COVID-19 Data Dispatch

Tag: mortality data

  • COVID source callout: NYT continues to push misleading information

    Longtime readers may remember that I am no fan of “The Morning,” a daily newsletter from the New York Times that has frequently downplayed COVID-19 in recent years. Last summer, for example, I called out the newsletter for misleading reporting about who was dying most from COVID-19.

    Well, this week, the newsletter’s primary author, David Leonhardt, has done it again. Leonhardt wrote on Monday that “the pandemic really is over.” As evidence, he pointed to excess deaths (i.e. deaths above expected norms from past years), writing that this metric has returned to a pre-COVID-19 baseline.

    It is true that excess deaths have been low since early 2023, when the country’s holiday COVID-19 surge concluded. And sure, this is good news about COVID-19’s current impact on mortality. You can see the CDC’s estimates here. However, Leonhardt’s newsletter fails to mention several caveats:

    • If the pandemic were truly “over,” excess deaths would actually be below historical averages, not at them, to reflect people who had died prematurely of COVID-19 in the last three years. (Health law scholar Blake Murdoch pointed this out on Twitter.)
    • Current death data are seriously undercounting COVID-19 deaths, thanks to the now-very-limited availability of COVID-19 tests combined with limited surveillance following the end of the federal public health emergency. The CDC revises up its estimates every week.
    • Excess death data, in general, are typically considered preliminary estimates for about a year. So, the data Leonhardt sites are preliminary and likely to be revised up once the CDC compiles more information from death certificates.
    • The pandemic has disproportionately impacted people of color and other vulnerable groups. Analysis from APM Research Lab shows that this pattern has continued through the first half of 2023.
    • Plenty of other metrics (including wastewater surveillance, hospitalizations, and the virus’ continued evolution) suggest that COVID-19 is still circulating and still making people sick. The U.S. is likely heading into a summer surge right now, in fact.
    • Leonhardt fails to mention Long COVID, one of the most dire outcomes of COVID-19. Even though millions of people are still dealing with prolonged symptoms.

    So, for whom is the pandemic really “over”?  It might be over for Leonhardt himself, but it’s not over for people with Long COVID, people still mourning lost loved ones, high-risk people still taking every precaution, people who will get infected this summer, and so many more. All of these people challenge the NYT’s misleading narrative.

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  • Sources and updates, July 16

    • Real-time detection of coronavirus in the air: A new study, published this week in Nature Communications, describes a tool to detect airborne SARS-CoV-2 particles. Researchers at Washington University in St. Louis developed this tool; it works by collecting aerosols in a container and screening them for chemical properties matching the coronavirus spike protein. In the researcher’s proof-of-concept study, the detector tool was able to detect coronavirus particles with 77% to 83% accuracy, and could detect the virus when it was present at relatively small volumes. If the tool holds up to further tests, it could be valuable for monitoring healthcare settings and other public places.
    • Routine respiratory virus testing at K-12 schools: Another study about testing, published in the CDC’s Morbidity and Mortality Weekly Report: researchers in Kansas City, Missouri regularly tested students and staff members at the public school district for SARS-CoV-2, the flu, RSV, and several other common respiratory viruses. About 900 participants opted into monthly testing for the 2022-23 school year, for a total of 3,200 tests conducted. Overall, about one in four tests were positive for at least one respiratory virus. Pre-K students had the highest positivity rate (40%), while rhinovirus/enterovirus was most commonly detected. The study shows how many viruses are going around in school settings, as well as the potential value of testing for reducing spread.
    • Predicting COVID-19 activity with Google searches: COVID-19 data commentators have long suspected that online trends indicating people were losing their sense of smell or taste in large numbers could predict an upcoming surge. (Remember the Yankee Candle Index?) Well, a new study in the CDC’s Emerging Infectious Diseases journal provides some evidence for this pattern. Researchers at Yale and Columbia Universities compared Google search trends for “loss of smell” and “loss of taste” to COVID-19 hospitalization and death numbers in five countries. They found a strong correlation between these searches and COVID-19 increases for major COVID-19 waves. So, even as official data become less available, online trends may still be a good indicator.
    • Estimating infection rates from mortality data: COVID-19 mortality data can be used to work backward and estimate true infection rates, according to a new paper in Science by researchers at the University of California Davis and the University of the Basque Country (in Spain). The scientists used a machine learning model to analyze death reports from several European countries, essentially predicting infection rates in reverse. Their analysis found that lockdowns and mask requirements, among other COVID-19 safety measures, had a major impact on transmission, one of the authors said in a press release. Mortality data continues to present a useful tool for tracking COVID-19’s full impact.
    • Long COVID cohort study suggests full recovery may be rare: One more notable new study, shared by The Lancet as a preprint: researchers at a hospital in Barcelona shared the results of a study following Long COVID patients for two years. The study followed 548 people, including 341 with Long COVID and 207 who did not have long-term symptoms after acute COVID-19. Only 26 (7.6%) of the Long COVID patients recovered during the two-year follow-up period, according to symptom surveys and diagnostic testing. Hannah Davis, a patient-researcher at the Patient-Led Research Collaborative, shared additional highlights and takeaways from the study in a Twitter thread.
    • New bill to strengthen wastewater surveillance: Finally, a bit of hopeful news: three U.S. senators just introduced a bipartisan bill that would strengthen the CDC’s National Wastewater Surveillance System (NWSS). The bill would specifically expand NWSS to include surveillance for other public health threats, and would enable it to provide more funding to state and local health agencies. Cory Booker from New Jersey, Angus King from Maine, and Mitt Romney from Utah are the three sponsors. I’m not a political reporter, so I won’t pretend to know how likely this bill’s chances are of passing, but I hope it’s a step toward making the U.S.’s wastewater surveillance infrastructure permanent.

