COVID-19 Data Dispatch

Tag: race & ethnicity data

  • Ending emergencies will lead to renewed health equity issues

    Ending emergencies will lead to renewed health equity issues

    The header image from a story I recently had published in Amsterdam News about declining access to COVID-19 services.

    Last week, I gave you an overview of the changes coming with the end of the federal public health emergency (PHE), highlighting some shifts in publicly available COVID-19 services and data. This week, I’d like to focus on the health equity implications of the PHE’s end.

    COVID-19 led the U.S. healthcare system to do something unprecedented: make key health services freely available to all Americans. Of course, this only applied to a few specific COVID-related items—vaccines, tests, Paxlovid—and people still had to jump through a lot of hoops to get them. But it’s still a big deal, compared to how fractured our healthcare is for everything else.

    The PHE allowed the U.S. to make those COVID-19 services free by giving the federal government authority to buy them in bulk. The federal government also provided funding to help get those vaccines, tests, and treatments to people, through programs like mass vaccination sites and mobile Paxlovid delivery. Through these programs, healthcare and public health workers got the resources to be creative about breaking down access barriers.

    Now that the emergency is ending, those extra supplies and resources are going away. COVID-19 is going to be treated like any other disease. And as a result, people who are already vulnerable to other health issues will become more at risk for COVID-19.

    I wrote about this health equity problem in a recent story for Amsterdam News, a local paper in New York City that serves the city’s Black community. The story talks about how COVID-19 services in NYC are changing with the end of the PHE, and who will be most impacted by those changes. It’s part of a larger series in the paper covering the PHE’s end.

    Most of the story is NYC-specific, but I wanted to share a few paragraphs that I think will resonate more widely:

    Jasmin Smith, a former contact tracer who lives in Brooklyn, worries that diminished public resources will contribute to increased COVID-19 spread and make it harder for people with existing health conditions to participate in common activities, like taking the subway or going to the grocery store.

    COVID-19 safety measures “make the world more open to people like myself who are COVID-conscious and people who might be immunocomprmised, disabled, chronically ill,” Smith said. “When those things go away, your world becomes smaller and smaller.”

    The ending federal public health emergency has also contributed to widespread confusion and anxiety about COVID-19 services, [said Dr. Wafaa El-Sadr, a professor of epidemiology and global health at Columbia University’s Mailman School of Public Health]. “People have so many questions about this transition,” she said, and local leaders could do more to answer these questions for New Yorkers.

    The near future of COVID-19 care in the U.S. could reflect existing health disparities for other endemic diseases, like the seasonal flu and HIV/AIDS, [said Steven Thrasher, a professor at Northwestern University and author of the book, The Viral Underclass]. For example, people with insurance and a primary care physician are more likely to get their annual flu shots, he said, while those without are more likely to face severe outcomes from the disease.

    After May 11, COVID-19 outcomes are likely to fall along similar lines. “More people have died of AIDS after there were HIV medications,” Thrasher said. “More people have died of COVID when there were vaccines in this country than before.”

    For more news and commentary on COVID-19 emergencies ending, I recommend:

  • How official death data underestimate COVID-19’s inequities

    How official death data underestimate COVID-19’s inequities

    In the last week of December, I had a major story published at MuckRock, USA TODAY, and local newsrooms in Arizona, Oregon, and Texas. The story explains that official COVID-19 statistics underestimate the pandemic’s true toll—particularly on people of color, who are more likely to have their deaths inaccurately represented in mortality data.

    This story was part of Uncounted, MuckRock’s broader project to investigate death certificate errors and other death reporting issues uncovered by looking at all excess deaths during the pandemic, not just those deaths officially marked as COVID-19. It relies on data from the CDC’s provisional mortality statistics and excess death estimates by a team of demography researchers at Boston University led by Andrew Stokes.

    I’ve copied the introductory section of the story here, because I don’t think anything else I write would do a better job at summarizing it. I encourage you to read the full piece; it is the biggest (and likely most important) story that I wrote in 2022.

    It’s not always easy to identify a COVID-19 death.

    If someone dies at home, if they have symptoms not typically associated with the disease or if they die when local health systems are overwhelmed, their death certificate might say “heart disease” or “natural causes” when COVID-19 is, in fact, at fault.

    New research shows such inaccuracies also are more likely for Americans who are Black, Hispanic, Asian or Native.

