New CDC team: a meteorological service to predict the rest of the pandemic

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A new team of federal health scientists officially embarks Tuesday on a mission to provide what has often been missing from the country’s response to the coronavirus pandemic: better and faster information about what is likely to happen next in this public health emergency and in future outbreaks.

“We think of ourselves as the National Weather Service, but for infectious diseases,” said Caitlin Rivers, epidemiologist and associate director for science at the initiative, led by the Centers for Disease Control and Prevention.

About 100 scientists will analyze technical data and communicate policy options to policy makers and the public on how the virus behaves and who is most at risk – in user-friendly terms.

“We’d love for people to turn to us and say, ‘I’m about to commute the red line. … Should I bring a mask based on what’s going on with respiratory disease in my community? “Do I have my birthday party outside or inside? Those kinds of decisions, I think, are where we’d like to go,” Rivers said.

The Center for Forecasting and Outbreak Analytics, which is starting with $200 million in funding, was created last summer to improve the CDC’s and broader government’s understanding of the coronavirus — and future outbreaks — in real time. White House officials plan to officially kick off the effort on Tuesday during a Mountain peak on strengthening US early warning systems for health threats.

The center comes into being at an uncertain time in the pandemic.

As the United States plods through the third year of the health crisis, cases of covid-19 are on the rise. But it’s still unclear whether new, highly transmissible versions of the omicron variant in New York state and Europe will trigger a new wave of infections.

If there is a new surge, elected leaders may be reluctant to reinstate restrictions such as mask mandates, given the availability of vaccines and therapies and a political environment in which many Americans express ambivalence, even hostility. pure and simple, towards vaccines and public health recommendations.

When the CDC brought in outside experts to lead the new team, the move was widely seen as an acknowledgment of long-standing systemic failures in surveillance, data collection, and preparedness that have come to light. by the pandemic.

The CDC’s failure to share the data set it back when delta arrived

There is no national system in the United States for forecasting infectious diseases. During the last major health threats – the 2009 H1N1 swine flu pandemic, the 2014-2016 Ebola outbreak, the 2016 Zika outbreak – the CDC had experts, but the public health agency also recruited volunteer academic experts.

“Academic experts have acted as volunteer surge capacity, but it’s not sustainable,” Rivers said.

Experts, including Rivers and other team members, have long advocated for an infectious disease prediction center.

The center will provide support and analysis to decision-makers in the federal and state governments. This includes forecasting the number of covid cases could be expected in the coming days and weeks by analyzing the number of new cases and hospitalizations, and looking at the most affected population groups.

Scientists will also examine who infects whom, how well vaccines protect against infection and serious illness, and how that depends on the vaccine, the variants and the time since vaccination, said Marc Lipsitch, epidemiologist and scientific director of the center.

The center will work with other experts from government and the private sector to answer practical questions about how certain measures – contact tracing and isolation, border closures, masking, testing of travelers – work to reduce transmission. This “will help policy makers choose the most effective and least costly and disruptive policies,” Lipsitch said in an email.

Health officials and experts are hungry for information, especially at a time when advice is often confusing and official case counts and testing data are increasingly unreliable as many people test from home and are not required to communicate the results.

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Anne Zink, emergency physician and Alaska’s chief medical officer said lessons from the pandemic must be applied moving forward.

“We’re reaching close to a million deaths, huge economic consequences, schools closed for long periods of time, travel plans and everything halted one way or another,” Zink said. “How can we learn from the challenges of the last two years to know what will happen this fall, this winter? Should I plan my wedding? … Can I plan international trips?

Scientists at the center expect new waves of covid cases as immunity wanes and variants emerge. There’s a strong possibility that the coronavirus pattern won’t behave like the seasonal flu, which typically arrives during the winter, “but instead surges occur at different and not entirely predictable times of the year. “Rivers said in an email.

Center scientists expect that vaccinating children under age 5 — which awaits Food and Drug Administration approval — will have a “modest impact” on the trajectory of the pandemic.

The center’s scientists have not an overview of two new omicron subvariants, called BA.2.12 and BA.2.12.1.

Rivers is on leave from Johns Hopkins University. Lipsitch divides his time between the CDC and Harvard University. Other center leaders include Rebecca Kahn, senior scientist, splitting her time equally between Harvard and the CDC; Dylan George, chief operating officer and former adviser to the White House Office of Science and Technology Policy in the Obama administration; and Alison Kelly, Deputy Director and CDC veteran.

The center will be based in DC and will eventually have about 100 staff, including some at CDC headquarters in Atlanta. He will report to CDC Director Rochelle Walensky.

Even before its official launch, the team quickly pivoted when news of omicron broke on Thanksgiving. US officials knew the variant would spread quickly. The key question, Lipsitch said, was, “How serious are these cases going to be? This is where we had no US data at all.

Working with Kaiser Permanente of Southern California and researchers from the University of California, Berkeley, the team produced the first American estimates showing this disease of omicron was not as bad as what the delta variant caused. Walensky presented the results at the White House on January 11.

The team also recognized early on that omicron would cause a surge in the United States and alerted federal and state health officials in December to the next surge in January, according to George.

Despite the initial funding, the center’s work must be sustained over the long term and must be matched across public and state health departments by a skilled workforce that understands disease modeling methods.

“I’m concerned that we don’t have enough resources invested to ensure the necessary level of community testing, monitoring and access to other data sources to get the most out of this new high-quality modeling center” , said Jeffrey Duchin, health worker. for Seattle and King County in Washington State. Models, he said, are only as good as the quality of the data that informs them.

One of the priorities of the center is communication. Pandemic advice and vaccine effectiveness information to have been confusing. It is now largely up to the individuals of assess risks and make sense of a data blizzard.

“We shouldn’t be asking people to say, hey, just to keep you safe, we’d like you to have a PhD in epidemiology or a medical degree. And we would also like you to have a master’s degree in biostatistics and, perhaps, a bachelor’s degree in economics,” said Maria Sundaram, a scientist at the Marshfield Clinic Research Institute, which is part of the Marshfield Clinic, a Wisconsin health system.

A third of the staff of the new CDC center will be devoted to communication. Its website will expand to include information “to help people understand and make decisions about infectious diseases in their community,” Rivers said.

The center will also appoint experts whose job will be to reach vulnerable communities that do not have easy access to the internet.

To understand the mission of the new CDC center, Rivers cites the National Weather Service, which issued bulletins referring to the drop in barometric pressure. The problem was that people didn’t know how to interpret this information.

After conducting research to better understand how consumers assess risk, the weather service adjusted the bulletins to give specific advice.

“They say things like ‘wind can uproot small trees and flying debris can crack windows,'” Rivers said.


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