COVID-19 Data Dispatch

Tag: State data

  • Tips for following COVID-19 trends this winter

    Tips for following COVID-19 trends this winter

    This chart from Biobot Analytics shows that current coronavirus levels in wastewater (the light green line) have followed a similar pattern to fall 2021 (light blue).

    The U.S. is heading into our first winter since the end of the federal public health emergency for COVID-19. Those of us still following COVID-19 trends might need to change which data sources we use to track the disease this winter, and how we think about trends.

    The pandemic certainly hasn’t ended: COVID-19 still leads to hundreds of hospitalizations and deaths each day, not to mention millions with Long COVID. Since the U.S. government ended its emergency response to this disease, we now have significantly less information—but not zero information—about how it’s spreading.

    To recap the key changes to COVID-19 data following the emergency’s end (see this post from May for more details):

    • The CDC is no longer collecting case data, as it lost authority to require reporting from PCR testing labs.
    • Following the CDC’s lead, many state and local health departments have also stopped tracking COVID-19 cases.
    • The CDC is still tracking COVID-19 hospitalizations, though these data are more delayed and less comprehensive following the PHE’s end.
    • Death reporting is also more delayed and less comprehensive.
    • The CDC is using networks of testing labs and healthcare centers (like the National Respiratory and Enteric Virus Surveillance System) to estimate COVID-19 trends, similar to its strategies for tracking flu and RSV.
    • To track variants, the CDC is relying on a mix of continued PCR samples, wastewater testing, and travel surveillance.
    • Vaccinations are no longer reported directly to the CDC, leading the agency to track the 2023-24 vaccines through other means.

    In short, we lost a few of the primary data sources that people have used to follow COVID-19 over the last three years. But there’s still a lot of data available, primarily from wastewater surveillance, the CDC’s sentinel networks, and local health agencies.

    Here are my tips for tracking COVID-19 this winter.

    Look at multiple sources for your community.

    Following COVID-19 in your city or state used to be easy: you could just look at case numbers. Now, with that metric unavailable in many places, I would recommend having two or three go-to data sources that you check in tandem. Don’t be certain about a trend (like a new surge) until you’ve seen it in multiple sources at once. These sources might be local wastewater pages, local health department pages, and regional trends from the CDC.

    For example, when I want to check on COVID-19 spread in New York City (where I live), I look at:

    Wastewater is the best early indicator.

    It’s pretty universally acknowledged among epidemiologists and public health experts at this point in the pandemic that, without case data, wastewater surveillance is now our best way to spot new changes in COVID-19 spread. When a new surge occurs, coronavirus levels in wastewater tend to go up days or weeks before other metrics, like hospitalizations.

    So, as you track COVID-19 for your community, I would highly recommend that one of your top sources is a wastewater surveillance dashboard.

    Test positivity is still helpful for trends.

    Test positivity—the rate of COVID-19 tests that returned positive results—was a popular indicator early in the pandemic, with policy decisions like whether students could attend school in-person tied to this metric. While test positivity numbers are less available now, people are still getting tested for COVID-19: these tests mostly occur in healthcare settings among people who present with COVID-like symptoms or had recent exposures to the virus.

    I still find test positivity to be a helpful metric for watching trends in COVID-19 spread. When the positivity rate goes up, more people are getting COVID-19; and when the rate goes over 10%, that’s a decent indicator that the disease is spreading in significant magnitudes.

    Two places to find test positivity data:

    Acknowledge data delays, especially around holidays.

    Many COVID-19 dashboards used to update on a daily basis. Now, we get weekly updates from most health agencies—and even less frequency in some places. With these update schedules, all data are inevitably delayed by at least a few days. So, when you look at a dashboard, it’s important to keep the update schedule in mind and ask yourself how a trend might have continued following the most recent data available.

    Data delays become particularly prominent after holidays: remember, public health officials take days off just like the rest of us. Holiday reporting delays often lead to appearances of low COVID-19 during the immediate week of a holiday, followed by appearances of higher COVID-19 in the weeks after as cases (and other metrics) are retroactively reported. The weeks around Christmas and New Year’s are particularly bad, as most people take both of those holidays off.