    The true toll of the COVID-19 pandemic on many communities of color – from Portland, Oregon, to Navajo Nation tribal lands in Arizona, New Mexico and Utah, to sparsely populated rural Texas towns – is worse than previously known.

    Incorrect death certificates add to the racial and ethnic health disparities exacerbated by the pandemic, which stem from long-entrenched barriers to medical care, employment, education, housing and other factors. Mortality data from the Centers for Disease Control and Prevention point to COVID-19’s disastrous impacts, in a new analysis by the Documenting COVID-19 Project at Columbia University’s Brown Institute for Media Innovation and MuckRock, in collaboration with Boston University’s School of Global Public Health; the USA TODAY Network; the Arizona Center for Investigative Reporting; Willamette Week in Portland; and the Texas Observer.

    The data shows that deaths from causes the CDC and physicians routinely link to COVID– including heart disease, respiratory illnesses, diabetes and hypertension–have soared and remained high for certain racial and ethnic groups.

    In Arizona’s Navajo and Apache counties, which share territory with Navajo Nation, COVID deaths among Native Americans drove nation-leading excess death rates in 2020 and 2021. While COVID death rates among Natives dropped during the second year of the pandemic thanks to local health efforts, other causes of death such as car accidents and alcohol poisoning increased significantly from 2020 to 2021.

    In Portland, deaths from causes indirectly related to the pandemic went up in 2021 even as official COVID deaths remained relatively constant. Black residents were disproportionately impacted by some of these causes, such as heart disease and overdose deaths – despite a county-wide commitment to addressing racism as a public health threat.

    In Texas, smaller, rural counties served by Justices of the Peace were more likely to report potential undercounting of COVID deaths than larger, urban counties served by medical examiners. Justices of the Peace receive limited training in filling out death certificates and often do not have sufficient access to postmortem COVID testing, local experts say.

    Experts point to several reasons for increased inaccurate death certificates among non-white Americans. These include resources available for death investigations, the use of general or unknown causes on death certificates, and how the race and ethnicity fields of these certificates are filled out.

    Such barriers to accurate death reporting add on to existing health disparities that made non-white Americans more susceptible to COVID in 2021, despite widespread vaccination campaigns and health equity efforts.

    “Even if you try to level the playing field, from the jump, certain populations are dealing with things that put them at greater risk,” said Enrique Neblett, a health equity expert at the University of Michigan’s School of Public Health. These issues include higher exposure to COVID, as people of color are overrepresented among essential workers, as well as higher rates of chronic conditions that confer risk for severe disease. “Those things aren’t eliminated just by increasing access to a vaccine,” Neblett said.

    It is critical to improve data collection and reporting for deaths beyond those officially labeled as COVID because data is a “major political determinant of health,” said Daniel Dawes, executive director of the Satcher Health Leadership Institute at the Morehouse School of Medicine. Information on how people are dying in a particular community can shape priorities for local public health departments and funding for health initiatives.

    “If there is no data, there is no problem,” Dawes said.

  • Sources and updates, October 30

    • More detailed bivalent booster data: As of this week, the CDC is reporting some demographic data for the bivalent, Omicron-specific booster shots. The new data suggest that these boosters have had higher uptake among seniors, with about 11 million people over age 65 receiving a shot (compared to just 60,000 in the 5 to 11 age group). White and Asian Americans have higher booster rates than Black, Hispanic, and Native Americans, suggesting that the new doses are following a similar equity pattern to what we’ve seen with prior vaccines.
    • COVID-19 mortality by occupation: A new report by the CDC’s National Vital Statistics System provides a rare area of data we don’t usually get in the U.S.: occupational data. CDC researchers used mortality data from 46 states and New York City to examine risk of death by occupation. People working in protective services, accommodation and food services, and other essential jobs that couldn’t be done remotely had the highest death rates—confirming what many public health experts have suspected throughout the pandemic.
    • Life expectancy changes during the pandemic: A new study published in Nature, by researchers at the University of Oxford and other European institutions, estimated how life expectancy changed in 29 countries since the start of the pandemic. After a universal life expectancy decline in 2020, the researchers found, some western European countries “bounced back” in 2021 while the U.S. and eastern European countries did not. The results show the impacts of lower vaccination uptake in the U.S., particularly among younger adults.
    • Disparities in Paxlovid prescriptions: Another CDC study that caught my attention this week was this analysis in Morbidity and Mortality Weekly Report (MMWR), describing racial and ethnic disparities in prescriptions of Paxlovid—the antiviral COVID-19 treatment which reduces risk of severe symptoms. Between April and July 2022, the researchers found, the share of COVID-19 patients over age 20 who received a Paxlovid prescription was 36% lower among Black patients than among White patients, and 30% lower among Hispanic patients. More work is needed to make Paxlovid availability more equitable.
    • New estimates of Long COVID prevalence: One more notable paper published this week: researchers at Massachusetts General Hospital, Harvard, and collaborators conducted an online survey of about 16,000 U.S. adults who tested positive for COVID-19 in the last two months. Of those survey respondents, 15% reported current symptoms of Long COVID. The survey found that older adults and women were more likely to report Long COVID, while those who were fully vaccinated prior to infection had a somewhat lower risk of long-term symptoms. All of these findings are in line with results from other studies, but it’s helpful to see continued validation of these known trends.