    Editor’s note, July 23, 2023: An earlier version of this post misstated the virus most commonly detected in the Kansas City schools study. (It was rhinovirus/enterovirus, not RSV.)

  • COVID source shout-out: excess deaths estimates

    This week, a team of demography researchers published a paper sharing excess death estimates by county, for the first two years of the COVID-19 pandemic. The team, led by Andrew Stokes at Boston University, has been analyzing excess death data for years in order to understand the true toll of COVID-19 on the U.S.

    To measure excess deaths, researchers compare the number of deaths that they’d expect to occur in a given place, over a given timeframe—based on modeling from historical data—to the number of deaths that actually happened. This metric is a helpful one for COVID-19 research, because official COVID-19 deaths are undercounted for a variety of reasons. (To name a few: lack of standards for death certificates, politicization of the pandemic, health equity issues.)

    Especially now that official COVID-19 data are becoming less and less reliable, I see excess deaths as a useful avenue for continued reporting on the pandemic. And for any journalists or researchers interested in looking into this issue, Stokes and his team’s work is a great starting point. I collaborated with them for MuckRock’s Uncounted project, using a preprint iteration of the paper published this week.

    For more info on this topic, see the Uncounted project and this 2021 post about excess death data from the CDC.

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  • The CDC’s new COVID-19 dashboard hides transmission risk

    The CDC’s new COVID-19 dashboard hides transmission risk

    The CDC’s new COVID-19 dashboard suggests that the national situation is totally fine, because hospitalizations are low. But is that correct?

    On Thursday, the CDC revamped its COVID-19 dashboard in response to changing data availability with the end of the federal public health emergency. (For more details on the data changes, see my post from last week.) The new dashboard downplays continued COVID-19 risk across the U.S.

    Overall, the new dashboard makes it clear that case counts are no longer available, since testing labs and state/local heath agencies aren’t sending those results to the CDC anymore. You can’t find case counts or trends on the homepage, at the top of the dashboard, or in a county-level map.

    Instead, the CDC is now displaying data that shows some of COVID-19’s severe impacts— hospitalizations and deaths—without making it clear how widely the virus is still spreading. Its key metrics are new hospital admissions, currently-hospitalized patients, emergency room visits, and the percentage of recent deaths attributed to COVID-19. You can find these numbers at national and state levels in a revamped “trends” page, and at county levels in a “maps” page.