    Compare current trends to past surges and lulls.

    With interpreting COVID-19 data, context is everything. Spread of the virus is usually either rising or falling; comparing current numbers to historical data can help you understand the magnitude of those recent patterns. Is your community seeing as much COVID-19 as it has at past times commonly recognized as surges? Or are you in more of a lull between waves?

    One helpful tool that I often use for such context is a chart on Biobot’s COVID-19 dashboard that provides year-over-year comparisons between coronavirus levels in wastewater in the U.S. Right now, for example, you can see that current viral levels have followed a similar trendline to what we observed in the fall 2021 Delta surge (before Omicron appeared), but lower than this time last year (when different BA variants were spreading quickly).

    The original Omicron surge in winter 2021-22 is often a popular point for these comparisons, as pundits love to assure us that a new variant won’t cause as intense a wave as we saw with Omicron’s first appearance. While this can be reassuring, I think it’s important to not just look at the highest peaks for comparison. The summer/fall of Delta in 2021 wasn’t a great time either, and we’re on track to repeat it right now even if no wildly competitive new variants appear.

    Keep an eye on variants.

    As we watch for a likely COVID-19 surge this winter, viral variants could have an impact on how much the virus is able to spread during our holiday travel and gatherings. You can keep an eye on variant development through a couple of CDC data pages:

    • The CDC’s variant proportions, which estimate levels of different variants based on PCR testing;
    • Variant patterns from wastewater, which the CDC and local health departments track from select sewage testing sites (many state and local wastewater dashboards include these data as well);
    • Travel-based genomic surveillance, a CDC program in which international travelers can opt into PCR testing as they return to U.S. airports, contributing to the agency’s understanding of variants circulating globally.

    If you have further data tracking questions or suggestions, please reach out via email or in the comments below.

  • COVID source shout-out: Wastewater surveillance in Wyoming

    Wastewater surveillance is re-starting in some Wyoming sewersheds after an earlier iteration of the program ended in December 2021, according to local news reports. This monitoring is a good sign for expanded coverage across more rural parts of the U.S.

    Researchers at the University of Wyoming, working with the state health department, first started testing wastewater for SARS-CoV-2 in fall 2020. The program included about 50 testing sites across the state, according to public data shared by the researchers online.

    In December 2021, however, the testing program ran out of funding and had to scale back. The CDC’s wastewater dashboard includes just four sites in Wyoming that have reported to the National Wastewater Surveillance System in 2023. Data from these sites also appear on the Biobot dashboard, suggesting that they’re being monitored by the company in partnership with local health agencies.

    Now, the state’s surveillance program is getting renewed funding, according to a report by Caitlin Tan for Wyoming Public Radio. Tan writes that “some of the larger communities in Wyoming” will soon be testing their wastewater for the coronavirus and other viruses. Data will be posted by the CDC, and the surveillance will continue through at least July 2024, Tan reports.

    While the article doesn’t specify how many sites will participate, this is still good news for a state that’s had limited wastewater monitoring over the last two years. I hope to see other more rural states follow Wyoming’s lead.

    more source spotlights
  • COVID source shout-out: Virginia’s new wastewater dashboard

    COVID source shout-out: Virginia’s new wastewater dashboard

    One of the visuals available on Virginia’s new wastewater dashboard.

    With the public health emergency ending, a lot of state and local health departments are sunsetting or paring down their COVID-19 dashboards. Wastewater surveillance data are an exception, though, with agencies continuing to test sewage (and share the results) as other forms of COVID-19 testing become less available.

    Virginia’s Department of Health is one notable example: this past week, the agency added a new wastewater surveillance section to its COVID-19 dashboard. The new section includes a map of testing sites, coronavirus trends by site, viral loads over time, and plenty of text explaining how to interpret the data.

