation’s genetic sequencing game, and all of those data should be publicly shared.
      • Support the local public health agencies: Nationwide data coordination is obviously important, and is something that’s been desperately needed since last spring. But most of the COVID-19 data work—logging test results, standardizing those test results, sending them to a central location—is done by state and local public health officials. Local public health agencies, in particular, have been under-funded and threatened by partisan policies since before the pandemic started. To truly improve COVID-19 data collection, the Biden administration must provide support to these local agencies in the form of funding, personnel, technology, and truly anything else they need right now.

      When Biden’s nationwide pandemic dashboard does drop, you’d better believe I’ll be giving it a comprehensive review. For now, if you want to see how well Biden’s doing at keeping his campaign trail promises, I recommend checking out Politifact’s Biden Promise Tracker.

      Related posts

      • What a President Biden could mean for COVID-19 data

        Last weekend, President-Elect Biden and Vice President-Elect Harris unveiled a Transition Plan. Their website covers detailed steps that the new administration intends to take for addressing COVID-19, climate change, economic recovery, and more.

        One item in the COVID-19 plan caught my attention immediately:

        Create the Nationwide Pandemic Dashboard that Americans can check in real-time to help them gauge whether local transmission is actively occurring in their ZIP codes. This information is critical to helping all individuals, but especially older Americans and others at high risk, understand what level of precaution to take.

        A nationwide pandemic dashboard? Standardizing information from all 50 states? Providing local data down to the ZIP code level? This is literally all I’ve wanted from federal COVID-19 data since February. If the Biden team provides a publish date for this dashboard, I will mark it on my calendar and eagerly count down the days.

        But, as you might imagine from reading my Source Callouts, I have a lot of thoughts on what types of organization, design, and documentation can make COVID-19 dashboards either easy to use—or frustratingly complex. Many other COVID Tracking Project volunteers, who have similarly been wading through state dashboards, have similar expertise. A group of data entry veterans, designers, science communication specialists, and other Project volunteers put together a set of recommendations for the dashboard that President-Elect Biden’s administration might build.

        You can read all the recommendations on the Project’s blog. Here are a few highlights:

        • Prioritize clarity, by putting the most important data points front and center.
        • Offer transparency, through accessible data definitions and methodologies as well as time series which allow users to see how metrics have changed over time.
        • Structure the dashboard with consistency, through the use of logical section headers, color schemes, and regular updates.
        • Provide absolute and per capita values for all major metrics.
        • Report different test types seperately, and provide both positives and totals to allow for accurate test positivity calculations.
        • Make the design inclusive, through providing access for different internet connection speeds, mobile use, and easily surfaced information (i.e. no hovering).
        • Provide annotations and disclaimers to help users understand caveats and complexities in the data.
        • Include data in the forms of charts, sortable tables, and downloadable spreadsheets to allow for easy analysis.
        • Place sex, age, race/ethnicity, and other demographic data in context by comparing COVID-19 rates with the overall population.

        There’s a pretty big caveat to my dashboard excitement, though. In order for President-Elect Biden’s administration to put together a Nationwide Pandemic Dashboard, his team must first be able to access the nationwide pandemic data. So far, as President Trump has yet to concede the election, current Department of Health and Human Services (HHS) leadership are not able to communicate with their successors. POLITICO’S Adam Cancryn described the situation in a November 10 story:

        Biden’s HHS transition team is not yet allowed to have any contact with its agencies, including with officials at the center of the pandemic response like infectious disease expert Anthony Fauci and HHS testing czar Brett Giroir. It’s also barred from accessing nonpublic information or setting up government offices, limiting the new administration’s ability to get a full picture of the public health crisis that it’ll take responsibility for in just over two months.

        The separate coronavirus-specific squad has been held up as well, over concerns about how to structure it ahead of the formal start of the transition process and how willing the Trump administration will be to cooperate.

        The sooner top national politicians accept the election results, the sooner Biden’s COVID-19 team can get to work. That work includes data dashboards, ramping up testing, public health communication, and just about everything else we need to get the virus under control.

        more federal data