    The “maps” page with county-level data has essentially replaced the CDC’s prior Community Level and Transmission Level page, where users were previously able to find COVID-19 case rates and test positivity rates by county. In fact, as of May 13, the URL to this maps page is still labeled as “cases” when you click into it from the main dashboard.

    While these changes might be logical (given that case numbers are no longer available), I think the CDC’s design choices here are worth highlighting. By prioritizing hospitalizations and deaths, the CDC implicitly tells users of this dashboard that the virus should no longer be a concern for you unless you’re part of a fairly small minority of Americans at high risk of those severe outcomes.

    But is that actually true, that COVID-19 is no longer a concern unless you’re going to go to the hospital? I personally wouldn’t agree. I’d prefer not to be out sick for a week or two, if I can avoid it. And I’d definitely like to avoid any long-term symptoms—or the long-term risks of heart problems, lung problems, diabetes, etc. that may come after a coronavirus infection.

    These outcomes still persist after a mild COVID-19 case. But the current CDC data presentation makes it hard to see those potential outcomes, or your risk of getting that mild COVID-19 case. The agency still has some data that can help answer these questions (wastewater surveillance, variant surveillance, Long COVID survey results, etc.) but those numbers aren’t prioritized to the same degree as hospitalizations and deaths.

    I’m sure the CDC data scientists behind this new dashboard are doing the best they can with the information they have available. Still, in this one journalist’s opinion, they could’ve done more to make it clear how dangerous—and how widely prevalent—COVID-19 still is.

    For other dashboards that continue to provide updates, see my list from a few weeks ago. I also recommend looking at your state and local public health agencies to see what they’re doing in response to the PHE’s end.

    More federal data

  • Sources and updates, May 7

    • KFF Medicaid Unwinding tracker: The Kaiser Family Foundation just published a new tracker detailing Medicaid enrollment by state. Enrollment rose to record levels during the pandemic, as a federal measure tied to the public health emergency forbid states from taking people off the insurance program. Now, states are going through the slow process of evaluating people’s eligibility and taking some off the program, in a process called “unwinding.” The KFF tracker is following this process, presenting both Medicaid enrollment data by state and information on each state’s timeline for evaluation.
    • Biden administration ends vaccine mandates: In time with the federal public health emergency’s end, the Biden administration has announced that it will lift its COVID-19 vaccine rules for federal workers and contractors. International travelers to the U.S. also will no longer need to provide proof of their vaccination status, and the administration is working to end requirements for other groups of workers and travelers. This change is, essentially, another signal of the administration giving up on mass vaccination campaigns; after all, most of the people who got their shots under these rules haven’t received an Omicron booster.
    • Vaccine protection wanes over time: A new review paper from researchers in Trento, Italy, published this week in JAMA, shows the importance of booster shots for maintaining protection from COVID-19. The researchers compiled and analyzed findings from 40 studies that evaluated vaccine effectiveness. Overall, they found, the protection that both primary series and booster shots provide against an Omicron infection drops significantly by six months and nine months after vaccination. Remember: Americans over 65 and/or immunocompromised, you’re now eligible for another bivalent/Omicron-specific booster.
    • Disparities in COVID-19 deaths persist: Two new studies this week examine COVID-19 deaths by race and ethnicity. The first study, from the CDC’s National Center for Health Statistics, examined deaths of all causes during the pandemic, finding that Black and Native Ameircans had higher death rates than other racial/ethnic groups. COVID-19 was the fourth highest cause of death in 2022, after heart disease, cancer, and unintentional injury. The second study, from Andrew Stokes and collaborators, examined COVID-19 deaths during the U.S.’s first Omicron wave compared to earlier surges, finding that disparities decreased—but only because white deaths went up during the second year of the pandemic.
    • Characterizing Long COVID neurological symptoms: Another new study from this week: researchers at the NIH performed detailed examinations of 12 Long COVID patients to better understand their neurological symptoms. The researchers used an approach called “deep phenotyping,” which involves a variety of tests that aren’t typically used in clinical settings. They found that the patients had a number of abnormalities in their immune systems and autonomic nervous systems compared to healthy controls, pointing to different potential drivers of symptoms.
    • FDA approves RSV vaccine: Finally, a bit of non-COVID good news: for the first time, the FDA has approved a vaccine for RSV, the seasonal respiratory virus that can cause severe symptoms in older adults and young children. This vaccine, made by GSK, was approved for adults ages 60 and up and will likely get distributed during the next cold/flu season. Scientists have been working on RSV vaccines for decades, making this a major milestone for reducing the disease’s impact. Helen Branswell at STAT has more details.

