scholarly journals How should we present the epidemic curve for COVID-19?

2021 ◽  
Author(s):  
Jean-Paul R. Soucy ◽  
Sarah A. Buchan ◽  
Kevin A. Brown
Keyword(s):  
Public Health ◽  
Symptom Onset ◽  
Public Reporting ◽  
Downward Trend ◽  
Public Health Authority ◽  
Onset Date ◽  
Current Response ◽  
Sample Collection ◽  
The Public ◽  
Epidemic Curve

Epidemic curves are used by decision makers and the public to infer the trajectory of the COVID-19 pandemic and to understand the appropriateness of current response measures. Symptom onset date is commonly used to date cases on the epidemic curve in public health reports and dashboards. However, third-party trackers often plot cases on the epidemic curve by the date they were publicly reported by the public health authority. These two curves create very different impressions of epidemic progression. On April 1, the epidemic curve for Ontario, Canada based on public reporting date showed an accelerating epidemic, whereas the curve based on a proxy variable for symptom onset date showed a rapidly declining epidemic. This illusory downward trend (the "ghost trend") is a feature of epidemic curves anchored using date variables earlier in time than the date a case was publicly reported, such as symptom onset date or sample collection date. This is because newly discovered cases are backdated, creating a perpetual downward trend in incidence due to incomplete data in the most recent days. Public reporting date is not subject to backdating bias and can be used to visualize real-time epidemic curves meant to inform the public and policy makers.

scholarly journals How should we present the epidemic curve for COVID-19?

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jean-Paul R. Soucy ◽  
Sarah A. Buchan ◽  
Kevin A. Brown
Keyword(s):  
Public Health ◽  
Symptom Onset ◽  
Health Authority ◽  
Public Reporting ◽  
Decision Makers ◽  
Public Health Authority ◽  
Onset Date ◽  
The Public ◽  
Epidemic Curve ◽  
Incident Cases

Epidemic curves are used by decision makers and the public to infer the trajectory of the COVID-19 pandemic and to understand the appropriateness of response measures. Symptom onset date is commonly used to date incident cases on the epidemic curve in public health reports and dashboards; however, third-party trackers date cases by the date they were publicly reported by the public health authority. These two curves create very different impressions of epidemic progression. On April 1, 2020, the epidemic curve based on public reporting date for Ontario, Canada showed an accelerating epidemic, whereas the curve based on a proxy variable for symptom onset date showed a rapidly declining epidemic. This illusory downward trend is a feature of epidemic curves anchored using date variables earlier in time than the date a case was publicly reported, such as the symptom onset date. Delays between the onset of symptoms and the detection of a case by the public health authority mean that recent days will always have incomplete case data, creating a downward bias. Public reporting date is not subject to this bias and can be used to visualize real-time epidemic curves meant to inform the public and decision makers.

Considerations for Improving Reporting and Analysis of Date-Based COVID-19 Surveillance Data by Public Health Agencies

2021 ◽  
Vol 111 (12) ◽  
pp. 2127-2132
Author(s):  
Ian Hennessee ◽  
Julie A. Clennon ◽  
Lance A. Waller ◽  
Uriel Kitron ◽  
J. Michael Bryan
Keyword(s):  
Public Health ◽  
Symptom Onset ◽  
The United States ◽  
Public Reporting ◽  
National Standards ◽  
Surveillance Data ◽  
Onset Date ◽  
Public Health Agencies ◽  
Starting Point ◽  
Health Agencies

