National Academies Release COVID-19 Data Guide for Decision-Makers
News Release | June 11, 2020
The rapid expert consultation says that decision-makers should consider five criteria when evaluating COVID-19 data: representativeness, potential for systematic under- or over-estimation, uncertainty, time range, and geographical area.
The rapid expert consultation summarizes the benefits and drawbacks of seven specific COVID-19 measurements that decision-makers can consider as they use these measurements to respond to the outbreak:
- Number of confirmed cases: This measure is readily available, but is likely to substantially underestimate the prevalence of COVID-19 in the population. As testing expands to include populations with less severe symptoms and asymptomatic individuals, this measure will become increasingly useful.
- Hospitalizations: Hospitalization data are typically available in real time, though there may be uneven volume of reporting on certain days. This measurement reflects only the most severe cases of infection, but as the proportion of hospitalizations to confirmed cases declines, it likely reflects a decline in the total number of infections in a community.
- Emergency department visits: In some places, emergency department visits are available at the local level in close to real time. These data are most useful in the early stages of an outbreak, or to assess resurgence, though it should be noted that patients with symptoms were exposed up to two weeks earlier.
- Reported confirmed COVID-19 deaths: Reported COVID-19 deaths reflect the state of the outbreak several weeks prior, due to the long course of COVID-19 infection.
- Excess deaths: Compared with the other measurements reviewed, excess deaths are the best indicator of mortality impacts of the pandemic. However, because of the potential for death misclassification, excess deaths represents a mix of confirmed COVID-19 deaths and deaths from other causes.
- Fraction of viral tests that are positive: While widely used, this may not be a good indication of the prevalence of the disease, and may tend to be an overestimate, as the people tested are often not representative of the population. Understanding of the utility of antibody testing is still evolving.
- Representative prevalence surveys: Representative prevalence surveys, in which a representative sample of people are selected and tested, are the best strategy for understanding the prevalence of the disease in any given population. Such surveys can be undertaken for specific populations, such as in a workplace, nursing home, or prison. However, gathering this data requires undertaking a special study and is not available from routinely collected data. Many public health agencies have the capacity to undertake such surveys.
A new interactive web tool, also released today, is designed to help decision-makers dive further in to the strengths and weaknesses of these seven data types.
“Our intent is not to discourage decision-makers from using any of these data, as they represent the best of what is available,” said Mary Bassett, co-chair of SEAN’s executive committee and director of the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University. “Rather, the goal of our rapid expert consultation is to clarify the limitations of these data points and help leaders as they make decisions, such as when to allow public gatherings or reopen businesses.”
“This is our network’s first official response, and we’re well-positioned to address other questions from governors, mayors, city councils, and other leaders grappling with how to respond to the outbreak,” added SEAN executive committee co-chair Robert Groves, executive vice president and provost at Georgetown University. “Social science is uniquely poised to help weigh risks, understand the causes and consequences of people’s behavior, and guide informed decisions forced to be taken under uncertainty.”
SEAN is a collaboration between the National Academies of Sciences, Engineering, and Medicine and the National Science Foundation. This project is affiliated with the National Academies’ Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats. The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln.
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