Some Thoughts on the CDC’s New COVID Indicators

Uncharitable ones. Last Friday, as the invasion of Ukraine kicked into high gear, the CDC released new COVID guidelines, “Indicators for Monitoring COVID-19 Community Levels and COVID-19 andImplementing COVID-19 Prevention Strategies.” I suppose the tl;dr version is that the CDC didn’t explain what the outcomes for each of these levels would translate into numbers of deaths and long COVID cases, and these measures are not about defining individual risk. Anyway, let’s dig deeper:

  1. One problem, as many have pointed out, is that focusing on hospitalizations is too late. By the time a surge in hospitalization occurs, community spread will be rampant because hospitalizations lag infections for a variety of reasons.
  2. The goal of these measures is to keep hospitals functioning, but they do very little to indicate your personal risk of infection. This is galling as it is clear infection prevention has been turned into an individual level responsibility, yet these indicators do not provide any assistance for those who want to avoid infection.
  3. In any realistic sense, much of the Omicron surge wouldn’t have been classified as “high”, meaning masks are required. Seems that way for D.C., and also Puerto Rico; haven’t checked other states or territories).
  4. Also, the CDC should show its work in a more technical document. This is too important not to do so.
  5. Related to point 1, while the indicators obviously incorporate hospitalizations (that’s one of the key indicators), there is no translation into what this means in terms of either deaths or long COVID (and will some journalist fucking ask what percentage of vaccinated people are expected to contract long COVID). This, of course, is contingent in no small part on vaccination status, which isn’t an indicator.
  6. There’s also a technical issue: these calculations use a denominator of county-level population, but hospitals’ catch area is typically larger than a single county.
  7. Another technical issue: at least for D.C., depending on which CDC website one looks at, the number of hospitalizations per 100,000 people is either 1.56 or 5.7. They both can’t be correct.
  8. What would be a very useful statistic that could help people would be timely release of the percentage of asymptomatic hospital patients who test positive (e.g., pregnant women, someone who comes in with a broken leg etc.). This would tell us what the community prevalence actually is, even though the patient population is somewhat skewed. This is critical for people who want to minimize the risk of infection.
  9. Related to the above, I don’t even understand the CDC’s logic or reasoning. It seems focused on hospitals, not people. People includes both the immunocompromised and others at high risk of bad outcomes if infected, along with people who are concerned about long term illness (e.g., missing work) and long COVID. One can blather on about equity all one wants, but a serious commitment to the concept would recognize that, in 2022, Year of Our Gritty, a lot of people can’t afford to get sick, never mind long COVID. By the way, you’re not the weird one if you want to avoid long COVID, even if you can afford it financially. At a fundamental level, I think the CDC’s priorities and understanding of how people live is skewed. There are a lot of people who are trying to avoid contracting COVID. If the CDC thinks that’s a foolish goal, it should go Full Iceland and admit it.

I guess the pandemic over, whether the virus ‘thinks so’ or not…

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3 Responses to Some Thoughts on the CDC’s New COVID Indicators

  1. Ted says:

    Here’s another problem with the CDC’s new metric: there are a bunch of counties here in Alabama with really low vaccination rates and really high transmission rates, but because they don’t have hospitals, now they’re considered “low risk.” Meanwhile, Jefferson county (home to the state’s largest metro area, Birmingham) has (relatively) high vaccination rates and (relatively) low transmission rates, but is considered high risk because the hospitals there are all full of unvaccinated patients from those “low-risk” counties that don’t have hospitals.

  2. Joe Shelby says:

    There’s an html error on line-item 4 (the twitter link is missing the close quotes), making this hard to read in that section.

  3. Pingback: Links 3/11/22 | Mike the Mad Biologist

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