    This dashboard will be a great resource for Virginia residents aiming to continue following COVID-19 spread in their communities. It’ll be updated weekly on Tuesdays, according to the department.

    more source spotlights

  • COVID source callout: Montana ends its dashboard

    Last week, I wrote about the Iowa health department’s move to end COVID-19 case reporting requirements for labs, and in turn stop reporting these data to the CDC. Well, Montana just became the next state to follow this trend.

    The state’s public health agency announced that it will stop updating its COVID-19 dashboard on May 5, the week before the federal public health emergency ends, in a note on the dashboard and a statement to local media outlets.

    Unlike Iowa, Montana will continue reporting COVID-19 numbers to the CDC; so residents of that state will still be able to find information on the CDC’s dashboard. But the discontinuation of Monatana’s own dashboard shows how the state is taking resources out of pandemic response and treating COVID-19 as an endemic virus—even though it’s not.

    more source spotlights

  • COVID source callout: Iowa ends COVID-19 case reporting

    As of April 1, Iowa’s state health department is no longer requiring public health laboratories to report positive COVID-19 test results—and no longer reporting statewide data to the CDC. This decision, announced in late February, is part of a growing trend away from relying on case data as people use at-home tests instead of PCR tests.

    Iowa’s health department “will continue to review and analyze COVID-19 and other health data from several sources,” including hospitalization metrics and syndromic surveillance, according to the agency. It’s essentially treating COVID-19 similarly to the flu and other common respiratory viruses.

    As a result of this change, Iowa is now no longer reporting COVID-19 case data to the CDC, the national agency said in this week’s data update. National, regional, state, and county-level CDC data exclude the state of Iowa, starting on April 1.

    This move seems like a natural extension of the state health reporting changes that we’ve seen across the country since last spring. I wouldn’t be surprised if more state health departments similarly stop reporting every COVID-19 case when the federal health emergency ends in May. Unfortuantely, this will become another driver of increasingly-less-reliable COVID-19 data in the U.S.

    more source spotlights

  • Sources and updates, March 26

    • Paxlovid may lower risk of Long COVID: Taking paxlovid in the acute phase of a COVID-19 case may lower a patient’s risk of long-term symptoms by about 25%, according to a paper published this week in JAMA Internal Medicine. The paper, which summarizes an analysis of health records in the Veterans Affairs database, was originally posted as a preprint in the fall; lead author Ziyad Al-Aly and his colleagues at the St. Louis VA did more number-crunching during the peer review process. Several clinical trials (including one just announced at Yale this week) will test paxlovid as a potential treatment for Long COVID, with a longer course than people typically take during the acute disease.
    • Estimating true vaccination rates in the U.S.: A new report from the COVID States Project, a group of academic researchers focused on connections between social behaviors and COVID-19 spread, provides estimates of vaccination rates by state in the U.S. The researchers compared vaccination data from the CDC to polling sources, including the Kaiser Family Foundation and original polling conducted by the COVID States Project. They found that CDC data often diverged from survey data, suggesting that the public health agency’s information has errors due to the CDC’s inability to connect disparate immunization records from different states. (In other words, if someone got their primary series in one state and a booster in another, they might show up twice in the CDC’s data.)
    • Comparing COVID-19 outcomes by state: Another report looking at state-by-state data: researchers at the University of Washington’s Institute for Health Metrics and Evaluation compared COVID-19 death rates to state actions on COVID-19. The researchers found that states with higher poverty, more income inequality, higher Black and Hispanic/Latino populations, and less access to healthcare faced higher COVID-19 rates. States where more people voted for Trump in 2020 also saw more COVID-19. These patterns “seem to reflect the release of public health mandates” in more Republican states, journalist Amy Maxmen wrote in a Twitter thread summarizing the study.
    • COVID-19 origins docs, raccoon dog analysis: Federal intelligence documents about investigations into the coronavirus’ origins will be declassified in the coming months, as required by a new law that President Biden signed this week. The law specifically requires that the Director of National Intelligence release “all information relating to potential links between China’s Wuhan Institute of Virology and COVID-19.” This information will first go to Congress, and then may become public. Meanwhile, there’s been some controversy about a recent analysis of viral samples at the Huanan Seafood Wholesale Market in Wuhan: news about this analysis was shared in the media before a scientific report was completed, and some researchers who worked on the analysis had their access to sequence repository GISAID revoked. This article in Science Magazine has more details on the situation.
    • Increased Candida auris spread during the pandemic: C. auris is a pathogenic fungus that has developed resistance to multiple common drugs, and that can pose a serious threat to human health. (Yes, a fungus similar to the one that causes a pandemic in “The Last of Us”—though C. auris doesn’t turn people into zombies.) The fungus has spread more widely during the pandemic according to a recent CDC report, with a 44% increase in cases from 2019 to 2021. Other types of anti-microbial resistance have been on the rise as well, as COVID-19 led to less rigorous monitoring and heightened antibiotic use in many hospitals. More recent CDC data on the fungus are available here.

