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Wednesday, October 19, 2022
Cameron Hood, Newsletter EditorJonathan Lambert
Public Health Reporter
Welcome to Grid Health, bringing you stories on the intersections of health and politics, technology, climate change, misinformation and more. In this issue:  
🎬 Grid’s on YouTube: Why is fentanyl so deadly? Watch this episode and more from our “No Dumb Questions” series on our new YouTube channel
 
👋 I want to hear from you: If you’ve got thoughts about what else I should be covering, or questions about health in the news, send me your questions – I read every message. 📩 

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FROM THE HEALTH DESK

I’ve been reporting on covid since Jan. 10, 2020. We’ve learned so much about this virus since then, but I’ve been struck by how many basic epidemiological questions remain poorly answered, like how long people with covid are contagious, what proportion of infections lead to hospitalization or death, and where cases are trending up.  

That information is the foundation of a sound public health response, dictating how long isolation periods should last or when social distancing measures should be ramped up or down. And yet, after all this time, we still don’t have a good handle on many of these questions. In asking scientists why, I often hear the same refrain: We need better data, ideally coming from a robust national disease surveillance system. 

A new study in PLOS One shows just how far we are from that ideal system,
identifying many, many gaps in the United States’ data collection. The study, which analyzed nearly 300 studies affiliated with government public health researchers, concluded that a lack of complete and timely data has hampered the U.S. response. Here are some of the biggest questions we couldn’t answer well – and still need to, especially if covid surges again this winter. 

Who is getting infected, where? There are no federal guidelines for how states should report their data to the Centers for Disease Control and Prevention. Some states reported at daily or weekly intervals that changed over time, and the demographic data submitted also varied widely. Had states uniformly reported cases with consistent data on race, occupation and exposure history, public health officials could have had a much clearer view of where to prioritize efforts. 

How does the virus spread in different contexts? Official estimates of basic parameters, like how many people an infected person tends to infect, were based on studies done outside of the U.S. The authors found no authoritative estimate of the secondary attack rate (risk of infection due to an infectious contact), much less estimates in different settings, like households, workplaces or public transit. Such data could have shown in more detail where transmission risk is highest, informing more targeted mitigation measures. In Norway, public health officials did this
throughout the pandemic, finding healthcare, food service, transportation and child care as some especially risky occupations. But the U.S. did not. 

Who is most at risk? The U.S. lacked standardized national data on covid cases by county, geography, sex, age, race and ethnicity during much of the pandemic’s first year, the study found, but that improved by the end of 2021. Such data reveals disparities in risk and impact among various groups of Americans. But better data on incidence by occupation, living situation, or prior infection could have helped officials better tailor the response towards those who needed the most help. 

Better data could have helped answer other questions, including the optimum duration of isolation and quarantine, how long immunity from infection lasts, and whether these parameters change over time and with new variants. Fancier methods, like wastewater tracking to detect surges early or genomic surveillance to monitor viral evolution would help bolster future responses even further. But such systems take sustained investment that doesn’t dry up after a surge wanes, an investment
Congress seems unwilling to make

MORE FROM GRID

💠 First the pandemic, now the hurricanes: Some of the first test scores capturing the effects of the pandemic show that American students have lost a staggering amount of ground in reading and math over the course of the health crisis, Freelance Reporter Nirvi Shah writes. But many kids are still dealing with unstable schooling situations – because of natural disasters like wildfires, floods and hurricanes. Read more.

💠 
Privacy post-Dobbs: Like an earthquake’s aftershocks, jolts to privacy rights have rumbled across the legal landscape following the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, the June ruling that ended the national right to abortion. Read Grid’s deep dive into the legal, health, political and business implications by Science Reporter Dan Vergano, Technology Reporter Benjamin Powers and me. Read more.


💠 Off the menu: Officials in Alaska have canceled the state’s fall king crab and winter snow crab fishery seasons after summer surveys showed a sharp drop the crustaceans’ populations, Science Editor Lauren Morello and Climate Reporter Dave Levitan write. Though there may be several causes to the declining crab numbers, climate change has clearly played a role – another example of warming altering the food we eat and the ecosystems we depend on. Read more

💠 This generation’s Halloween candy scare: Repeated Drug Enforcement Agency warnings about brightly colored “rainbow” fentanyl in the illicit drug market have turned into misguided warnings about poisoned candy buckets ahead of Halloween, Dan reports. It’s the latest twist on the warnings about tainted candy, razor blades and pins hidden in Halloween goodies that have circulated for decades in the U.S. Read more.

 

🎧 Don’t miss Grid’s new podcast, Bad Takes! Each week, Executive Editor Laura McGann and Editor-at-Large Matthew Yglesias discuss a take that’s gotten under their skin, peeling back its layers to figure out what it tells us about American politics and society. Catch up on the latest episodes here

Have a bad take for Laura and Matt to review in a future episode? Send it to us📩

DATA DIAGNOSIS

Political polarization has come for the flu shot. So far this year, Democrats are about twice as likely to have gotten the flu vaccine than Republicans, with a 49 percent-22 percent breakdown, a new Harris-Grid poll finds. Overall, a third of U.S. adults have gotten the shot this year, with another 30 percent planning to soon. 

While Americans’ flu vaccine uptake started splitting along party lines before the pandemic, the gap has gotten much wider since 2020, as vaccines have become a symbol of political identity. Democrats were about twice as likely to say that the pandemic has made them more likely to get the flu shot, while the converse was true for Republicans, 18 percent of whom said the pandemic has made them less likely to get vaccinated against the flu. 

💉 
Read the full story here.

WHAT WE’RE READING

  • FDA wants to yank pregnancy drug. Firm argues Black women will suffer. (Washington Post
  • The COVID Data That Are Actually Useful Now (The Atlantic
  • Inflation is near a four-decade high. So why aren't health care costs significantly higher? (USA Today)
  • After Dobbs, U.S. medical students head abroad for abortion training no longer provided by their schools (Stat

👋 Thanks for reading. Until next week, take care. –Jon 

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Alex Leeds Matthews, Cameron Hood and Lillian Barkley also contributed to this edition of Grid Health.
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