Thursday, August 31, 2023

No News Is . . . Now Commonplace


As we approach the fall respiratory season in the Northern Hemisphere, more than 90% of the world's countries no longer regularly report COVID hospitalizations, ICU admissions, or deaths to the World Health Organization.  

The map above, from this week's WHO epidemiological report, shows the entire Western Hemisphere as a blank slate, with no updates provided since early August.  But even those few countries that have reported data have greatly reduced their testing and surveillance. 

 While presenting the available data, the WHO warns:

As countries discontinue COVID-19-specific reporting and integrate respiratory disease surveillance, WHO will use all available sources to continue monitoring the COVID-19 epidemiological situation, especially data on impact. COVID-19 remains a major threat and WHO urges Member States to maintain, not dismantle, their established COVID-19 infrastructure. It is crucial to sustain early warning, surveillance and reporting, variant tracking, early clinical care provision, administration of vaccine boosters to high-risk groups, improvements in ventilation, and regular communication.

Currently, reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally. During this 28-day period, 44% (103 of 234) of countries reported at least one case to WHO – a proportion that has been declining since mid-2022. It is important to note that this statistic does not reflect the actual number of countries where cases exist.

Data is so sparse that the WHO now reports (see table below) data based on the combined past two 28-day monitoring periods, instead of the standard past 28 days alone

Otherwise, there'd be a more than just two WHO regions with data listed as N/A on this chart. 

Among the roughly 8% of countries that are consistently reporting to the WHO, a significant portion (35%) are seeing an increase in ICU admissions. 

Among the 17 countries consistently reporting new ICU admissions to WHO, six (35%) countries showed an increase of 20% or greater in new ICU admissions during the past 28 days compared to the previous 28-day period: Ireland (16 vs six; +167%), Malta (seven vs four; +75%), Singapore (10 vs six; +67%), Latvia (five vs three; +67%), Greece (27 vs 17; +59%), and Netherlands (12 vs 10; +20%). The highest numbers of new ICU admissions were reported from Brazil (375 vs 627; -40%), Australia (82 vs 148; -45%), and Italy (57 vs 61; -7%).

But based on the increasingly inconsistent, and flimsy global reporting, it is impossible to say whether  that represents a genuine trend, or simply a blip in the data.  

I'm seeing anecdotal reports on social media (and in the press, such as this one today from Serbia) of increased hospital admissions for COVID in a few places around the globe, but without good data it is impossible to put it into any reasonable context.

The political decision to declare victory, and dismantle COVID surveillance and reporting (primarily to improve the global economy), only works as long as COVID cooperates. 

On the plus side, with surveillance like this, we will have far less time to worry about the next wave.