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  • Sources and updates, April 30

    • Local COVID-19 resources from the People’s CDC: In advance of the federal public health emergency’s end, advocacy and communications organization the People’s CDC has compiled a list of COVID-19 resources for people still seeking to stay safe during the ongoing pandemic. The list includes testing and treatments, food support, mutual aid, advocacy organizations, and links to other People’s CDC resources.
    • Premature deaths during the pandemic: A new analysis from the Peterson-KFF Health System Tracker examines the impact of COVID-19 on premature deaths, or deaths that occurred before the person reached age 75. This analysis included all excess deaths (so, not just those deaths officially reported as COVID-19, but also deaths from other diseases, drug overdoses, violence, etc.). All demographic groups experienced an increase in premature mortality during the pandemic, the researchers found, but deaths increased more for people of color than for white people. Hispanic and Native Americans had the highest impact, with premature all-cause mortality rising 33% betweeen 2019 and 2022.
    • Youth risk behaviors during COVID-19: This week, the CDC published a wealth of data and analysis from its 2021 Youth Risk Behavior Surveillance System, a regular survey examining health-related behaviors among U.S. high school students. The survey asks questions about gun violence, unstable housing, mental health, sexual behaviors, dietary behavior, drug use, and more. As this survey is conducted every two years, the 2021 iteration was the first to capture youth behavior during the COVID-19 pandemic, and it included some questions specifically designed to look at COVID-19’s impacts.
    • Lessons from COVID-19 report: A new book, published this week, explores what went wrong (and right) from the U.S.’s COVID-19 response. 34 leading experts from a variety of backgrounds collaborated on the book; the group originally convened in anticipation of a 9/11 Commission-style inquiry into the federal government’s COVID-19 response, and continued to investigate what went wrong even though that commission did not actually come into being. For highlights from the book, see this Q&A between two of the authors and STAT’s Helen Branswell.
    • Long-term financial issues after COVID-19: A new paper, published this week in the Journal of Hospital Medicine, finds that a COVID-19 diagnosis may lead to financial challenges. Researchers at the University of Michigan and Johns Hopkins studied this issue by linking healthcare records from a large Michigan-based insurance network with financial records from the credit company Experian. The study included over 132,000 Michigan residents. People who had COVID-19 were more likely to see their credit score drop following that infection, the researchers found; those who were hospitalized with severe symptoms had the highest risk of this financial impact.

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  • Sources and updates, March 19

    • Long-term effects of COVID-19 on kids: The National Academies of Sciences, Engineering, and Medicine (NASEM) recently published a report about how the COVID-19 pandemic has impacted children and families. It includes a variety of health impacts (physical, behavioral, mental), interventions taken by schools and other institutions, access to healthcare coverage, impacts of COVID-related economic policies, and recommendations for addressing this issue in the future. The report’s authors note that, for “almost every outcome” related to health and well-being, COVID-19’s impacts were worse for Black, Hispanic/Latino, Native American, and low-income families.
    • Shorter sleep duration during the pandemic: On a similar topic: the CDC’s Preventing Chronic Disease journal recently published an article about teenagers’ sleep habits during the pandemic. The study used data from the 2021 Adolescent Behaviors and Experiences Survey, a nationally-representative survey of high school students. About three-quarters of students surveyed slept for less than eight hours a night, and students who slept less were more likely to report that doing their schoolwork became more difficult during the pandemic. While shorter sleep was becoming an issue before COVID-19, this study shows how COVID-related stress may have exacerbated the problem.
    • Maternal mortality keeps getting worse: This week, the CDC released its most recent, official statistics on maternal mortality in the U.S. The new data reflect deaths in 2021, and show that mortality rates rose to about 33 deaths per 100,000 births, compared to rates closer to 20 per 100,000 births in 2020 and 2019. Mortality rates were more than 2.5 times higher for Black women compared to white women. For more recent data (and additional demographic figures), see this story and GitHub repository from MuckRock, also shared in last week’s newsletter.
    • WHO updates its variant tracking system: The World Health Organization announced on Thursday that it will start classifying subvariants of Omicron as distinct Variants of Interest (VOIs) and Variants of Concern (VOCs), and will assign new Greek-letter names to VOCs. Omicron lineages have accounted for the vast majority of coronavirus circulating globally since early 2022, but all subvariants have previously been clustered under that one Greek-letter name. Now, the WHO will give us new names as needed, hopefully making future variants a bit easier to talk about. The WHO also updated its definitions for classifying new subvariants as VOCs or VOIs.
    • Wastewater monitoring continues to expand: Two updates about local wastewater surveillance programs caught my attention this week. First, the City of Chicago’s public health department has announced it will start monitoring wastewater for polio, in collaboration with the University of Illinois, state health department, and national CDC. And second, two local agencies in the Bay Area, California recently started testing wastewater for traces of drugs, including fentanyl, methamphetamine, cocaine, and nicotine. We’ll likely see more announcements like this across the U.S. as agencies continue to expand their wastewater surveillance programs beyond COVID-19.

