Disease Tracking and Surveillance
Disease surveillance helps us detect disease cases, understand burden of disease and risk factors, provide the basis for timely and informed decision-making, guide control measures, and monitor impacts. Since the onset of COVID-19, surveillance efforts have worked to provide real-time tracking and forecast data, despite challenges with diagnostic capacity, case reporting, insufficient contact tracing, and fragmented data systems. COVID-19 has highlighted the need to invest in modern data systems, expand and skill up the workforce, and ensure data reporting and interpretation retain high ethical and epidemiological standards.
- COVID-19 data tracking: Surveillance data provides us essential information about burden and distribution of disease in terms of person, place, and time. Specific COVID-19 tracking metrics include number and proportion of positive tests, vaccinations, hospitalizations, viral reproduction numbers, and deaths, among others.
- Surveillance guidance: Valid and reliable data require consistent definitions, surveillance strategies and reporting. Guidance exists to support the public health workforce in implementing surveillance strategies, expanding surveillance, partnering on site surveillance, and reporting cases as part of a national surveillance system.
- The future of disease surveillance: Needs and challenges of COVID-19 have led to expansions and innovations, including social media- and internet-based surveillance, use of apps for contact tracing and self-reporting, wastewater surveillance, and syndromic surveillance. Future, integrated disease surveillance should reflect core principles of population-based monitoring; scaled laboratory confirmation; digitized data and surveillance systems; standardized case definitions and common data elements; and adequate funding.
Equity & Systems
Integration of common demographic data elements, like race, ethnicity, age, gender, place of residence, occupation, and income among others allows us to disaggregate data by these important factors in order to better understand health disparities and act to disrupt them. Expanded use of social epidemiology measures, for example social vulnerability, income inequality and other social determinants of health, can elucidate inequities in access to vaccines and other interventions.
This article highlights the importance of and need for reliable, high-quality COVID-19 surveillance data. It provides a detailed chart of suggestions on how to improve the validity and interpretation of COVID-19 data by laying out commons issues, examples of misleading statements, and advices on how to better collect, display, and convey data.
This article describes gaps in the data on COVID-19 that threaten our public health response, and calls for the rapid adoption of a uniform short digital form for COVID-19 testing and surveillance.
Public Health Authority
The authority to act to protect and promote the public's health has emerged over the course of our Nation’s history, and has enabled many of modern public health’s greatest achievements. Today, public health agencies use their authority to promote health, prevent the spread of infectious disease, protect against environmental hazards, advance equity and assure local public health infrastructure and health services. During declared emergencies, state and federal authorities have broader powers to act to assist governments, suspend or modify legal requirements, pass and enforce law and expend funds for the health, safety and welfare of society. Recently, some states have moved to limit public health powers. Such efforts pose a mounting challenge for public health’s response to COVID-19 and future threats.