More than a year after the first domestic COVID-19 cases, the United States does not have national standards for COVID-19 surveillance data analysis and public reporting. This has led to dramatic variations in surveillance practices among public health agencies, which analyze and present newly confirmed cases by a wide variety of dates. The choice of which date to use should be guided by a balance between interpretability and epidemiological relevance. Report date is easily interpretable, generally representative of outbreak trends, and available in surveillance data sets. These features make it a preferred date for public reporting and visualization of surveillance data, although it is not appropriate for epidemiological analyses of outbreak dynamics. Symptom onset date is better suited for such analyses because of its clinical and epidemiological relevance. However, using symptom onset for public reporting of new confirmed cases can cause confusion because reporting lags result in an artificial decline in recent cases. We hope this discussion is a starting point toward a more standardized approach to date-based surveillance. Such standardization could improve public comprehension, policymaking, and outbreak response. (Am J Public Health. 2021;111(12):2127–2132. https://doi.org/10.2105/AJPH.2021.306520 )

scholarly journals Houston Health Department’s response to the threat of Zika virus

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Eric Bakota ◽  
Kirsten Short ◽  
Amanda Eckert
Keyword(s):  
Public Health ◽  
Zika Virus ◽  
Mosquito Control ◽  
Action Plan ◽  
Community Outreach ◽  
Health Department ◽  
Public Health Authority ◽  
The Public ◽  
Incident Command ◽  
The City

ObjectiveThis session will explore the role of the Houston Health Department(HHD) in the City of Houston’s response to the threat of Zika. Thepanelists will provide perspective from the roles of Bureau Chief,informatician, and epidemiologist and provide insight into lessonslearned and strategic successes.IntroductionZika virus spread quickly through South and Central America in2015. The City of Houston saw its first travel-related Zika cases inDecember of 2015. On January 29th, the City held the first planningmeeting with regional partners from healthcare, blood banks,petrochemical companies, mosquito control, and others. Additionallythe City activated Incident Command Structure (ICS) and designatedthe Public Health Authority as the Incident Commander.Initial steps taken by HHD included expanding the capabilityand capacity of the public health laboratory to test for Zika virus;expand surveillance efforts; created an educational campaign aroundthe “3Ds” of Zika defense (Drain, Dress, DEET) which were thendisseminated through several means, including a mass mailing withwater bills; and provided DEET to mothers through the WIC program.The Houston Health Department took the lead in authoringthe City’s Zika Action Plan. In this 3 goals and 6 strategies wereidentified. Goals included 1) Keep Houstonians and visitors aware ofthe threat of Zika; 2) minimize the spread of the virus; and 3) protectpregnant women from the virus. The 6 strategies employed were toA) develop preparedness plans; B) implement ICS within the City;C) ensure situational awareness through surveillance; D) Increasecommunity awareness; E) reduce opportunities for Zika mosquitobreeding grounds; and F) provide direct intervention to reduce thethreat of Zika.HHD was responsible for many of the action items within theplan. We conducted several community outreach events, where wedisseminated educational materials, t-shirts, DEET, and other give-aways. These events allowed frequent engagement with the public forbidrectional communication on how to approach the threat.

scholarly journals The control of consumption by the public health authority

1903 ◽  
Vol 115 (1) ◽  
pp. 7-21
Author(s):  
T. Percy C. Kirkpatrick
Keyword(s):  
Public Health ◽  
Health Authority ◽  
Public Health Authority ◽  
The Public

scholarly journals Maximum incubation period for COVID-19 infection: do we need to rethink the 14-day quarantine policy?

2020 ◽  
Author(s):  
Boris Bikbov ◽  
Alexander Bikbov
Keyword(s):  
Public Health ◽  
Incubation Period ◽  
Published Data ◽  
Global Policy ◽  
The Public ◽  
Epidemic Curve ◽  
Recent Policy ◽  
Isolation Period ◽  
Infection Spread

Manuscript presents the shortcomings of the widely accepted 14 days maximal incubation period for COVID-19 infection. We listed the accumulating published data which indicate substantially longer incubation period up to 32 days (in some studies more than 14 days incubation period was registered in more than 5% of patients with traced contacts), and recent policy requirements in some Chinese provinces to increase the mandatory isolation period over the 14 days for travelers coming from countries with rising epidemic curve. The data summarized in our comment could lead to substantial changes in global policy to minimize the risks of further infection spread and have important implications to the public health.

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