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  • Sources and updates, March 12

    • COVID-19 polling data from Axios/Ipsos: During the workshop I led at NICAR last weekend, one attendee (who works at the market research company Ipsos) recommended that journalists and researchers interested in Long COVID data should check out the Axios/Ipsos polling project to track American attitudes on COVID-19. Recent iterations of the poll have included questions about Long COVID, and the polling results are broken out by demographics (age, race, houeshold income). The surveys ask many other COVID-19 questions as well, such as attitudes about masking. To access the data, you can download PDFs from the Ipsos site or spreadsheets from Roper.
    • CDC provides guidance for Long COVID deaths: The CDC National Center for Health Statistics has started to add information about Long COVID to its guidance for death certificates, following a report that the agency published in December about deaths from Long COVID. The guidance now explains that SARS-CoV-2 “can have lasting effects on nearly every organ and organ system of the body weeks, months, and potentially years after infection,” and can contribute to premature death months or years after a patient’s original infection. For context, see MuckRock’s report on Long COVID deaths from December.
    • Long COVID gastrointestinal symptoms: Ziyad Al-Aly and his team at the Veterans Affairs St. Louis Health Care System have a new paper in Nature about long-term gastrointestinal symptoms following COVID-19. Using the VA electronic health records database, the researchers compared 150,000 people who’d had COVID-19 to millions of controls. They found people with COVID-19 had elevated risks of many gastrointestinal disorders (including acid-related illness, intestinal disorders, pancreatitis, and more) in the year following their acute cases, compared to the controls. GI symptoms have long been an under-publicized aspect of COVID-19 and Long COVID.
    • Clinical trial for Long COVID shows promising results: And one more Long COVID study: researchers at the University of Minnesota examined the potential for three common medications to lower risk of Long COVID. This study was a blinded, randomized control trial—the gold standard of medical research. One of the drugs tested, metformin (which is a common medication for type 2 diabetes), led to a significantly lower risk of Long COVID compared to the placebo. The study hasn’t yet been peer-reviewed, but it shows promising results for metformin as a potential Long COVID treatment option.
    • Examining trust in public health agencies: Another new paper, published this week in Health Affairs, shares results from a survey of about 4,200 U.S. adults (a nationally representative sample) about trust in public health agencies. The survey suggested that trust in federal agencies is connected to perceptions of scientific expertise, while trust in state and local agencies is more tied to “perceptions of hard work, compassionate policy, and direct services.” Survey respondents who reported the least trust in public health cied concerns about political influence, private sector influence, inconsistency, and excessive restrictions.
    • Some parents lied about children’s COVID-19 status: One more notable survey study, published this week in JAMA Network Open: researchers at Middlesex Community College (in Connecticut) and University of Utah Health, among other collaborators, surveyed a group of 1,700 U.S. parents about COVID-19 protective measures for their children. The study found about 26% of respondents reported lying about or misrepresenting their child’s COVID-19 status in order to break quarantine rules. Common motivations for this behavior were wanting to “exercise personal freedom as a parent,” not being able to miss work or other responsibilities, and wanting kids to have normal experiences. The results suggest “a serious public health challenge” for continued COVID-19 outbreaks and other infectious diseases, the paper’s authors write.
    • Maternal mortality during the pandemic: MuckRock (where I work part-time) has published new analysis showing a significant increase in maternal deaths during the COVID-19 pandemic, based on CDC mortality data. The death rate for women ages 15 to 44 went from about 29 deaths per 100,000 births in 2019 to 46 deaths per 100,000 births in 2021. Death rates were significantly higher for Black women and in states with more restrictive policies on maternal healthcare. You can find the full analysis (including a selection of state-level data) here.