    All featured sources
  • COVID-19 risk factors that should lead to Omicron booster priority

    COVID-19 risk factors that should lead to Omicron booster priority

    Parts of the South and Midwest have higher rates of chronic conditions (colored darker red on the map) that confer higher risk for severe COVID-19. Chart via the CDC.

    The U.S. has started a new booster shot campaign, this time using vaccines designed to specifically target super-contagious subvariants Omicron BA.4 and BA.5. (For more details on the shots themselves, see last week’s post.)

    Unlike previous vaccination campaigns, these boosters are available to all adults across the country who have been previously inoculated. There was no prioritization for seniors, healthcare workers, or other higher-risk adults. The official guidance from the federal government is actually pretty straightforward, for once: everyone should get the new booster. And get a flu shot soon, too, possibly even at the same time as your COVID-19 shot.

    But all previously-vaccinated Americans are not facing similar levels of COVID-19 risk. Many of the same qualifications that might have warranted you an earlier dose in spring 2021 should now lead you to prioritize your Omicron booster, even if you might have been infected recently. At the same time, people who fall in these groups (or who share their households) have a good reason to continue using other safety measures after their boosters.

    Here are the major qualifications for higher risk, with data to back them up:

    • Seniors, especially those over age 70: More than 90% of Americans over age 65 have received at least their primary vaccine series, according to the CDC, while over 70% have received at least one booster. Yet older Americans continue to have the highest rates of hospitalizations and deaths. For example, those older than 70 have consistently been hospitalized at several times the rate of younger adults (when adjusted for population). The same pattern is true for deaths among adults over age 75. Seniors who receive the new booster shots will face a lower risk of severe COVID-19 this fall and winter.
    • Black, Indigenous, and other Americans of color, especially seniors: Despite dedicated vaccination campaigns and other health equity efforts, Americans of color have continued to be hit harder by the pandemic than white Americans. Higher rates of chronic conditions in minority populations combined with other socioeconomic factors (POC are more likely to work essential jobs, to lack healthcare, etc.) have led to disproportionately high hospitalization and death rates. And the U.S.’s booster shot campaigns so far have been inequitable, as shown in a recent study by demography experts. Reaching these populations should be a priority for the new Omicron boosters.
    • Immunocompromised people: National estimates consider about 3% of Americans to be moderately or severely immunocompromised, meaning that their immune systems have limited capacity to respond to infections without medical assistance. This group includes cancer patients, organ transplant recipients, people with autoimmune diseases, and more. (This Yale Medicine article provides more information.)  Immunocompromised people might have already had multiple booster shots but are still eligible to receive an Omicron booster as soon as possible, the CDC recommends.
    • People with Long COVID and related conditions: While there isn’t as much established data in this area, I have seen a lot of anecdotal reports from Long COVID patients who work hard to avoid new coronavirus infections—concerned about reinfection’s possibility to worsen their symptoms. On the flip side, vaccination might lead to improvement in Long COVID patients, as the shot boosts a patient’s immune system in responding to lingering reservoirs of virus. The Atlantic covered this possibility when Long COVID patients were first eligible for vaccination in early 2021, and other studies since then have backed it up. More research is needed, but at the very least, Long COVID patients receiving a new booster will have lower risk of a new severe case.
    • People with other preexisting health conditions: The CDC has an extensive list of medical conditions that can confer additional risk for severe COVID-19, with plenty of links to other CDC pages and medical sites where you can learn more about relevant evidence. I won’t go through them all here (that’s a topic for another week’s issue), but I do recommend checking out the CDC’s information and linked sources if you have a condition on the list. You can also explore this map of chronic condition rates by county.