    All featured sources
  • COVID-19 is inspiring improvements to surveillance for other common viruses

    COVID-19 is inspiring improvements to surveillance for other common viruses

    The CDC provides norovirus test positivity data from a select number of labs that report test results for this virus. Due to limited reporting, data are only available at the regional level.

    This week, I have a new story out in Gothamist and WNYC (New York City’s public radio station) about norovirus, a nasty stomach bug that appears to be spreading a lot in the U.S. right now. The story shares some NYC-specific norovirus information, but it also talks more broadly about why it’s difficult to find precise data on this virus despite its major implications for public health.

    Reporting this story led me to reflect on how COVID-19 has revealed cracks in the country’s infrastructure for tracking a lot of common pathogens. I’ve written previously about how the U.S. public health system monitored COVID-19 more comprehensively than any other disease in history; the scale of testing, contact tracing, and innovation into new surveillance technologies went far beyond the previous standards. Now, people who’ve gotten used to detailed data on COVID-19 have been surprised to find out that such data aren’t available for other common pathogens, like the flu or norovirus.

    It might feel disappointing to realize how little we actually know about the impacts of endemic diseases. But I choose to see this as an opportunity: as COVID-19 revealed gaps in public health surveillance, it inspired development in potential avenues to close those gaps. Wastewater surveillance is one big example, along with the rise of at-home tests and self-reporting mechanisms, better connectivity between health systems, mobility data, exposure notifications, and more.

    Norovirus is a good example of this trend. Here are a few main findings from my story:

    • Norovirus is a leading cause of gastrointestinal disease in the U.S., and is estimated to cause billions of dollars in healthcare and indirect societal costs every year.
    • People who become infected with norovirus are often hesitant to seek medical care, because the symptoms are disgusting and embarrassing. Think projectile vomit, paired with intense diarrhea.
    • Even when patients do seek medical care, norovirus tests are not widely available, and there isn’t a ton of incentive for doctors to ask for them. Testing usually requires a stool sample, which patients are often hesitant to do, one expert told me.
    • The virus is not a “reportable illness” for the CDC, meaning that health agencies and individual doctors aren’t required to report norovirus cases to a national monitoring system. (So even when a patient tests positive for norovirus, that result might not actually go to a health agency.)
    • The CDC does require health agencies and providers to report norovirus outbreaks (i.e. two or more cases from the same source), but national outbreak estimates are considered to be a vast undercount of true numbers.
    • Even in NYC, where the city’s health agency does require reporting of norovirus cases, there’s no recent public data from test results or outbreaks. (The latest data is from 2020.)

    As I explained in an interview for WNYC’s All Things Considered, the lack of a national reporting requirement and other challenges with tracking norovirus are linked:

    It seems like the lack of a requirement and the difficulty of tracking kind-of play into each other, where it’s not required because it’s hard to track—but it’s also hard to track because it’s not required.

    The lack of detailed data on pathogens like norovirus can be frustrating on an individual level, for health-conscious people who might want to know what’s spreading in their community so that they can take appropriate precautions. (For norovirus, precautions primarily include rigorous handwashing—hand sanitizer doesn’t work against it—along with cleaning surfaces and care around food.)

