To Fight Covid-19, the U.S. Needs a More Detailed View
(Bloomberg Opinion) -- Americans have a good sense of how the Covid-19 pandemic is going in their country: very badly. Infections, hospitalizations and deaths just keep rising. By Tuesday, the case count was over 4 million, more than a quarter of the global total, and U.S. deaths had climbed above 149,000. Per capita, the American death rate is the fourth highest in the world.
Yet these statistics provide an imprecise picture. They suggest things are bleak, but say almost nothing about how to make them better. For that, officials need to see where exactly outbreaks are occurring and whether the measures they’re taking to defeat Covid-19 — including mask-wearing, testing and treatment — are working. The U.S. needs to know more specifically which people are being infected and where they’re picking up the coronavirus.
The failure to collect such information can largely be blamed on the Trump administration, which has demonstrated a reckless disregard for transparent recordkeeping, going so far as to undermine the role of the Centers for Disease Control and Prevention in gathering hospital data. From the start of the outbreak in the U.S., a well-functioning CDC would’ve gathered clear, uniform information about infections and the actions taken to address and prevent them.
Because this hasn’t happened, states have concocted their own dissimilar reporting systems, many of which are grossly inadequate. A recent review found that many states fail to promptly report daily statistics, and many offer only raw case counts without showing whether rates of infection are rising or falling. Hardly any states gather and publicize detailed statistics on testing and contact tracing. Most do not show how many health-care personnel are being infected. Not one reports test turnaround time — a growing problem in the U.S. because of the overwhelming case counts — or how soon after a positive test people are isolated.
Countries that report standard national data on the virus — including Germany and South Korea — have done a better job of controlling the pandemic. And it’s no wonder: Public-health officials need to see where infections are occurring and what works to control them. Detailed data also helps them to see whether things that seem true really are — that outdoor gatherings are relatively safe, for example, or that most infections come from friends and family members.
That leaves the question of exactly what data states should be providing. One group of experts — Resolve to Save Lives, a nonprofit that receives funding from Bloomberg Philanthropies — has compiled a useful list. It includes much data that states could report almost immediately, including per-capita case rates by date, the share of infections that can be traced to other cases, rates of testing per capita, the share of tests coming up positive, hospitalization rates, outbreaks in big facilities (such as nursing homes, prisons and meatpacking plants), and death rates. Other data might take a bit longer to gather — including test turnaround time, the share of infected people who are interviewed for contact tracing, and the percentage of people who wear masks on public transit and in stores or other indoor public places.
All such records should be broken down by age, sex, race and ethnicity. They should include numbers of patients who have recovered. And they should be published in a standardized manner that the public can readily understand. Finding measures to publicize recoveries could help fill out the picture, underscoring that the pandemic is navigable.
Ideally, the CDC would collect these statistics and provide a national dashboard of Covid-19 data, always up to date. Perhaps that will be possible in 2021, if the CDC gets new leadership. In the meantime, states that want to heal their economies by suppressing Covid-19 should collect this essential information and make it public on their own.
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