Breakthrough Covid Case Report Holes Prevent CDC Response

This critical data stream gap raises questions about the ability of the Biden administration to detect and respond to changes in viral behavior (such as the rapid spread of delta mutants congested with other strains) and vaccine performance. increase. It also emphasizes that 18 months after the pandemic began, the CDC and public health departments across the country are struggling to collect and investigate important Covid-19 information.

“I think it’s really difficult [for the CDC] To interpret the results or to interpret the data when only some jurisdictions are reporting [breakthrough infections]”. Teresa Sokol, chief epidemiologist in the Louisiana Public Health Department, is working closely with the CDC to study breakthrough infections. “I know that some jurisdictions do not even have access to vaccination data. They have no authority or permission.”

Many of the hurdles faced by the CDC and state authorities trying to collect data in the delta variant era are the result of patchwork in public health agency data systems, many of which cannot communicate with each other. For more than a decade, the state has sought funding from the federal government to make it easier to electronically collect and study disease trends. NS The pandemic overloaded those mysterious systems, Clarify the disorganized nature of public health reports and case investigations.

The CDC has allocated tens of millions of dollars this year to help the state address data issues., However, federal and state officials said it would take years for the United States to rebuild its public health infrastructure.

Meanwhile, years of negligence have again hampered state and federal authorities as they seek to contain Delta variants. Already this summer, new infectious diseases and hospitalizations are skyrocketing in the South and Midwest. It is now beginning to hit the northwest, including Oregon and Washington, where case rates are rising.

“Nothing has changed since the pandemic began,” said one senior health official in Biden. “We are still dealing with this patchwork system — and it keeps us failing.”

Of particular concern to health officials today is how rapidly the delta mutant spreads, whether it reduces the effectiveness of the vaccine, and whether it causes more serious illness.

CDC executives told POLITICO that the State Health Department’s reporting system is one of several tools the agency uses to analyze breakthrough infections. The CDC receives hospitalization data in several other ways, including from an established network drawn from a particular medical facility.Conducting targeted research on vaccine efficacy Frontline healthcare professionals, and residents of New York and Los Angeles, Released a second slate of findings on Tuesday.

However, most of the data on breakthrough infections is provided by the state health department via hospitals. The CDC updates statistics on breakthrough infections and mortality in inpatients weekly for a week or two.

State health officials can investigate data reported by hospitals, including lack of information on individuals of incorrect gender and age, and vaccination status, such as the type and status of injections received by individuals. He said he often finds errors. Fully vaccinated. There is also a significant delay (sometimes more than two weeks) in reporting from the state to the CDC, as hospital electronics do not automatically track breakthrough infections. The doctor must do it manually.

The CDC conducted a small survey using a subset of states to supplement data on inpatient cases from a reporting network of 50 states, including mild cases that do not send people to hospitals. We are investigating a breakthrough infection. The states participating in this small study can collate lab reports with immunization records, but do not maintain their own database of hospitalization data. They collect the information from the hospital and pass it to the CDC.

Louisiana epidemiologist Sokol said: “You can’t do that because of hospitalization. We rely on individual reports from the hospital. And some report well, others don’t. So it’s not perfect. I know that. “

State health officials say comprehensive data on breakthrough infections suggest that the proportion of these cases in their jurisdiction is higher than hospitalizations indicate. And the number of new infections continues to grow.

As of last week, the CDC said Received reports of 9,716 patients A breakthrough infectious disease that was hospitalized or died. In Louisiana, where cases are still booming, health officials counted 14,650 breakthrough infections as of last week. This is an increase of 4,700 from the previous week, the largest increase in the week since Louisiana began tracking breakthrough infections, Sokol said.

Louisiana is participating in the CDC’s small state survey of all sorts of breakthrough infectious diseases. However, Sokol said her department does not have reliable data that makes it possible to estimate what percentage of all breakthrough infections led to hospitalization.

However, the state can devote its staff to collating immune records with Covid-19 lab reports when dozens of health departments across the country are struggling to keep up with case studies.

Karen Landers, an adviser to the Alabama Department of Health, said the state is trying to track down all breakthrough infections, regardless of hospitalization. But the job is too overwhelming for weeks. Health officials are also stuck trying to persuade people to get vaccinated, process test reports, and make sure that state hospitals have enough ICU space for their children.

Wyoming’s local health authorities also said it was unclear if there were enough staff to track breakthrough infections other than the latest information sent by the hospital to the state health department.

The CDC’s fight to improve data on breakthrough infectious diseases has been attacked by senior Biden officials and outside health professionals for approving booster shots for all adults. Critics say the data released by the CDC on breakthrough infections, including a cohort study showing weakened immunity to vaccines in New York residents, are not conclusive enough to justify booster immunity. Insist. Many say the US government should instead donate more doses abroad before giving Americans a booster to end the pandemic and help end it.

For weeks, the CDC says it has unpublished data on breakthrough infections that support Booster’s decision. On Tuesday, he published a study focusing on front-line healthcare professionals, showing that the Covid-19 vaccine provides strong protection against hospitalization and death, but its effectiveness in preventing infection has diminished altogether. increase. One analysis examined the vaccine efficacy of front-line healthcare professionals. Other effectiveness tracked among residents of Los Angeles.

White House officials are increasingly complaining to the CDC that the government tends not to share data when making major pandemic policy decisions on everything from masks to school reopening. Two other senior Biden officials are working on the federal government Covid-19. The response told POLITICO.

“I don’t have a clear understanding of what the data really says about delta variants, transmissions and boosters,” said one of those officials.

CDC officials are collecting the best possible data on a variety of topics related to Covid-19’s current status, and gaps in current data at the state level and within hospitals clarify national conditions. It claims to limit its ability to evaluate.

“These issues don’t magically fix overnight,” said a CDC official.