    These data gaps can also be a challenge for public officials, as more detailed information about where exactly a virus is spreading or who’s getting sick could inform specific public health responses. For example, if the NYC health department knew which neighborhoods were seeing the most norovirus, they could direct handwashing PSAs to those areas. In addition, scientists who are developing norovirus vaccines could use better data to estimate the value of those products, and determine who would most benefit.

    So, how do we improve surveillance for norovirus and other viruses like it? Here are a few options I found in my reporting:

    • Wastewater surveillance, of course. The WastewaterSCAN project is already tracking norovirus along with coronavirus and several other common viruses; its data from this winter has aligned with other sources showing a national norovirus surge, one of the project’s principal investigators told me.
    • Better surveillance based on people’s symptoms. The Kinsa HealthWeather project offers one example; it aggregates anonymous information from smart thermometers and a symptom-tracking app to provide detailed data on respiratory illnesses and stomach bugs.
    • At-home tests, if they’re paired with a mechanism for people to report their results to a local public health agency. Even without a reporting mechanism, at-home tests could help curb outbreaks by helping people recognize their illness when they might be asymptomatic.
    • Simply increasing awareness and access to the tests that we already have. If more people go to the doctor for gastrointestinal symptoms and more doctors test for norovirus, our existing data would get more comprehensive.

    Are there other options I’ve missed? Is there another pathogen that might be a good example of common surveillance issues? Reach out and let me know.

  • Where to find wastewater data for your community

    Where to find wastewater data for your community

    The Massachusetts Department of Public Health is one of the latest state agencies to set up a public wastewater dashboard.

    As we head into the holidays with limited COVID-19 testing and undercounted case numbers, wastewater surveillance is the best way to evaluate how much the virus is spreading in your region. And it’s now available in more places than ever, thanks to the many research groups and public health agencies setting up sewage testing.

    To help you find wastewater surveillance in your area, I recently updated my COVID-19 Data Dispatch resource page about U.S. wastewater dashboards. The page includes links to and notes about national, state, and a few local dashboards.

    Let’s review the options. First, there are now three national dashboards with U.S. wastewater data, each covering a different set of locations.

    • The CDC’s National Wastewater Surveillance System is the biggest, including more than 1,000 sites from almost every state, though some states have far better coverage than others. Click on an individual site to see coronavirus trends for that location.
    • Biobot Analytics is the biggest private company doing wastewater surveillance; it provides analysis for hundreds of sites in the CDC NWSS network as well as its own, separate network. Biobot’s national and regional data (which include NWSS sites) are particularly helpful for large-scale trends.
    • WastewaterSCAN is a project that started from an academic partnership between Stanford University, Emory University, the University of Michigan, and communities in California. It’s since expanded to include sites in about 20 states, and participating sewersheds are tested for monkeypox, flu, and RSV in addition to the coronavirus.

    Second, 21 states currently have their own wastewater dashboards or reporting systems. If this is available in your area, I highly recommend looking at your local dashboard in addition to the national options. State and local dashboards tend to include more detailed and/or more frequently updated data, and are often tailored to their community’s needs more closely.

    These are the states with wastewater dashboards; see the resource page for links and more info:

    • California, Colorado, Georgia, Hawaii, Idaho, Indiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New York State, North Carolina, Ohio, Oklahoma, Oregon, Utah, West Virginia, Wisconsin.

    Wastewater trends do not correspond directly to infection trends, because people sick with COVID-19 might shed the virus at different rates (based on where they are in their infection, variants, and other factors). Some researchers are working to better understand the correlation between wastewater trends and cases, but for now, the sewage data are best understood as a broad indicator of risk—not a precise estimate of how many people in your community are sick.

    For tips on interpreting wastewater data, I recommend looking at past COVID-19 Data Dispatch posts on this topic, as well as this FAQ from the People’s CDC.

    More wastewater data

  • Tips for interpreting COVID-19 data while the CDD goes on hiatus

    Tips for interpreting COVID-19 data while the CDD goes on hiatus

    How do you find and interpret COVID-19 data during this largely-ignored surge? Here are some tips. Chart via the CDC, with data as of July 29.