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  • This winter’s COVID-19 surge wasn’t “mild”

    This winter’s COVID-19 surge wasn’t “mild”

    Wastewater surveillance data from Biobot suggests that COVID-19 spread this winter (2022-2023) was higher than all other surges prior to Omicron’s emergence.

    You might have seen some headlines like this in the last few weeks: COVID-19 was “mild” this winter. This winter was “better” than previous winters. COVID-19 is becoming “another seasonal virus” like flu and RSV. But is this true?

    While it’s accurate that the U.S. reported fewer COVID-19 cases this past winter compared to last year (when the country experienced our first, massive Omicron surge) or the prior year (our biggest surge pre-vaccines), this winter still saw an extraordinary amount of severe illness, death, and potential future disability due to COVID-19. Surges of other respiratory viruses also put enormous strain on the healthcare system.

    If we call this winter “mild,” we run the risk of believing this level of disease is acceptable. Such portrayals of COVID-19 seek to make us think future surges will be nothing to worry about, despite clear evidence to the contrary.

    Let’s go through some numbers. Since the beginning of November, the U.S. has reported:

    • More than 5 million new COVID-19 cases (reported). Note that cases are likely underreported by 10 to 20 times in our era of under-testing, so the true number may be closer to 100 million.
    • More than 400,000 new COVID-19 hospitalizations, piling on top of hospitalizations for the flu, RSV, and other diseases, and coming as hospitals deal with staff shortages and worker burnout.
    • More than 40,000 new COVID-19 deaths, amounting to more than 400 new deaths per day. This number is also likely an undercount, as death certificates can take a long time to be processed.
    • The majority of COVID-19 deaths were among vaccinated people. A report from the Kaiser Family Foundation found that breakthrough deaths started to outnumber those among unvaccinated people in summer 2022, a trend that has continued with low booster uptake.
    • Coronavirus levels in wastewater were higher than all surges prior to Omicron, including the winter surge in 2020-2021 and the Delta surge in summer 2021, according to data from Biobot.
    • XBB.1.5, the latest and most contagious Omicron subvariant, evolved in the U.S. this winter, likely in New York State. Unchecked COVID-19 spread makes it easier for the virus to keep mutating.
    • More than 5% of American adults are currently experiencing Long COVID. This number has ranged from 5.5% to 7% since September 2022, according to the CDC and Census’ Household Pulse Survey.
    • Almost 80% of adults with Long COVID report activity limitations due to the condition, including about 25% who report “significant” activity limitations, per the Household Pulse Survey.

    In an average week this winter, the U.S. reported more deaths from COVID-19 than the number of casualties on September 11, 2001. The latter event was a horrific tragedy that inspired lasting changes to national security, while the former has been written off as “mild.”

    Past surveys from many sources—including the CDC itself—have suggested that, when people know COVID-19 is spreading widely in their communities, they’re willing to take basic safety precautions. But when government leaders and mainstream media outlets downplay the risks, people don’t have the information they need to make informed choices. We’ve seen this pattern at a large scale this winter, and I worry that the trend will only continue.

    And here’s what concerns me even more: in previous winters, cases went up over the holidays, then declined through January and February. This year, however, the decline isn’t really happening. Transmission has gone down a bit from its peak, but it’s now plateaued at a level higher than the peaks of previous surges, per Biobot’s data.

