Despite improvements in diagnostics over the past two years, they say, some recent developments do not bode well:
– The more people who test COVID-19 quickly at home, the fewer people get the gold-standard tests that the government relies on for case counting.
োগ Centers for Disease Control and Prevention will soon use fewer labs to look for new forms.
Health officials are increasingly focusing on hospital admissions, which are increasing as time goes on.
A wastewater monitoring program remains as a patchwork that still cannot be counted for the data needed to understand incoming growth.
– White House officials say government funding for vaccines, medical care and testing is running out.
“We’re not in a very good position,” said Jennifer Nujo, an epidemiologist at Brown University.
Scientists acknowledge that the widespread availability of vaccines and treatments has put the nation in a better position than before the epidemic began, and that observation goes a long way.
For example, scientists this week talked about a 6-month-old program that tests international travelers flying at four U.S. airports. On December 14, genetic testing of a sample turned out to be a coronavirus variant – a descendant of Omicron, also known as BA.2 – seven days earlier than any reported identification in the United States.
More good news: US lawsuits, hospitalizations and deaths have been declining for weeks.
But different elsewhere. The World Health Organization reported this week that the number of new coronavirus cases worldwide has risen for two consecutive weeks, probably because COVID-19 immunizations have been discontinued in many countries and because BA.2 has spread more easily.
Some public health experts aren’t sure what that means for the United States
BA.2 accounts for the growing share of U.S. cases, the CDC said – more than one-third nationally and more than half in the Northeast. Hospital admissions in New York and New England have seen a slight increase in overall case rates.
Katrina Shea of Penn State University noted that some states in the northern United States have the highest rates of BA.2, but some have the lowest case rates.
Dr. James Muser, an infectious disease specialist at Houston Methodist, called the national case data for BA.2 “vague.” He added: “All we really need is as much real-time data as possible … to make decisions.”
Here’s what the COVID-19 trackers are seeing and what scientists are worried about.
Test numbers were at the root of the understanding of coronavirus spread from the beginning, but they were always inaccurate.
Initially, only sick people were tested, which meant people who missed the case count who had no symptoms or who were unable to swab.
Home test kits became widely available last year, and demand fell when omicron waves hit. But many people who take the test at home do not tell anyone the result. Health agencies do not even try to collect them.
Mara Aspinall is the managing director of an Arizona-based consulting firm that tracks COVID-19 testing trends. He estimates that in January and February, an average of about 8 million to 9 million rapid home tests were performed daily – four to six times the number of PCR tests.
Nuzzo said: “Case numbers are not a reflection of reality as before.”
Hunting for variants
In early 2021, the United States lagged far behind other countries in using genetic testing to detect worrying virus mutations.
A year ago, the company contracted 10 major labs to perform that genomic sequencing. The CDC will reduce that program to three labs in the next two months.
The weekly volume of sequences performed through contracts was much higher during the Omicron wave in December and January, when more people were being tested and had already dropped to about 35,000. By the end of the spring, it will drop to 10,000, although CDC officials say the contracts allow for an increase of more than 20,000 if necessary.
The company added that the new agreement improved turnaround time and quality and did not expect the change to harm its ability to find new variants.
External experts have expressed concern.
“This is actually a significant reduction in our baseline surveillance and intelligence systems to track what’s going on there,” said Brownwin McInnis, director of pathogen genomic surveillance at the Broad Institute of MIT and Harvard.
An evolving monitoring system is looking for coronavirus symptoms in sewers, which could potentially capture an alcoholic infection.
One week after the researchers linked the wastewater samples to a positive COVID-19 test number, it suggested that health officials could get an early indication of the tendency to infection.
Some health departments have also used sewers to look for alternatives. New York City, for example, detected signs of the Omicron variant in a sample taken on November 21 – about 10 days before the first case was reported in the United States.
However, experts believe that the system does not cover the whole country. It doesn’t matter who is infected.
“It’s a really important and promising strategy, no doubt about it. But the final value is probably not yet understood, “said Dr. Jeff Duchin, a health officer in Seattle / King County, Washington.
Last month, the CDC outlined a new set of arrangements for the decision to lift the mask-wearing rules, focusing less on positive test results and more on hospitals.
Hospitalization is a lagging indicator, as a week or more may pass between infection and hospitalization. But many researchers believe the change is appropriate. They say hospital data is more reliable and more easily interpreted than case numbers.
The gap is not as long as one might think. Some studies have suggested that many people wait to be tested. And when they finally do, the results are not always immediate.
Spencer Fox, a data scientist at the University of Texas who is part of a team that uses hospital and cellphone data to predict COVID-19 for Austin, said “hospitalization is a better signal than growth test results.”
However, there are concerns about future hospital information.
If the federal government withdraws its public health emergency declaration, officials will lose the power to force hospitals to report COVID-19 data, a group of former CDC managers recently wrote. They called on Congress to pass a law that would give permanent authority “so we do not risk becoming blind with the emergence of health threats.”
AP reporter Lauren Nirgard in Washington and Laura Unger in Louisville, Kentucky have contributed.
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