    On July 26, 2020, I sent out the first COVID-19 Data Dispatch newsletter. In the two years since that day, I have sent newsletters (and published blog posts) every Sunday, with no breaks. I’ve posted from vacations, over holidays, and on days when I was exhausted or approaching burnout.

    While this schedule has felt punishing at times, I’m proud of it. The coronavirus doesn’t care about holiday schedules, after all, and I enjoy maintaining regular updates for the readers relying on this publication as a key source of COVID-19 news. (Also, not many writers can say they’re more consistent than the CDC.)

    But even I have to admit that two years without breaks is a long time. When I’m scrambling to send out an issue every Sunday, it’s difficult to reflect on key questions, like, “Is my current posting format meeting readers’ needs?” and, “What does helpful COVID-19 coverage look like right now?” I wouldn’t call myself burned out, but at a few points in the last few months, I have felt like I’m operating on autopilot: writing around 3,000 words every weekend because it’s my routine, without evaluating how I might improve that routine.

    This is a rather longwinded way of announcing that I’m about to take a break from the COVID-19 Data Dispatch. August 2022 will be a brief hiatus: over the next four weeks, I won’t write any newsletters or blog posts. I’m also taking this month off of freelancing and working fewer hours at my part-time job, making it basically the longest vacation I’ve had since graduating college.

    I plan to use this time to reflect on this project’s future, including potential format and content changes that might make it easier for me to maintain long-term. I’m also going to reflect on some potential CDD side projects—more resources, events, even a podcast idea?—that I haven’t had the bandwidth to pursue while producing weekly issues.

    Readers: if you have any feedback for me, please reach out! I would love to hear from you about the topics and formats you’d find helpful at this point in the pandemic.

    I also wanted to share some tips for keeping track of COVID-19 data while this publication is on a break, as I’m very aware that we are still in an active surge across the country. (This post is also responding to a reader question that I received from a fellow data reporter last week, after I announced this upcoming break in the newsletter.)

    Look at multiple data sources or metrics.

    COVID-19 case data, once our best window into the virus’ spread, are becoming much less reliable thanks to a decline in PCR testing. Other singular metrics have their own flaws: hospitalization numbers often lump together patients admitted for severe COVID-19 symptoms with those who tested positive while admitted for other reasons; wastewater data are unevenly reported across the country and can be hard to interpret; death data lag significantly behind transmission trends, and so on.

    As a result, it’s important to check a few different metrics rather than relying on just one. For example, you might notice that my “National numbers” posts these days typically cite cases, hospital admissions, and wastewater together to identify national trends.

    Similarly, if I were trying to identify what’s going on in New York City, where I live, I would likely look at: case and test positivity data from the city health department, cases in public schools (which include positive at-home test results) compiled by the department of education, and wastewater data from Biobot, focusing on the northeast region and counties in the greater NYC area.

    In May, I wrote a post listing datasets that I’d recommend looking at during the Omicron subvariant surge. Much of that advice still holds true, two months later. Here’s the summary (though you should check out the full post, if you haven’t read it):

    • Case rates are still useful, if we acknowledge that they are undercounts.
    • Hospitalization rates are useful, particularly new hospital admissions.
    • The CDC’s old transmission level guidance is still actually pretty helpful for guiding health policies, especially for vulnerable populations.
    • Look at wastewater surveillance, if it’s available in your area.
    • The COVID Cast dashboard, from Carnegie Mellon University’s Delphi Group, is another helpful source.

    Look at multi-week trends.

    Just as you don’t want to rely on a single metric, you shouldn’t look at only one week of data. (Looking at just one or two days at a time is an even worse idea.) This has always been a good rule for interpreting COVID-19 numbers, but it’s even more true now, as many public health departments have fewer resources devoted to tracking COVID-19—and may take more time to compile data for a given day or week.

