The CDC appears to have answered my question in last week's post, at least partially. While we are by no means in the clear, the new transmission prevention guidelines signal a more logical approach to NPIs (non-pharmaceutical interventions) that fits the current stage of the pandemic. On the other hand, we did see some controversy about whether the CDC is purposely withholding data from the public.
Is the New Guidance Too Confusing?
The guidance for specific areas depends on both disease activity and healthcare capacity for that region which makes a lot of sense because we know we won't reach herd immunity. Prevention of severe disease, death, and healthcare rationing are primary goals. We've seen healthcare taxed beyond capacity trying to care for both COVID-19 patients as well as all the other population health needs. CDC has set up a site that gives a specific answer for a community's level of risk (high, medium, or low) and corresponding advice. Just look at the color of your area of interest in their map and you will have the quick answer.
Getting to the underlying data for the categorization is a little harder but not terribly imposing. For example, if you wanted to know what's going on in Montgomery County, MD, you'd see that as of February 27, 2022, community transmission is "substantial" with the case rate at 66/100,000 and percent of positive tests at 1.83%. 4.43% of inpatient beds and 8.42% of staffed ICU beds are occupied by COVID-19 positive patients. What this all means, going back to the main site link, is that Montgomery County is in the Low community risk level.
I am most interested to see what happens in those jurisdictions where states have made pre-emptive rulings about NPIs that may contradict CDC's guidance. How many of them will toe the new line? Also, will citizens comply when their community experiences an increase in risk and should increase precautions?
Transparency is Essential
I don't have a problem with CDC or other agencies not releasing data that could be inaccurate, but I do have a problem with withholding information because someone might misinterpret the data. Just as with any scientific study, the investigators are obligated to discuss what the results mean and the limitations of the study.
Let's look at the example of wastewater testing and compare the US to the UK. Wastewater testing can be extremely valuable for tracking disease hotspots and also for tracking variants. CDC reports 15-day data on their website. You can see trends and activity in different parts of the country, though I couldn't find any information about variant tracking.
The UK, on the other hand, offers much more extensive information about wastewater tracking in monthly reports, including variant percentages across the country. The country coverage is much more extensive than in the US, though I didn't see any data from Wales.
Here is a screenshot of sites covered by wastewater tracking in the US. Large swaths of the country are not represented:
In general I wouldn't worry as much about misinterpretation of CDC data as I would about deliberate misuse of data. An example of the latter has been an ongoing problem with use of the Vaccine Adverse Events Reporting System (VAERS) data during the pandemic. Virtually every pediatric healthcare provider knew well before the pandemic that VAERS could not provide information about causation - anyone can report any type of event as being associated with a vaccine, and the reports are publicly available. That didn't stop many bad actors from using the data to falsely support claims of harm from COVID-19 vaccines.