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About two weeks after Florida health officials discontinued publicly reporting some data and stopped issuing their daily COVID-19 summaries detailing cases, test positivity and vaccinations, some researchers remain concerned that the moves were made too early.
Even as the pandemic wanes, scientists such as Jennifer Nuzzo, a leading epidemiologist at the Johns Hopkins Center for Health Security, say that state health departments should be presenting more data, not less, while the medical and science communities continue to gauge the effectiveness of a still-fresh vaccination campaign.
“It feels like we’re running a marathon and we’re almost giving up a couple miles from the finish line,” Nuzzo said in an interview with the Miami Herald.
Many of the same COVID metrics that used to be reported by the Florida Department of Health on a daily basis remain available through federal data sources, such as the U.S. Centers for Disease Control and Prevention for cases and deaths, and the U.S. Department for Health and Human Services for hospitalizations, which used to be reported by the state’s Agency for Health Care Administration.
Those numbers are still fed by daily reporting from state health officials outside of public view — the norm prior to the pandemic.
But Nuzzo said that the public and researchers alike have lost easy access to critical details in the absence of the state health department’s reports and data, which researchers could use to tie case rises to certain age groups in different counties.
“In counties with lower vaccination rates, there remains a possibility that there’s a resurgence of cases in the fall,” she said. “In my view, data are essential for making sure that doesn’t happen. If you want to spot a trend, you need very granular data.”
Florida health officials contend they are monitoring for flare-ups internally — and would alert the public if one were simmering.
“We have not scaled back surveillance,” said Weesam Khoury, the state health department’s communications director. “We still have epidemiologists that are doing everything they were doing before — that hasn’t changed. The change is the public-facing aspect of the reporting.”
That “public-facing aspect” expired on June 4, when the department downshifted its reports, and with them, its crisis footing toward the virus, citing the success of the state’s vaccination campaign and more than a year of harsh demands on its already-beleaguered staff. Employees routinely had to show up at dawn to begin compiling the day’s COVID reports.
While Nuzzo said she is sympathetic to those employees being overworked, she countered that public health hinges on trust, and trust is built through the regular release of data. The shift from daily to weekly reporting is inevitable, Nuzzo said, but it would ideally be coordinated with other states, and after the virus has been further suppressed.
There were still more than 2,000 people hospitalized with COVID when Florida made the switch to less frequent updates, joining with Alabama as two of the first states to do so. At the virus’ peak last July, more than 9,500 people in Florida were hospitalized with COVID. Oklahoma’s health department made a similar pivot to weekly reporting in March.
Metrics get murkier
Though he still has most of what he needs to gauge the virus, Jason Salemi, an epidemiologist at the University of South Florida who has tracked the state’s COVID data, said there are other areas where it’s hard to discern what’s happening in the wake of health officials cutting off their reports.
The federal data for hospitalizations is actually more detailed than what the state put out, Salemi said, and the CDC has information on cases and deaths. But for the latter metric, it has become more problematic to estimate the lag in reporting because he no longer has access to the actual date of death — just when deaths were reported.
“It’s really hard to pin down what the recent data on deaths are saying,” Salemi said. “We know what’s being reported today may not be reflective of the past two weeks, it could have been more than a month ago. Without that information, it’s just a challenge.”
For most laypeople, Salemi added, the weekly reports will be a good “one stop shop” to spot the latest general trends with the virus.
Accepting of the fact that he now has less data, Salemi said he’s hopeful that the hours freed up for state health officials will be put to good use. Specifically, the biostatitician is hoping for deeper dives on COVID variants and vaccination data.
“That’s what I hope this transition in reporting frees up the epidemiologists to do,” Salemi said. “That is my prayer.”
When asked by the Herald if the department had any intention to share more data on vaccinations and variants, Khoury, the communications director, said those concerned about variants should get two doses of a COVID vaccine.
“If you get two vaccines, two weeks after that, you are protected from the known variants in the U.S.,” Khoury said. “That’s our message.”
The threat of a changing virus
Marco Salemi, a professor of experimental pathology at the University of Florida who is an expert on viral variants and no relation to Jason Salemi, said it’s understandable that the health department would want to conserve resources as the state’s epidemic recedes.
There is limited personnel, and a large territory to cover, he said.
“In the end, it’s a decision of cost-benefit analysis, and it’s understandable,” Salemi said. “Personally, I think it may be a bit too early.”
What concerns Salemi, he said, is the number of emerging variants now circulating in the state. His team has sequenced the genetics of about 5,000 COVID virus samples from North and Central Florida — the bulk of them coming from hospitalized patients at the university’s health center.
Lately, that’s included some, though “not very many,” samples of viral variants that caused “breakthrough infections,” occurring in fully vaccinated people. About a third of those were caused by the “U.K. variant,” Salemi said, though others were registered as different strains, including some that weren’t listed by health officials as “variants of concern.”
“What this tells me is it’s not just the highly contagious or infectious variants that get into vaccinated people,” Salemi said. “This is a phenomenon that can happen with pretty much anybody.”
Though breakthrough infections appear to be rare, there’s far less testing being done, and it’s still unclear whether such infections can be readily transmitted from person to person, Salemi said. That means health officials should be accelerating surveillance and data collection, especially with fewer cases circulating, he added, to monitor for whether a vaccine-resistant variant is emerging.
“This is the time to be proactive, not reactive,” Salemi said.