Current COVID-19 Infection Surveillance, Data Desert Gaps, and Pandemic Preparedness


Surveillance data such as hospitalizations and wastewater metrics provide real COVID-19 prevalence numbers, but do we need to do more to be prepared ahead of another potential health crisis?

In summers past—well, through 2020—COVID-19 surges during the summer were a worrisome and frustrating trend. For many, the thought of a respiratory virus surging in the summer seemed out of place. During this time of the pandemic, the summer represented a potential reprieve where the outdoors could provide a bit of flexibility in the intense masking and distancing that we had become accustomed to. Now though, we are starting to see a small shift in cases that could indicate a summer surge, albeit likely smaller than years past.

Biobot is reporting wastewater surveillance data rising, which is at 325 copies/mL of sewage, on July 26; this is an increase from 168 copies/mL on June 14th. Wastewater surveillance is a helpful tool—like batch testing—to help maintain some gage of COVID in the community, but at a more cost-conscious level given the state of the pandemic and the drop in clinical testing. The challenge though, is that testing outside of this has become extremely limited.

Read this recent article on the value of wastewater surveillance and infection prevalence and how it can an accurate predictor of case loads.

The CDC has pulled back on COVID data reporting as the United States, and the world, moved away from the emergent state of the pandemic, into a more sustained approach. With this though, comes a data void, where we no longer have the same level of accessibility to testing and thus reporting of cases. The access to at-home tests is a hugely helpful tool to ensure people can easily get COVID tests, but this also translate to a gap in reporting of cases, as those tests are not reported to health departments. This is just the tip of the iceberg in terms of the new COVID data deserts that exist, which is why we rely more heavily on wastewater surveillance and hospitalization data now.

The CDC has reported a 12.1% increase in hospitalizations in the last week— what we’re seeing now is a 8035 COVID hospital admissions, which is 2.42 per 100,000. For context, in January 2021 there was a high of 115k new weekly hospital admissions, and during the Omicron surge, in January 2022, there were 150k new weekly admissions due to COVID. Meaning that this increase is something to keep an eye on but doesn’t represent the surges we used to experience.

Katherine Wu, PhD, noted, “With so much of the world now infected, vaccinated, or both, and COVID mitigations almost entirely gone, the global situation is less in flux now. The virus itself, although still clearly changing at a blistering pace, has not pulled off an Omicron-caliber jump in evolution for more than a year and a half. But no one can yet promise predictability.”

Right now, the biggest issue we face is to maintain a consistent and sustainable level of investment in public health and pandemic prevention. The cycle of panic-neglect is real when it comes to how the United States approaches infectious disease threats and pandemic readiness. Even now, we are struggling to re-authorize the Pandemic and All Hazards Preparedness Act, which is a critical piece of national biosecurity work. It’s ultimately up to us to decide how ready we’ll be for the next outbreak.

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