CDC Stops Monitoring Community Spread of COVID-19

Just after 5 PM on April 28 2023, a Friday, CNN.com tweeted a “breaking” story, reporting that the Centers for Disease Control and Prevention (CDC) planned to stop tracking “community spread” of COVID-19 in the United States:

In addition to the news being reported, elements of the tweet and its content benefited from contextual information. “Community spread” is a public health-related term, defined in passing in a February 26 2020 press release issued by the CDC at the very beginning of the pandemic:

The Centers for Disease Control and Prevention (CDC) has confirmed an infection with the virus that causes COVID-19 in California in a person who reportedly did not have relevant travel history or exposure to another known patient with COVID-19.

At this time, the patient’s exposure is unknown. It’s possible this could be an instance of community spread of COVID-19, which would be the first time this has happened in the United States. Community spread means spread of an illness for which the source of infection is unknown. It’s also possible, however, that the patient may have been exposed to a returned traveler who was infected.

This case was detected through the U.S. public health system — picked up by astute clinicians. This [brought] the total number of COVID-19 cases in the United States to 15 [as of February 26 2020].

CNN.com’s tweet was published at 5:14 PM on Friday, April 28 2023. An entry on political commentator Taegan Goddard’s The Political Dictionary, “Friday news dump,” excerpted a scene from the television show The West Wing, explaining:

Releasing bad news or documents on a Friday afternoon in an attempt to avoid media scrutiny is often called a “Friday news dump” by members of the media.

NPR: “Often, the White House sets the release of bad news and unflattering documents to late Friday afternoon. The Pentagon and other agencies also use the practice, a legacy of earlier administrations.”

The television show The West Wing had an episode on the technique called, “Take Out the Trash Day” … “Any stories we have to give the press that we’re not wild about, we give all in a lump on Friday.”

Not all Friday afternoon and evening news stories constitute a “Friday news dump,” but it is a common practice. CNN’s linked article cited an anonymous CDC source, and its reporting began with an indication the change was due to the anticipated expiration of a declared public health emergency:

As the nation’s public health emergency expires on May 11 [2023], the United States Centers for Disease Control and Prevention will stop reporting its color-coded Covid-19 Community Levels as a way to track the spread of the infection.

Instead, the CDC will keep tabs on Covid-19 largely by tracking hospitalizations in some areas, according to a source familiar with the agency’s plans.

Within the hour, NBC News reported that the agency confirmed it planned to “stop tracking the spread of Covid in communities across the U.S.” According to CNN.com, the color-coded system was introduced in February 2022; the article continued:

The end of the public health emergency will mean that the government no longer has the authority to require labs to report their Covid-19 testing data, which will impact the ability to calculate a metric called percent positivity.

Covid-19 is a reportable condition, so doctors will still have to report cases to public health officials, but the frequency of that reporting may change. New Mexico, for example, has said that it will report its cases on a monthly basis going forward.

“Some of the metrics simply cannot be sustained, because of the change in data reporting,” the person said.

On April 30 2023 (two days after CNN’s CDC report), the New York Times published an editorial, “Our Covid Data Project Is Over, but the Need for Timely Data Is Not.” Its four authors lead the effort to build the Johns Hopkins Coronavirus Resource Center; they began the piece lamenting their growing inability to access timely data about community spread:

The four of us [authors Beth Blauer, Lauren Gardner, Sheri Lewis and Lainie Rutkow] spent the last three years immersed in collecting and reporting data on Covid-19 from every corner of the world, building one of the most trusted sources of information on cases and deaths available anywhere. But we stopped in March [2023], not because the pandemic is over (it isn’t), but because much of the vital public health information we need is no longer available.

This is a dangerous turn for public health. The data on cases and deaths is critical for tracking and fighting the coronavirus, which has killed more than 1.1 million people in the United States and nearly 6.9 million worldwide. For the week of April 13 to April 19 [2023], 1,160 people were reported to have died from the virus in the United States. This is, in all likelihood, an underestimate.

Unfortunately, nearly all states have stopped frequent public reporting of new cases and deaths, making it difficult to enable us to see how the virus is trending. And the widespread use of at-home tests has meant that most positive results almost never get recorded in public health databases, making it virtually impossible to detect and monitor outbreaks in a timely way.

Subsequently, the authors explained:

The seven-day averages of cases and deaths still reported weekly by the C.D.C. is valuable but of limited use for spotting and reacting to trends. As testing data has declined and the public health emergency is about to end, hospitalization data collected and reported by the U.S. Department of Health and Human Services is the best information available, but it is insufficient to fully track and understand the pandemic because hospitalizations lag several weeks beyond infections.

Less than half an hour after CNN’s tweet about the CDC no longer tracking community spread, the Washington Post published the paywalled article “CDC meeting, intended to mark covid progress, sees virus cases of its own.” We accessed an archived copy, which reported:

The staff dedicated to investigating disease outbreaks for the Centers for Disease Control and Prevention received a reminder [on April 28 2023] of the pandemic’s persistence: confirmed covid cases at their own conference.

“We’re letting you know that several people who attended the [Epidemic Intelligence Service] Conference have tested positive for COVID-19,” a CDC branch chief wrote in an email to staff on Friday [April 28 2023] and obtained by The Washington Post, adding that at least one person at the division’s recruiting event on Wednesday had tested positive … A CDC official said the agency was “aware” of several confirmed cases that could be connected to the conference, but cautioned “the cases we’re aware of at this time should not be referred to as an ‘outbreak.’”

“These cases are reflective of general spread in the community. It’s not news that public health employees can get COVID-19,” CDC’s Kristen Nordlund wrote in an email.

Just after 5 PM on Friday April 28 2023, CNN published a “breaking” story reporting that the CDC planned to “stop reporting its color-coded Covid-19 Community Levels as a way to track the spread of the infection.” Less than an hour later, NBC News reported the confirmed spread of COVID-19 at a recent CDC conference. On April 30 2023, four prominent experts in public health authored a New York Times editorial warning of a “dangerous turn for public health” in terms of the quality of COVID-19 data available to epidemiologists.