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To Fight Pandemics, We Need Better Data

Topic: To Fight Pandemics, We Need Better Data

The United States has had many problems coping with the coronavirus. A critical — and underappreciated — problem is bad data, which makes coping more difficult.

We still don’t know how many people have the virus, how many are hospitalized, how many are in intensive care units, and how many are on ventilators. There is poor data on testing availability, and testing results are too often incorrect, delayed, or not counted. Contact tracing, necessary for avoiding community spread of coronavirus, lacks both the needed data and the human or technological resources to use it. And for much of the pandemic, we have not known whether medical supplies were adequate, whether equipment was even working, or how quickly we could obtain crucial items such as personal protective equipment and ventilators or ramp up to produce them domestically.

Without good data, planners can’t plan, epidemiologists can’t model, policy makers can’t make policy, and citizens don’t trust what they’re told. Bad data has led to poor decisions — behavioral and policy-oriented — which in turn have prolonged the disease and contributed to unneeded suffering and death.

Pandemics and other public health crises (such as opioid overdoses, AIDS, and SARS) occur frequently. The U.S. needs a robust program to develop and make available the trusted data needed to prevent, mitigate, and deal with them, through professional management of the data supply chain. We are losing the battle on COVID-19 data, so we must act quickly. We must put in place a system and a set of policies that can help fight future pandemics and public health crises.

The U.S. public health care system, like all industries, had many data quality problems before this pandemic. COVID-19 has brought these weaknesses into sharp relief. The Centers for Disease Control and Prevention (CDC) has played an effective role in fighting pandemics in the past, but it has focused less on a strong set of data policies and data quality standards. And the federated approach we’ve adopted to manage this pandemic, with each state choosing its own path to disease reporting and treatment, has been particularly unsuccessful.

Basic data on numbers of cases and “death due to coronavirus” are reported differently by different states. Some report presumed cases and deaths, and others do not. Some report on cases and deaths of nonresidents that occur in the state or in long-term care facilities, prisons, and business sites — and others do not. Some report on cases and deaths in all hospitals, whereas others rely on samples.

The net results are both a significant undercount and a hodgepodge of figures, making predictions and comparisons difficult. One is forced to conclude that the data needed to manage the COVID-19 pandemic is effectively unmanaged. This is an acute problem, demanding urgent, professional attention.

Topic Discussed: To Fight Pandemics, We Need Better Data

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