Avian Flu Diary: CDC COVIDView

#15,172

Regular readers of this blog are familiar with the CDC's weekly FluView Report, which tracks influenza and ILI activity, hospitalizations, and laboratory results in the United States. In a similar format, the CDC this week has launched a weekly COVIDView report.

As with influenza surveillance (see Why Flu Fatality Numbers Are So Hard To Determine), it is unrealistic to expect an accurate count of cases, and/or deaths, from COVID-19.

Many people with mild or moderate symptoms will never be tested and therefore go uncounted, and others who die due to COVID-19 may do so at home, or in a nursing home, and never be tested as well. It will likely take years to determine a reasonable estimate of the burden of COVID-19 in the United States, and around the world.

Also, many of the surveillance systems that will be used to track COVID-19 are just coming online, and it will take some time for them to become both refined and robust. Some of the data (such as P&I mortality) lags by two or more weeks.

First stop, a press release describing this new report, then we'll look at some highlights from the first edition, published yesterday.

CDC Launches New Weekly COVID-19 Surveillance Report

Media Statement
For Immediate Release: Friday, April 3, 2020
Contact: Media Relations
(404) 639-3286

CDC Launches New Weekly COVID-19 Surveillance Report

Indicators that track flu-like illness and deaths from pneumonia both elevated at this time

CDC is modifying existing surveillance systems to track COVID-19, and posted the first of what will be a weekly surveillance report called, “COVIDView.” The report, updated each Friday, will summarize and interpret key indicators, including information related to COVID-19 outpatient visits, emergency department visits, and hospitalizations and deaths, as well as laboratory data.

The first COVIDView shows:

Visits to outpatient providers and emergency departments for illnesses with symptom presentation similar to COVID-19 are elevated compared to what is normally seen at this time of year. At this time, there is little influenza (flu) virus circulation.

The overall cumulative COVID-19 associated hospitalization rate is 4.6 per 100,000, with the highest rates in persons 65 years and older (13.8 per 100,000) and 50-64 years (7.4 per 100,000). These rates are similar to what is seen at the beginning of an annual influenza epidemic.

The percentage of deaths attributed to pneumonia and influenza (P&I) increased to 8.2% and is above the epidemic threshold of 7.2%. The percent of deaths due to pneumonia has increased sharply since the end of February, while those due to influenza increased modestly through early March and declined this week. This could reflect an increase in deaths from pneumonia caused by non-influenza associated infections, including COVID-19.

The National Center for Health Statistics is monitoring deaths associated with COVID-19. Those data are available beginning today and will be featured in this report next week.

COVIDView specifically reports the following:

Virus information: This includes COVID-19 diagnostic testing data provided by public health and clinical laboratories. For example, COVIDView will include the percentage of respiratory specimens collected from patients that test positive for SARS-COV-2.

Outpatient and Emergency Department Visits: This is syndromic (i.e., not laboratory confirmed disease) data and will be reported as the percentage of outpatient visits for influenza-like illness (ILI) or COVID-19-like illness (CLI) nationally and in each of the 10 Health and Human Services (HHS) surveillance regions across the country. This data is provided through two surveillance systems: the U.S. Outpatient Influenza-like-illness Surveillance Network (ILINet) and the National Syndromic Surveillance Program (NSSP).

Severe Disease Information: This includes information on COVID-19-associated hospitalizations and deaths. The hospitalization data is provided by COVID-NET, which conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations among children and adults through a network of over 250 acute care hospitals in 14 states. Mortality data is provided by the National Center for Health Statistics (NCHS), which reports provisional death counts based on death certificate data received and coded by the National Center for Health Statistics. COVID-NET hospitalization data and NCHS mortality data are summarized in COVIDView each week, but they also each have a webpage where this data is posted (links provided below).

Additional surveillance systems and data sources, including expansions of the currently launched systems and sources of data, will be added over time.

Links for additional information:

COVIDView (A Weekly Surveillance Summary of U.S. COVID-19 Activity): https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview.html

COVID-NET (U.S. COVID-19 Hospitalization Data): https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html

Some excerpts from the first COVIDView report, but follow the link to read it in its entirety.

Updated April 4, 2020

COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity

Download and print this page [PDF-775KB]

This CDC report provides a weekly summary and interpretation of key indicators being adapted to track the COVID-19 pandemic in the United States. This includes information related to COVID-19 outpatient visits, emergency department visits, hospitalizations and deaths, as well as laboratory data.

Virus

Public Health, Commercial and Clinical Laboratories

Public health, commercial and clinical laboratories are all conducting testing and reporting testing results for COVID-19. The national percentage of respiratory specimens testing positive for SARS-CoV-2 is increasing and is now: 16.5% at public health laboratories and, 8.8% at clinical laboratories.

Data from commercial laboratories will be incorporated into this report in the coming weeks.

Outpatient and Emergency Department Visits
Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)

Two indicators from existing surveillance systems are being monitored to track outpatient or emergency department (ED) visits for potential COVID-19 illness.
Nationally, the percentage of visits for influenza-like illness (ILI) and COVID-19-like illness (CLI) is elevated compared to what is normally seen at this time.

Recent changes in health care seeking behavior are likely impacting both networks, making it difficult to draw further conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
Severe Disease

Hospitalizations

Cumulative COVID-19-associated hospitalization rates since March 1, 2020, will be updated weekly. The overall cumulative hospitalization rate is 4.6 per 100,000, with the highest rates in persons 65 years and older (13.8 per 100,000) and 50-64 years (7.4 per 100,000).

Mortality

The percentage of deaths attributed to pneumonia and influenza is 8.2% which is above the epidemic threshold of 7.2%. Deaths due to pneumonia have increased sharply since the end of February, while those due to influenza increased modestly through early March and declined this week. Deaths attributed specifically to COVID-19 will be reported next week.

Key Points

CDC is modifying existing surveillance systems, many used to track influenza and other respiratory viruses annually, to track COVID-19.

Visits to outpatient providers and emergency departments for illnesses with symptom presentation similar to COVID-19 are elevated compared to what is normally seen at this time of year. At this time, there is little influenza virus circulation.

The overall cumulative COVID-19 associated hospitalization rate is 4.6 per 100,000, with the highest rates in persons 65 years and older (13.8 per 100,000) and 50-64 years (7.4 per 100,000). These rates are similar to what is seen at the beginning of an annual influenza epidemic.

The percentage of deaths attributed to pneumonia and influenza increased to 8.2% and is above the epidemic threshold of 7.2%. The percent of deaths due to pneumonia has increased sharply since the end of February, while those due to influenza increased modestly through early March and declined this week. This could reflect an increase in deaths from pneumonia caused by non-influenza associated infections including COVID-19.