In a move that marks a turning point in the COVID-19 public health crisis, the Centers for Disease Control and Prevention's (CDC) Covid Data Tracker, a once-revered source of information regarding the number of COVID-19 cases in the United States, has made its penultimate update. The final one will occur on June 1, 2023, to reconcile historical data; after that, the CDC will no longer track such numbers, at least not comprehensively.
When the SARS-CoV-2 virus first swung tore across the world, the CDC's COVID-19 Data Tracker emerged as a beacon of statistical knowledge, illuminating the changing landscape of transmission within American communities. Its real-time updates, which counted cases and deaths daily, were a lifeline for individuals seeking clarity in a time of uncertainty.
In October 2022, after two years of publishing daily, the tracker shifted to weekly updates. But now, because the country's public health emergency declaration is expiring, the CDC will no longer be tracking COVID-19 case counts — not even on an occasional basis. Instead, it will merely track hospital admissions and wastewater samples, which only account for 40 percent of the population.
In other words, this marks the end of the federal government's effort to comprehensively track COVID-19 cases in the United States.
The shift in COVID-19 surveillance certainly marks a big moment in the pandemic — one in which rising case counts no longer matter, but instead only hospitalizations and deaths. Is this the right move? Or does this herald the beginning of a new era of ignorance — in which the federal government is intentionally ignoring data regarding a virus that remains the fourth leading cause of death, and which has and continues to maim countless Americans?
Public health experts are torn over the CDC's decision. Some agree it was a mistake to cease tracking cases, or have related concerns.
But most of the experts with whom Salon spoke agree that the shift in tracking won't make that much of a difference because the country's tracking system was never very robust in the first place.
"Are we going to see another strain, family, and variant that will challenge whatever immunity that's been built up in the population?"
Dr. Eric Topol, Director of the Scripps Research Translational Institute and a professor of molecular medicine, told Salon the U.S. has never done a "very good job" of tracking COVID-19 cases in the first place, and this latest change in CDC tracking is "just an extension of that."
"I think that the big issue right now is, are we going to see another strain, family, and variant that will challenge whatever immunity that's been built up in the population?" Topol said. Topol believes that wastewater tracking and leaning on genomics sequencing — which is when scientists are able to detect a particular variant and determine its lineage — should help in the event that another variant emerges.
In September 2020, the CDC launched the National Wastewater Surveillance System (NWSS) as a means of tracking the presence of the coronavirus in wastewater samples collected across the country. The CDC said this type of surveillance can stand in as an "early warning that COVID-19 is spreading in a community." Wastewater tracking involves sampling a community's wastewater systems before waste is treated, and then analyzing those samples in a lab to measure the concentration of SARS-CoV-2 virus RNA; the data is then sent to the appropriate public health agency, and those agencies submit it to the CDC. Such wastewater sampling was crucial for detecting surges in various communities; intriguingly, it was also used to great effect to trace how often commercial aircraft wastewater contained the virus. (Planes, it seems, typically carry at least one passenger who is positive for COVID-19.)
Topol clarified that ideally public health agencies like the CDC would know that a variant was widely circulating before the point at which people were being sent to the hospital because of it.
"Obviously, you want to catch [a new variant] long before you see an increase in hospitalizations," Topol continued. "So I do think we have in place the surveillance tools, and we've never done a good job of tracking infections or transmission, and that's been a problem for some time."
Dr. Amesh Adalja, a Senior Scholar at the Johns Hopkins Center for Health Security, agreed with the CDC's decision, calling it a "justified change." He also added CDC counts have always been a "major underestimate," and became even more so with the rise of at-home testing. As Salon previously reported, most positive at-home tests weren't officially counted in public health numbers, as consumers rarely report those to any centralized agency database. Hence, as at-home tests became more popular, the overall daily CDC counts became more inaccurate.
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Topol agreed. "The CDC put out all sorts of obfuscated maps telling members [there was] a low rate of transmission when it was actually high, and it's been very confusing and it's been that way for quite some time," he said. "The virus is going to be with us for years to come, the resources are limited, and it would be better if we took the resources and put it into getting better treatments, better vaccines, and ways to treat long COVID."
Essentially, tracking COVID-19 cases, Topol said, isn't something that public health officials should "double down on," since they weren't tracked very well in the first place.
Likewise, Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California, San Francisco, told Salon she thinks this is an appropriate move by the CDC.
"Early in the pandemic, when there was little population immunity to the coronavirus, hospitalization rates roughly resembled case rates (although at a lower amplitude and more concentrated among older people)," she told Salon via email. "However, immunity to the virus leads to protection from severe disease (not all infections) and so cases and hospitalizations have become 'decoupled' over time."
Gandhi agreed that the federal government lost its ability to accurately track cases due to the increased access to at-home tests.
"Many people with mild symptoms are not tested and so case counts would not be accurate anyway," Gandhi said. "At this point, like any other endemic virus, we have to track the extent of severe disease or hospitalizations to see if a new variant has emerged that is more virulent or immune evasive, for instance."
"This is a virus that is still dangerous," LaVeist said. "There's always the chance that there will be another variant."
Gandhi noted that Singapore shifted to tracking hospitalization admissions in September 2021 after they weathered the delta variant surge. She said that COVID-19 related deaths are the lowest they have ever been (since March 2020) across the world.
Conversely, Thomas LaVeist, Dean of the School of Public Health at Tulane University, told Salon society has seemed to move on from COVID-19 and that policymakers are following suit. However, he still has his concerns regarding the end of tracking case counts.
"This is a virus that is still dangerous," LaVeist said. "This is a virus that we haven't had new problematic variants recently, but there's always the chance that there will be another variant." LaVeist said it would be his preference that the CDC tracks news cases, but recognized it's difficult to do with at-home testing.
Topol said this all boils down to the CDC's inability to have a "central control data flow," which would have been the best case scenario.
"We're not organized as a country, we're balkanized . . . and that is shown throughout the pandemic," Topol said. "We don't have the ability to track data like many other countries. Obviously, we're a very large country, but we don't have a national registry — we have to rely on large health systems."
Moving forward, for those who want to stay up to date with hospital admissions being tracked, the CDC directs people to new landing pages for hospitalizations, emergency department (ED) visits, and death data.
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