“Case surveillance is foundational to public health practice.”
Case reports were ended.
CDC – COVID-19 Case Surveillance Public Use Data Reporting of new COVID-19 Case Surveillance data will be discontinued July 1, 2024, to align with the process of removing SARS-CoV-2 infections (COVID-19 cases) from the list of nationally notifiable diseases.
Cases in case surveillance means a count of actual diagnosed cases of a disease. Case counts never represent the true amount of infections, because there are always infections that are never diagnosed for a number of reasons. But case surveillance is a tool to have a good idea what’s going on, because it’s hard data of proven actual diagnosed cases of a disease. It’s not an estimation. It’s not speculation, it’s a case count of actual instances of diagnosed infections.
![What is Case Surveillance? Print Overview Fact Sheet [162 KB, 2 Pages, 508] Case surveillance is foundational to public health practice. It helps us to understand diseases and their spread and determine appropriate actions to control outbreaks. Case surveillance occurs each time public health agencies at the local, state, or national levels collect information about a case or person diagnosed with a disease or condition that poses a serious health threat to Americans. These diseases and conditions include infectious diseases, such as coronavirus disease 2019 (COVID-19); foodborne outbreaks, such as E.coli; and noninfectious conditions, such as lead poisoning. View or Download Our Materials Infographic PDF [341 KB, 2 Pages, 508] Overview Fact Sheet [162 KB, 2 Pages, 508] Case surveillance starts at local, state, and territorial public health departments. Local laws and regulations specify which diseases and conditions must be reported.](https://wat3rm370n.com/wp-content/uploads/2024/09/image-12.png)
There have always been people who’ve done data models extrapolating how many real infections a particular case count represents. And it’s not wrong to do these speculative exercises. But I am seeing a lot of scientist influencers and doctor pundits out there repeating “new covid cases” but they really mean infection prevalence speculation based on data modeling from wastewater. This is another step removed from speculating from actual case counts. Wastewater surveillance is also an excellent public health tool, but experts have said that there’s no good way to translate that into some case surveillance equivalent because they’re two different surveillance methods.
Anyone reporting these numbers should be clear that the numbers are NOT “cases” because cases refers to diagnosed instances. If you muddy this, “case counts” become meaningless and unscientific and not founded in public health practice, and shared reality is being distorted.
While speculation itself isn’t a bad thing, if it’s presented in context, another issue with the speculations I’m seeing is that they are using wastewater data in models that are not published publicly, are not peer reviewed, and nobody is able to see or replicate. And I’m sorry no, publishing on twitter as a hotshot influencer and getting retweeted or a shoutout by some doctor pundit quoted in the media is NOT the same as publishing of peer reviewed data modeling, and then reporting the results as what they are – speculations on infection prevalence based on wastewater data — not “cases”. Because again, cases refer to actual cases of people diagnosed.
And all these problems are before you even get to the fact that the speculative models people are referencing are by people who already have shown themselves to be problematic when it comes to public messaging and hyping their own horns. One hyped up their own paper in a way to make people believe that it would be so influential it would on its own bring changes in hospital practices to protect the vulnerable, when I don’t even think it can be used for advocacy safely. The other person seems like a minimizer who has been rude to public health advocates. So I’m not sure how much I would trust what they say anyway.
But even if these models are good and accurate – it’s still not about “cases” because it’s not case surveillance. Because “cases” are diagnosed cases. It’s a public health tenet. If you want public health, then you want actual case surveillance. Not some counterfeit passed off as good enough. And respectable doctors and scientists with integrity shouldn’t present these speculative numbers as if they are true case surveillance. It muddies the waters, confuses the public discourse, derails advocacy for actual public health, and sets everyone involved up for (deserved) criticism.
The danger of not having a shared reality or tangible facts is serious. And the danger of settling for less is grave.
So often it feels as if we’re accepting the current media framework of speculation and prediction and punditry, not so much dealing with what is or contending for what should be but living in a bleak and unbroken shadow future, where everything is already decided, which frees us from the moral imperative to have to do anything. It’s just as freeing in a way to believe everything is doomed as it is to believe that everything will be fine; either way you don’t have to do much thinking or work, or even take the next step that will allow us to take the next step, however easy or hard or palatable or unpalatable that next step might be. So we behave as if we are political operatives, predictive wizards, demonstrating not our commitment to a better vision of the future by contending with reality here in the present and working for best outcomes, but rather our ability to know what will happen before it happens, so that when it happens we can say see? and if we are wrong, we just run on to the next topic, chasing seagulls.