It's not enough to report COVID-19 data. Arizona should put that data to work
Opinion: Arizona reports more COVID-19 data than many states. But the state has not given it much meaning, much less used it to set performance benchmarks. It should.
I’ve noted this before, but Arizona does relatively well in reporting COVID-19 data.
At least, it does well when compared to other states.
The latest report to give Arizona (relatively) high marks comes from Resolve to Save Lives, a public health group funded in part by Bloomberg Philanthropies and the Bill & Melinda Gates Foundation. Arizona scored fifth-best of all states in reporting the 15 indicators that the group says are essential to track and control the spread of COVID-19.
Granted, Arizona isn’t even tracking seven of those 15 indicators, and still it is fifth-best. As a nation, we have woefully little uniform public health data to help us understand and compare how the novel coronavirus is moving through our communities.
But while Arizona has done better than its peers at reporting data, it has not done as good of a job of giving that data context or meaning – much less using them to set targets for tightening or loosening restrictions as cases spike and wane.
What other states are doing
That is changing, somewhat, now that the state has recommended a set of tiered public health metrics to help schools decide when to reopen for in-person instruction. But we should extend this idea far beyond schools, as some other states, counties and cities have done nationwide.
Utah has created a color-coded risk system that ranges from green, which includes wearing face coverings and maintaining physical distance, to red, which is basically a stay-at-home order. The levels can vary by county and even by city, based on a suite of public health metrics, and escalate restrictions on businesses and gatherings as community spread increases.
The system focuses heavily on personal responsibility and offers differentiated suggestions for children and high-risk individuals in each level.
There are similar systems in place statewide in Ohio, in the county that contains Houston and in Dallas, among others. Most rely on specific testing, confirmed case and hospitalization benchmarks, which in turn determine when restrictions can ease or tighten.
Why Arizona should do the same
That can help take some of the guesswork out of closing and reopening decisions, which for better or worse in Arizona, often hinge on whatever executive order Gov. Doug Ducey may unveil at his weekly news conferences.
The state already has the data to create such a system, including a color-coded chart that groups activities according to their risk of transmitting the coronavirus.
All it would need to do is determine where to draw the line on cases, hospitalizations or other critical metrics. Considering that Ducey has promised to make decisions based on public health data, and to balance lives and livelihoods (but when there is a conflict, to err on the side of lives), this shouldn’t be that hard.
He’s already laid out the rationale for such a system.
And there’s nothing that says the metrics and thresholds can’t change over time, as we learn more about this disease and the impact that both personal and policy decisions have on its spread.
While we're at it, report this data too
Which brings me back to the data we are collecting and reporting. Even if Arizona is doing better than most states, there are additional data points that would round out these color-coded decisions, such as the average turnaround time for testing, the average time it takes to isolate or notify close contacts once someone tests positive, or the percentage of cases that have been epidemiologically linked to other cases.
These are important metrics to follow, because long turnaround times make even the most extensive testing programs useless. The good news is SonoraQuest, which processes the bulk of Arizona tests, is already reporting its turnaround times, so it shouldn’t take a lot to extend these metrics statewide.
We also need to know more about how contact tracing is going – both to ensure people are isolating if exposed and to glean important information about where that exposure may have occurred.
Johns Hopkins University echoed that idea in a recent report that argued it was time for the nation to rethink its COVID-19 response. It noted that public health officials should be regularly gleaning information from case investigations to help inform policy decisions and publicly reporting what they are finding.
“Without this information,” the authors argued, “it is not possible to understand where new cases are coming from or what new interventions are most needed.”
That’s ultimately what all of this should be about – not just collecting and reporting data but breaking them down in meaningful pieces so the rest of us can follow along.
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