    For example, the New York City health department’s daily updates to its COVID-19 dashboard frequently include changes to case numbers for prior days, in addition to new data for the past day. Experts call this “backdating”: in a data update on a Friday, new cases might be dated back to other days earlier in the week, changing broader trends.

    Keep in mind data reporting schedules.

    You especially need to be wary of backdating when there’s a holiday or some other interruption in reporting. For this reason, it’s important to keep track of reporting schedules: know when a health department is and is not updating their data, and interpret the data accordingly.

    The biggest example of this is that most state and local health departments—and the CDC itself—are no longer updating COVID-19 data on weekends. In most places, every Saturday and Sunday is now essentially a mini-holiday, with numbers from those days incorporated into backdated updates on Mondays. (And then edited in further backdated updates on later weekdays.)

    When I volunteered at the COVID Tracking Project, we regularly observed lower COVID-19 numbers on weekends, followed by increases towards the middle of the week when states “caught up” on cases that they didn’t report over the weekend. You can read more about this trend here; I suspect it has only become more pronounced as more places take weekends off.

    Acknowledge uncertainty in the data.

    This is the most important recommendation I can give you. Every COVID-19 number you see comes with a margin of error. Sometimes, we can approximate that margin of error: for example, we can estimate how far official COVID-19 death statistics might be off by looking at excess deaths. Sometimes, we really can’t: estimates of how far official case numbers might be off range from a factor of three to a factor of thirty.

    As a result, it’s often helpful to look at trends in the data, rather than trying to approximate exactly how many people in your town or county have COVID-19 right now. Is transmission trending up or down? Are you at high risk of encountering the coronavirus if you go to a large gathering? These questions can still be answered, but the answers will never be as precise as we’d like.

    Follow leaders from your local healthcare system.

    To augment official data sources, I often find it helpful to see what people in healthcare settings are saying about COVID-19 trends. Experts like Dr. Craig Spencer (who works in an ER in NYC) and Dr. Bob Wachter (who leads the University of California San Francisco’s department of medicine) frequently share updates about what they’re seeing in their practices. This kind of anecdotal evidence can help back up trends in case or hospitalization data.

    In a similar vein, you can look to essential workers in your community, like teachers and food service workers, as early indicators for transmission trends. If NYC teachers and parents are talking about more cases in their schools, for example, I know COVID-19 spread is increasing—because schools are often sources for transmission in the broader community.

    Keep your goals in mind.

    As you monitor COVID-19 numbers, it’s important to remember why this information is valuable. What are you using the numbers for? Are you making choices about when to put a mask on, or when to rapid test before a gathering? Are there high-risk people in your family or your broader social network whom you’re trying to protect? Or, if you’re a journalist, what questions are you trying to help your readers answer?

    Keeping track of COVID-19 data and news can feel like a large burden, especially when it seems like so many people have entirely forgotten about the pandemic. I always find it helpful to remember why I do this: to stay informed about this ongoing health crisis, and to keep others in my community safe.

  • Introducing a new resource page on wastewater data

    Introducing a new resource page on wastewater data

    North Carolina is one of 17 states that maintains its own wastewater surveillance dashboard, independent of the CDC’s.

    As official COVID-19 case data become less and less reliable, wastewater surveillance can help provide a picture of where and how much the virus is spreading. This week, I put together a new COVID-19 Data Dispatch resource page that outlines major national, state, and local wastewater dashboards across the U.S.

    Of course, wastewater surveillance is not capable of completely replacing clinical data. Wastewater testing is still pretty spotty across the country (though almost all states are now represented on the CDC’s dashboard), while scientists and public health officials are still working to determine how best to interpret and use these data; see my April FiveThirtyEight article for more on these challenges. There are also equity concerns around which communities have access to wastewater surveillance, as discussed in this recent paper from Colleen Naughton et al.

    Still, if you live in a place where wastewater data are publicly available, I highly recommend keeping an eye on these numbers. Trends in wastewater data tend to closely match—or preempt—trends in case data, and wastewater testing includes everyone in a sewershed regardless of their access to (or interest in) getting a PCR test. This is one of the best COVID-19 indicators we have right now.

