Public health data systems need to be improved

When an infectious disease strikes, every day matters. The longer it takes to spot, investigate and contain an outbreak, the more lives we may lose.

That is why public health data systems must be prepared for the next pandemic and revamped to tackle the current one. The COVID-19 pandemic is far from over; in many countries, it is getting worse. By investing in digital technologies now and publishing data online, policymakers can strengthen their response to the ongoing pandemic and act quickly when another public health threat appears.

An important first step toward more robust pandemic preparedness is reporting of hospitals' admissions data to national health officials as patients arrive. An unusually large number of admissions, even in the absence of laboratory testing, could be the first warning sign of a deadly new threat. Reporting admissions data together with diagnoses, such as pneumonia, can enhance the value of this stream of daily data and potentially enable public health officials to nip the next pandemic in the bud.

Countries should also build systems that enable laboratories to report their results in real time. Digitizing and linking infectious-disease reporting systems is a wise investment and will give countries a better shot at detecting the next pandemic.

As we think about preparing for the next pandemic, the current one is accelerating. Digital technologies need to be embraced now to improve the response to COVID-19.

For starters, digitizing COVID-19 hospital admissions and laboratory data would help decision-makers identify and respond to surges faster, potentially saving more lives and preventing the need for full lockdowns. In many countries, manual reporting tends to slow to a trickle, potentially causing deadly delays, when overburdened hospital workers take much-needed time off on weekends and holidays.

Next, more needs to be done to understand how well COVID-19 treatments and vaccines are working, but the aggregate information needed to answer these questions is still lacking. Countries should immediately start tracking people who receive certain therapies and vaccines. After controlling for age, sex, body mass index and other factors that influence a person's risk of developing severe COVID-19, treatment data can be used to understand whether therapies are improving patients' health. Likewise, vaccination data can be used to help measure vaccines' effectiveness and assess how long their protection lasts.

Public health authorities also need to record and digitize key data to reduce inequity. In many countries, COVID-19 has hit ethnic-minority communities especially hard, and these communities are disproportionately limited from accessing high-quality healthcare.

With much of the world's population still unvaccinated, the spread of new, more infectious coronavirus variants threatens to deepen this disproportionate impact.

On the data front, it is critical to collect information on the race, ethnicity, age, sex, postal code and underlying health conditions of those infected with COVID-19, along with data on health outcomes. This will enable public health leaders to distribute resources where they are needed most and assess the impact of programs designed to reduce inequalities.

Lastly, building up capacity to carry out extensive genomic sequencing could help the world stay ahead of the virus. Sequencing data can show how the virus is mutating, providing a blueprint for modifying COVID-19 vaccines as needed. As the last four months have shown, more transmissible variants, and variants that evade immunity due to a person's past infection or vaccination, are changing the pandemic's trajectory. Better genomic-sequencing data, provided in real time, can help decision-makers figure out where funding, vaccinations and hospital support are needed most.

High-income countries should seek to emulate the United Kingdom, which has built up a large genomic-sequencing system and shares the data freely online. In addition, the Africa Pathogen Genomics Initiative of the Africa Centres for Disease Control and Prevention is creating a continentwide infectious-disease reporting system and laboratory network focused on genomic sequencing. This could be a useful model for low-income economies.

Countries can also use genomicsequencing data to identify COVID-19 outbreaks and understand their origins, helping to pinpoint superspreader events and the locations where transmission occurs most frequently.

Faster and more detailed public health data can give us a road map to navigate the remaining stages of this pandemic and be better prepared the next time a virus like SARS-CoV-2 arrives, or an even deadlier one emerges. No investment is more important.

The author is a professor of global health and director of the Institute for Health Metrics and Evaluation at the University of Washington.