    More vaccination data

  • Sources and updates, July 3

    • Report on race and ethnicity data collection: Researchers at Boston University’s Center for Antiracist Research, who worked on collecting race and ethnicity data from states during the pandemic, have produced a report about the challenges of this work. I was a long-time volunteer for the COVID Tracking Project’s Racial Data Tracker, which became the first stage of a larger project for the BU center, and I’m glad to see this report highlight the issues with destandardized, incomplete data that I remember well.
    • Global impact of vaccines in 2021: In a new paper, published in The Lancet in late June, researchers at Imperial College London evaluate the lives saved by COVID-19 vaccines on a global scale during the first year that this technology was available. Vaccines prevented about 14 million COVID-19 deaths in 185 countries and territories, the researchers found. If global health initiatives like COVAX had met their goals, the lives saved could have been far greater.
    • COVID-19 spread from a cat: Scientists in Thailand have identified the first documented case of a human getting the coronavirus from a pet cat. In this case, the cat from a family going through isolation for COVID-19 infected a veterinarian who was caring for it; genetic analysis confirmed that three humans (father, son, and veterinarian) and the cat were infected with the same viral strain. While cases like this are likely rare, the documented transmission demonstrates why we need better tracking of COVID-19 in animals, as I noted last week.
    • Potential new approach for tracking variants: A new study in the Journal of Clinical Microbiology, funded by the National Institutes of Health, presents the potential for monitoring coronavirus variants through a PCR testing-based approach. Compared to the techniques labs currently use to track variants—which involve sequencing an entire viral genome—this new approach would be faster, cheaper, and could be performed by more labs. The researchers are eager to share their work “as a public health tool,” they said in an NIH press release.

    All featured sources
  • Nine areas of data we need to manage the pandemic

    Nine areas of data we need to manage the pandemic

    PCR testing has greatly declined in recent months; we need new data sources to help replace the information we got from it. Chart via the CDC.

    Last week, I received a question from my grandmother. She had just read my TIME story about BA.4 and BA.5, and was feeling pessimistic about the future. “Do you think we’ll ever get control of this pandemic?” she asked.

    This is a complicated question. And it’s one that I’ve been reflecting on as well, as I approach the two-year anniversary of the COVID-19 Data Dispatch and consider how this publication might shift to meet the current phase of the pandemic. I am not an infectious disease or public health expert, but I wanted to share a few thoughts on this; to stay in my data lane, I’m focusing on data that could help the U.S. better manage COVID-19.

    The coronavirus is going to continue mutating, evolving past immune system defenses built by prior infection and vaccination. Scientists will need to continue updating vaccines and treatments to match the virus, or we’ll need a next-generation vaccine that can protect against all coronavirus variants.

    Candidates for such a vaccine, called a “pan-coronavirus vaccine,” are under development by the U.S. Army and at several other academic labs and pharmaceutical companies. But until a pan-coronavirus vaccine becomes available, we’ll need to continue tracking new variants and the surges they produce. We also need to better track Long COVID, a condition that our current vaccines do not protect well against.

    Eventually, COVID-19 will likely be just another respiratory virus that we watch out for during colder months and large indoor gatherings, broadly considered “endemic” by scientists. But it’s important to note—as Dr. Ellie Murray did in her excellent Twitter thread about how pandemics end—that endemicity does not mean we stop tracking COVID-19. In fact, thousands of people work to monitor and respond to another endemic virus, the flu.

    With that in mind, here are nine categories of data that could help manage the pandemic:

    • More comprehensive wastewater surveillance: As I’ve written here and at FiveThirtyEight, sewers can offer a lot of COVID-19 information through a pipeline that’s unbiased and does not depend on testing access. But wastewater monitoring continues to be spotty across the country, as the surveillance can be challenging to set up—and more challenging for public health officials to act on. Also, current monitoring methods exclude those 21 million households that are not connected to public sewers. As wastewater surveillance expands, we will better be able to pinpoint new surges right as they’re starting.
    • Variant surveillance from wastewater: Most of the U.S.’s data on circulating variants currently comes from a selection of PCR test samples that are run through genomic sequencing tests. But this process is expensive, and the pool of samples is dwindling as more people use at-home rapid tests rather than PCR. It could be cheaper and more comprehensive to sequence samples from wastewater instead, Marc Johnson explained to me recently. This is another important aspect of expanding our wastewater monitoring.
    • Testing random samples: Another way to make up for the data lost by less popular PCR testing is conducting surveillance tests on random samples of people, either in the U.S. overall or in specific cities and states. This type of testing would provide us with more information on who is getting sick, allowing public health departments to respond accordingly. The U.K.’s Office for National Statistics conducts regular surveys like this, which could serve as a model for the U.S.
    • More demographic data: Related to random sample testing: the U.S. COVID-19 response still needs more information on who is most impacted by the pandemic, as well as who needs better access to vaccines and treatments. Random sampling and surveys, as well as demographic data connected to distributions of treatments like Paxlovid, could help address this need.
    • Vaccine effectiveness data: I have written a lot about how the U.S. does not have good data on how well our COVID-19 vaccines work, thanks to our fractured public health system. This lack of data makes it difficult for us to identify when vaccines need to be updated, or who needs another round of booster shots. Connecting more vaccination databases to data recording cases, hospitalizations, and Long COVID would better inform decision-making about boosters.
    • Air quality monitoring: Another type of data collection to better inform decision-making is tracking carbon dioxide and other pollutants in the air. These metrics can show how well-ventilated (or poorly-ventilated) a space is, providing information about whether further upgrades or layers of safety measures are needed. For example, I’ve seen experts bring air monitors on planes, citing poor-quality air as a reason to continue wearing a mask. Similarly, the Boston public school district has installed air monitors throughout its buildings and publishes the data on a public dashboard.
    • Tracking animal reservoirs: One potential source for new coronavirus variants is that the virus can jump from humans into animals, mutate in an animal population, and then jump back into humans. This has happened in the U.S. at least once: a strain from minks infected people in Michigan last year. But the U.S. is not requiring testing or any mandatory tracking of COVID-19 cases in animals that we know are susceptible to COVID-19. Better surveillance in this area could help us catch variants.
    • Better Long COVID surveillance: For me personally, knowledge of Long COVID is a big reason why I remain as cautious about COVID-19 as I am. Long COVID patients and advocates often say that if more people understood the ramifications of this long-term condition, they might be more motivated to take precautions; I think better prevalence data would help a lot with this. (The Census and CDC just made great strides in this area; more on that later in the issue.) Similarly, better data on how the condition impacts people would help in developing treatments—which will be crucial for getting the pandemic under control.
    • More accurate death certificates: The true toll of the pandemic goes beyond official COVID-19 deaths, as the Documenting COVID-19 project has discussed at length in our Uncounted investigation. If we had a better accounting of everyone whose deaths were tied to COVID-19, directly or indirectly, that could be another motivator for people to continue taking safety precautions and protecting their communities.

    If you are working to improve data collection in any of these areas—or if you know a project that is—please reach out! These are all topics that I would love to report on further in the coming months.

    More federal data

  • COVID source callout: The Morning

    Many COVID-19 experts have developed a growing skepticism about “The Morning,” the flagship daily newsletter from the New York Times. David Leonhardt, who writes this newsletter, has pretty limited expertise in science and health reporting, yet he frequently delivers pandemic “explainers” that mislead readers—often by cherry-picking data or suggesting false consensus among experts.

    This week, one of Leonhardt’s columns was particularly misleading. Titled “COVID and Race,” the newsletter reported that white Americans are now dying of COVID-19 at higher rates than Black, Latino, and Asian Americans.

    But Leonhardt missed one very important factor: age-adjustment. Public health experts frequently adjust morbidity and mortality rates by age in order to account for demographic differences among groups. For COVID-19, this is especially important, because the disease disproportionately impacts older adults—and white Americans generally live longer than people of color because of many other structural health factors.

    In her Your Local Epidemiologist newsletter, Dr. Katelyn Jetelina further explained why age-adjsutment is important and why this “COVID and Race” column is wrong. When you adjust the death rates by age, Black and Latino Americans are, in fact, still more heavily impacted by COVID-19 deaths than white Americans, though the gap is shrinking.

    Leonhardt’s newsletter also failed to discuss how COVID-19 has impacted Native Americans. This population has faced the highest death rates throughout the pandemic, according to the CDC and other sources.