    In the U.S., there are currently two main national wastewater dashboards:

    • CDC’s National Wastewater Surveillance System (NWSS) dashboard: This dashboard presents data from about 800 sewershed sites across the country, including both those managed by state and local health departments and those tested through the CDC’s contract with Biobot. Different data providers have different testing and analysis methods, which can make it difficult to interpret the information here on a national scale. But, if your state or county is represented on the dashboard, you can click into an individual site to see coronavirus trends. Historical data are available for download here.
    • Biobot Network dashboard: In addition to the company’s contract with the CDC, Biobot also tests wastewater at hundreds of sites across the country though its free Biobot Network, as well as through paid contracts with individual health departments and wastewater treatment plants. Biobot presents data from these non-CDC sites on its dashboard, updated weekly. One advantage of the Biobot dashboard over the CDC’s is that all Biobot sites are tested and analyzed with a uniform methodology, making the data easier to interpret. Data are available for download here.

    My resource page also links out to COVIDPoops19, a dashboard summarizing wastewater monitoring efforts around the world. Run by researchers at the University of California Merced, this project links out to almost 150 public and academic wastewater sites. If you’re looking for wastewater surveillance in your area, this dashboard may be a good place to check.

    At the smaller level, my page includes 17 statewide wastewater dashboards, seven at the local level (dedicated to a specific city or metropolitan area), and four at the regional level (representing multiple counties in a state).

    While many more states are doing wastewater surveillance, the majority of state health departments have not yet developed their own dashboards—redirecting residents to the CDC NWSS site. Personally, I think some state-specific dashboards are much easier to navigate and interpret than the CDC’s, and would like to see more states produce their own. But I understand the resource limitations here.

    Here are a few state and local dashboards I’d like to highlight:

    • Boston, Massachusetts: The Massachusetts Water Resources Authority’s dashboard is one of the oldest in the U.S., launched in spring 2020 through a partnership with Biobot. It’s fairly simple (presenting static images, not interactive dashboards), and easy to interpret, with charts showing long-term and short-term trends.
    • Colorado: Colorado’s dashboard follows a common format for presenting wastewater surveillance data: users are presented with a map of wastewater service areas, and can click into a specific area to see coronavirus trends for that sewershed. This state is also planning to expand wastewater testing to schools and other specific buildings, according to local reporting.
    • Maine: Maine’s wastewater “dashboard” is really a collection of PDF reports, posted for individual counties at regular intervals. The PDFs come directly from Biobot, which is running the state’s surveillance through a contract with the Maine CDC; I find it interesting to see the report format Biobot is using for its clients.
    • New York State: Researchers at Syracuse University, the State University of New York (SUNY), state departments of health and environmental conservation, and others collaborate on this wastewater surveillance project, which includes 54 counties and 90 treatment plants. Notably, the project does not include the five boroughs of New York City; the city has its own wastewater surveillance effort, but does not have its own dashboard. (NYC sites haven’t been updated on the CDC dashboard since April.)
    • North Carolina: Similarly to Colorado’s, North Carolina’s wastewater dashboard allows users to click into specific sites for coronavirus trends. This dashboard also provides reported case trends for comparison and information about concentration percentiles, similar to the metrics used by the CDC. It also gives users a lot of information about where the data come from—good for transparency!
    • Twin Cities, Minnesota: The Metropolitan Council, a local agency in the Twin Cities, Minnesota metro area, has monitored COVID-19 in wastewater since early in the pandemic; I shared an interview with a lead scientist there in April. Recently, the Met Council added variant information to its dashboard, showing which versions of the virus are currently driving spread (BA.5 is taking the lead right now).

    I know (from looking at the COVIDPoops19 dashboard) that my new resource page includes a small sample of academic and local wastewater sites; I chose to focus on those at the state level and for larger metro areas due to my own capacity. But if there’s another dashboard that you’d like to see added to the page, please reach out and let me know! I’ll try to keep it updated on a monthly cadence.

    More wastewater reporting