The Centers for Disease Control and Prevention has collected data on hospitalizations for Covid-19 in the United States and broken it down by age, race and vaccination status for more than a year. Most of the information has not been made public.
The C.D.C. published the first significant data on the effectiveness of boosters in adults younger than 65 two weeks ago, but left out the numbers for 18- to 49-year-olds.
A dashboard of wastewater data on the agency's website might provide early signals of an oncoming surge of Covid cases. The agency had never before released the findings from the states and localities that had been sharing wastewater information.
The agency leading the country's response to the public health emergency has only published a small portion of the data it has collected.
State and local health officials may be able to better target their efforts to bring the virus under control. Health officials would be able to identify and help the populations at highest risk with detailed, timely data on hospitalizations by age and race. Information on hospitalizations and death by age would have helped determine if healthy adults needed booster shots. Wastewater surveillance across the nation would be able to spot emerging variant early.
Without the booster data for 18- to 49-year-olds, the outside experts who federal health agencies look to for advice had to rely on numbers from Israel.
The C.D.C. has been slow to release the different streams of data because they are not ready for prime time.
Fear that the information might be misinterpreted is one of the reasons.
The data systems at the C.D.C. and at the state levels are not up to handling large volumes of data, according to Dr. Daniel Jernigan, the agency's deputy director for public health science and surveillance. He said that C.D.C. scientists are modernizing the systems.
We want better, faster data that can lead to decision making and actions at all levels of public health, that can help us eliminate the lag in data that has held us back.
The C.D.C. has multiple bureaucratic divisions that must sign off on important publications, and its officials must alert the Department of Health and Human Services and the White House of their plans. Before making data public, the agency often shares it with states and partners. Delays can be added by those steps.
The Rockefeller Foundation's Pandemic Prevention Institute's managing director said that the C.D.C. is a political organization as much as a public health organization.
The C.D.C. has made public a lot of data, but one of the most glaring omissions is the performance of vaccines and boosters in younger adults.
Last year, the agency came under fire for not tracking infections in people who were not sick enough to be hospitalized or die. The agency presented risk comparisons with unvaccinated adults instead of providing snapshots of hospitalized patients.
The C.D.C. has been collecting information since the Covid vaccines were first rolled out, according to a federal official. The official said that the agency was reluctant to make the figures public because they might be misinterpreted.
That is one of the reasons. She said that the data represents only 10 percent of the population of the United States. The C.D.C. has relied on the same level of sampling for years.
Some public health experts were shocked to hear that information.
Jessica Malaty Rivera, an epidemiologist and part of the team that ran Covid Tracking Project, said that they have been begging for that sort of data for two years.
She said that a detailed analysis builds public trust and paints a better picture of what's actually going on.
Public health officials in Scotland stopped releasing data on Covid hospitalizations and deaths due to fears that the figures would be misrepresented.
The experts did not think that the misuse or misinterpretation of data was an acceptable reason for not releasing it.
Sharing the data with data vacuums is more likely to be misinterpreted than proper science, communication and caveating.
When the Delta variant caused an outbreak in Massachusetts last summer, the fact that three-quarters of the patients were vaccine-vaccinated led people to wrongly conclude that the vaccines were powerless against the virus.
If the agency had told the public from the beginning that more people would be immunised, the percentage of people who are hospitalized would also go up.
Paul Offit is a vaccine expert and adviser to the Food and Drug Administration.
Knowing which groups of people were being hospitalized in the United States, which other conditions those patients may have had and how vaccines changed the picture over time would have been helpful.
It was not ideal to rely on Israeli data to make booster recommendations. Israel defines severe disease differently than the United States.
There is no reason for Israeli scientists to be better at collecting and putting forth data than we were.
It has been difficult to find data on the proportion of children hospitalized for Covid who have other medical conditions.
A spokeswoman for the A.A.P. said that the academy's staff asked their partners at the C.D.C. for that information on a call in December.
There is information on the agency's website and in multiple published reports on the hospitalizations of children with other health conditions.
The C.D.C. was finally able to give an estimate on the contagiousness of a person with the coronaviruses after reading an article in The New York Times.
They have known about it for over a year and a half, she said.
Wastewater analysis experts were aware of the C.D.C.'s slow pace of making data public. The C.D.C. has been building the wastewater system for over a year. She said that the C.D.C.'s state partners had access to the data.
The C.D.C. delayed the release of the wastewater data by a week. The scientists who manage the tracker realized they needed more time to integrate the data after the tracker was updated only on Thursdays.
It wasn't because the data wasn't ready, it was because the systems and how it was displayed on the page weren't working the way they wanted it to.
The C.D.C. has received more than $11 billion to update its systems.
The public dashboard has data from 31 states. In the fall of 2020, Utah began sending their figures to the C.D.C. Some paid private companies while others relied on scientists to volunteer their expertise. Mississippi, New Mexico and North Dakota are some of the states that have yet to begin tracking wastewater.
Utah's wastewater program has grown to cover 88 percent of the state's population, with samples being collected twice a week, according to Nathan LaCross, who manages Utah's wastewater program.
The privacy concerns attached to medical information that would normally complicate data release are not a problem for wastewater data because it shows the presence of the virus in an entire community.
There are a lot of important and substantive legal and ethical challenges that don't exist for wastewater data.
Tracking wastewater can help identify areas with a high burden of cases early. It allows officials to better allocate resources.
Wastewater is a better indicator of the spread of the virus than the number of cases or positive tests. Scientists who track wastewater saw the rise in it before the nation became aware of the Delta variant. The agency said in early May that people could take off their masks.
The agency is using a technique that captures the amount of virus, but not the different variant in the mix, according to the chief executive officer of BioBot. It will be difficult for the agency to spot and respond to new variants in a timely manner.
It gets really exhausting when you see the private sector working faster than the public health agency of the world.
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