    It’s important to call out this error, I think, because “The Morning” has a huge reach and can be influential in impacting national pandemic conversations. If we ignore the continued health disparities around COVID-19, we will fail to address them.

    more source spotlights
  • Sources and updates, June 5

    Sources and updates, June 5

    A new chart that the CDC added to its COVID-19 wastewater dashboard this week.
    • CDC adds new chart to wastewater dashboard: This week, the CDC updated its National Wastewater Surveillance System (NWSS) dashboard with a new chart that aims to summarize the overall picture of coronavirus trends in the country’s sewers. The chart shows the percentage of NWSS sites that have reported their coronavirus concentrations decreasing, staying stable, and increasing over two-week periods; it also shows the overall number of sites with recent data. (This number dropped when NWSS switched contractors, though it has ticked back up in recent weeks as Biobot onboards sites.) Of course, the sites included in NWSS represent a small fraction of the U.S. population, and different locations are using different analysis methods which may be difficult to summarize. But the new chart is still a helpful way to see national trends from the surveillance network.
    • Preprint suggests 30x scale of case underreporting: Last week, researchers from the City University of New York (CUNY) shared striking results from a study in which they’d surveyed about 1,000 New York City residents about their COVID-19 status during two weeks of the BA.2/BA.2.12.1 surge. The sample was designed to represent the broader city population, and residents could self-report positive test results on both PCR and at-home rapid tests as well as possible symptoms and contact with infected people. About 22% of the survey respondents had a coronavirus infection during the study period (April 23 to May 8), the researchers found. The study hasn’t been peer-reviewed and should be interpreted with caution, but still: it could indicate that one in five New Yorkers got COVID-19 within two weeks. Official case counts were 30 times lower, the researchers found, reflecting massive underreporting; and NYC has more access to PCR testing than many other places.
    • CDC study demonstrates disproportionate COVID-19 impact on Native Americans: One study from the CDC’s Morbidity and Mortality Weekly Report (MMWR) that caught my attention this week: researchers in Alaska (at the state’s health agency and tribal health institutions) examined COVID-19 rates for the state’s indigenous population. They found that the age-adjusted COVID-19 case rate among Native Americans/Alaska Natives was about twice as high as the rate among white people living in Alaska, and the death rate was about three times higher. Many indigenous people in Alaska live in rural, remote areas, some inaccessible by car, which heightens the challenges of accessing healthcare.
    • Native American life expectancy fell during the pandemic: Another related preprint: researchers at Virginia Commonwealth University, the University of Colorado Boulder, and the Urban Institute have produced multiple studies examining how life expectancy changed during the pandemic. In general, COVID-19 led to massive decreases in life expectancy across the board; but the latest update from this group showed that Native Americans were particularly hard-hit. Native American life expectancy dropped by 4.7 years, compared to a 2.1 drop for the white American population. Steven Woolf, corresponding author, discussed the study in a Q&A with Virginia Commonwealth University. (H/t Andrew Stokes.)
    • Higher burden of COVID-19 in developing countries: And one more notable new study, published this week in BMJ Global Health: a group of researchers at institutions in the U.S., Australia, Brazil, and other countries conducted an in-depth review of global COVID-19 serology data to estimate the disease’s true infection and fatality rates across the world. The researchers found that infection fatality rates (i.e. the share of infected people who die of COVID-19) were much higher in developing/low-income countries than in developed/high-income countries, in some cases up to three times higher. “The results are, in a word, depressing,” lead author Gideon Meyerowitz-Katz wrote in a Twitter thread discussing the study.
    • New job posting at CDC forecasting center: The CDC’s new Center for Forecasting and Outbreak Analytics, formally launched in April, has posted a job opening for (at least one?) data scientist. Considering that the center plans to hire 100 scientists and science communicators, this singular posting is likely just one of many more opportunities to come.