    So, not only did we have a bad surge this winter, we’re now stuck at a high-COVID baseline that seems very difficult to shake, in the era of many new variants and few public health precautions. The situation reminds me of a Twitter thread from the evolutionary biologist T. Ryan Gregory, which I shared when writing about XBB.1.5 in early January:

    That “area under the curve” is what the U.S. is seeing now, as COVID-19 spread stays at high levels. Thousands of cases a day, thousands of hospitalizations a day, hundreds of deaths a day.

    As a journalist and as an individual capable of taking precautions, I resist the narrative that any of this is acceptable. If you’re reading this, I hope you can, too.

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  • Sources and updates, January 22

    • New CDC dashboards track respiratory illness hospitalizations: This week, the CDC released two new dashboards that combine COVID-19 data with data on other respiratory illnesses. First, the RESP-NET dashboard summarizes information from population-based hospital surveillance systems in 13 states for COVID-19, the flu, and RSV; it includes overall trends and demographic data. Second, the National Emergency Department Visits dashboard provides data on emergency department visits for COVID-19, the flu, RSV, and all three diseases combined; this dashboard includes data from all 50 states, though not all hospitals are covered.
    • Early results from NIH at-home test self-reporting: Last week, ABC News shared early results from MakeMyTestCount.org, an online tool run by the National Institutes of Health allowing Americans to self-report their rapid, at-home test results. Between the site’s launch in late November and early January, “24,000 people have reported a test result to the site,” according to ABC. (While the article says “people have reported,” I think this number actually represents the number of test results reported, given that the website doesn’t track when one person submits multiple test results over time.) The majority of results reported are positive and women are more likely to self-report than men, per ABC. It’s unclear how useful these early data may be for any analysis, but I’m glad to see some numbers becoming public.
    • New preprint updates county-level excess death estimates: A new preprint from Boston University demographer Andrew Stokes and colleagues, posted this week on medRxiv, shares updated estimates on excess deaths and COVID-19 deaths by U.S. county. According to the analysis, about 270,000 excess deaths were not officially attributed to COVID-19 during the first two years of the pandemic, representing 24% of all excess deaths during that time. And the analysis reveals regional patterns: for example, in the South and in rural patterns, excess deaths were less likely to be officially attributed to COVID-19. For more context on these data, see MuckRock’s Uncounted project (which is a collaboration with Stokes and his team).
    • Factors contributing to low bivalent booster uptake: Another notable paper from this week: results from a survey of Americans who were previously vaccinated about their reasons for receiving (or not receiving) a bivalent, Omicron-specific booster this fall, conducted by researchers at Duke University, Georgia Institute of Technology, and others. Among about 700 people who didn’t get the booster, their most common reasons were a lack of awareness that the respondent was eligible for this vaccine, a lack of awareness that the bivalent vaccine was widely available, and a perception that the respondent already had sufficient protection against COVID-19. This survey shows how governments at every level have failed to advertise the bivalent boosters, likely to dire results.
    • More wastewater surveillance on airplanes: And one more notable paper: researchers at Bangor University tested wastewater from three international major airports in the U.K., including samples from airplanes and airport terminals. About 93% of the samples from airplanes were positive for SARS-CoV-2, while among the airport terminal samples, 100% at two airports were positive and 85% at the third airport were positive. Similar to the study from Malaysia I shared last week, this paper suggests that there’s a lot of COVID-19 going around on air travel—to put it mildly. The paper also adds more evidence that airplane/airport wastewater can be a useful source for future COVID-19 surveillance.
    • Nursing home infections ran rampant early in the pandemic: A new report from the Health and Human Services Office of Inspector General examines how much COVID-19 spread through nursing homes in 2020. The report’s authors used Medicare data from about 15,000 nursing homes nationwide, identifying those with “extremely high infection rates” in spring and fall 2020. In more than 1,300 of these facilities, 75% or more of the Medicare patients had COVID-19 during these surges; the same facilities had way-above-average mortality rates. “These findings make clear that nursing homes in this country were not prepared for the sweeping health emergency that COVID-19 created,” the authors write in the report’s summary.

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