    All featured sources

  • Sources and updates, May 1

    • Nursing Home Inspect (ProPublica): ProPublica recently published a major investigation into medical exemptions to COVID-19 vaccines among nursing home workers, finding that high numbers of workers are claiming these exemptions even though the actual, medical reasons causing someone to be ineligible for vaccination are fairly limiting. Along with the investigation, the newsroom added staff COVID-19 vaccination data to its Nursing Home Inspect database, which allows users to compare nursing homes based on negative inspection reports and other deficiencies.
    • Neighborhood Atlas: One source I learned about at the health journalists’ conference this weekend is the Neighborhood Atlas tool from researchers at the University of Wisconsin School of Medicine and Public Health. The atlas maps out metrics that put neighborhoods—i.e. Census block groups, a geographical level much more granular than counties—at a health disadvantage, including income, education, employment, and housing.
    • Access to hospital services for minority groups: Another source from the AHCJ conference: this February 2022 paper and corresponding dataset, measuring how far different minority communities across the country have to go to access hospital services. Over half of rural Native American communities are more than 30 miles from the closest intensive care unit, said Dr. Mary-Katherine McNatt in a talk introducing this source.
    • KFF’s State Health Facts: Also at the conference, Juliette Cubanski from the Kaiser Family Foundation (KFF) gave a presentation on the organization’s data tools and resources for journalists, focusing on Medicare data. One broadly useful KFF tool is the State Health Facts dashboard, which enables journalists and researchers to search through over 800 health indicators at the state level. These indicators are frequently updated with the most recent data.
    • Nursing home staffing reports: COVID-19 revealed how unprepared America’s nursing homes were for a health crisis. In a panel discussing this issue, Richard Mollot from the Long Term Care Community Coalition (a nonprofit that advocates for better long-term care) shared some data from his organization, highlighting drops in staffing during the pandemic that have not yet been recovered.

    All featured sources

  • Sources and updates, April 24

    • COVID-19 and public transportation: This week’s biggest COVID-19 news story was, without a doubt, a Florida judge striking down the U.S.’s mask mandate for public transportation (including airplanes, trains, buses, and terminals for all these transit methods). The federal justice department is appealing the decision, as the CDC has determined that masks are still necessary in these settings—at least, while the BA.2 surge is at large. Two good articles to read on this topic: Your Local Epidemiologist’s explanation of coronavirus transmission risk on planes, and Slate’s rundown of what this judge’s ruling could mean for future infectious disease outbreaks.
    • Hospitalizations of young children during Omicron: A major study released in the CDC’s Morbidity and Mortality Weekly Report (MMWR) this week describes hospitalization rates among children ages five to 11, focusing on the Omicron wave in December through February. Findings include: about nine in ten of the children hospitalized during this period were unvaccinated, and hospitalization rates were twice in high in unvaccinated children compared to vaccinated children, demonstrating the importance of vaccination in the five to 11 age group.
    • COVID-19 death rates by race and ethnicity: Another notable study published in MMWR this week: CDC researchers used provisional mortality data (based on death certificates) to study COVID-19 death rates among different racial and ethnic groups, comparing 2020 and 2021. Death rates for Hispanic, Black, and Native Americans were closer to the rates for white Americans in 2021 than they had been in 2020, the report found; this is likely tied to lower vaccination rates and, consequently, higher death rates in conservative and rural areas. For any reporters seeking to investigate these patterns in their regions, the Documenting COVID-19 project’s CDC mortality data repository includes county-level death data from the same source as this MMWR report.
    • New CMS data on hospital and nursing home ownership: Nursing homes and other long-term care facilities have been under increased scrutiny during the pandemic, as COVID-19 revealed major flaws in facilities’ ability to care for vulnerable seniors, A series of new datasets from the Centers of Medicare & Medicaid Services (CMS) aims to enable more scrutiny: the datasets include changes of ownership for skilled nursing facilities and for hospitals. CMS plans to update these datasets on a quarterly basis, according to a press release about the new data.
    • New funding for patient-led Long COVID research: The Patient-Led Research Collaborative (PLRC), a group of Long COVID patients that have produced leading research on their condition, announced this week that they’ve received $3 million in funding. This funding comes from Balvi, a fund for high-impact COVID-19 projects established by Ethereum co-creator Vitalik Buterin. PLRC announced that $2 million will go to start a pool of Long COVID research grants—to be awarded directly by patients—while the remaining $1 million will fund a series of PLRC-led studies. I look forward to reporting on the results of this research! (Also, related: this week, I updated the source list of Long COVID patients and experts willing to talk to reporters, which I compiled with Fiona Lowenstein.)
    • FDA authorizes breathalyzer for COVID-19: The latest new COVID-19 test is a breathalyzer: this machine, developed by Texas-based diagnostics company InspectIR,  analyzes chemicals in a person’s breath to quickly detect compounds signifying a coronavirus infection. This test can deliver results in just three minutes—even faster than an antigen test—but it needs to be performed in a medical setting; InspectIR is working on a version that could be hand-held, like breathalyzers for alcohol. Impressive as the technology is, this data reporter is asking: how will those test results get reported to public health agencies?

    All featured sources