By Ethan Covey

With the expiration of the federal COVID-19 Public Health Emergency (PHE) declaration, monitoring of the disease has shifted from an emergency approach to routine public health practice, changing the way data are collected and shared, according to the CDC. However, experts caution continued surveillance is important to prevent COVID-related illness and death.

“Monitoring the impact of COVID-19 and the effectiveness of prevention strategies remain a public health priority, because COVID-19 is not going away,” Benjamin J. Silk, PhD, an infectious diseases epidemiologist with the CDC’s Division of Viral Diseases and a commander in the U.S. Public Health Service, told Infectious Disease Special Edition. “We have good tools now to prevent COVID-19–associated hospitalizations and deaths through receipt of updated vaccines and timely administration of therapeutics.”

The U.S. PHE was declared by the Department of Health and Human Services on Jan. 31, 2020, and renewed 13 times prior to expiring on May 11, 2023 (MMWR Morb Mortal Wkly Rep 2023;72[19]:523-528). As of April 26, 2023, over 104 million U.S. COVID-19 cases, 6 million related hospitalizations and 1.1 million deaths were reported to the CDC and summarized on the agency’s COVID Data Tracker.

Although most COVID-19 surveillance data sources continue to be available, the reporting schedule has changed for many, and some sources have been discontinued.

Following the end of the PHE, HHS can no longer require reporting of negative SARS-CoV-2 testing results via COVID-19 Electronic Laboratory Reporting (CELR), which means the national percentage of positive SARS-CoV-2 test results using the CELR data source will no longer be available.

Although CELR data were highly useful as an early indicator of SARS-COV-2 transmission during the pandemic, the increased use of antigen tests and at-home testing kits as well as the decrease in nucleic acid amplification testing made the data less reliable as the pandemic continued. Community transmission levels, which were partially derived from the CELR data, will also be discontinued.

Additionally, reporting of aggregate weekly counts of COVID-19 cases and deaths as well as COVID-19 community levels was also discontinued upon the end of the PHE.

The decision to end aggregate weekly case and death counts is, according to the CDC, consistent with many state and local health authorities’ decisions to discontinue public reporting of these data.

To continue to effectively monitor COVID-19, the CDC established a new division, the Coronavirus and Other Respiratory Viruses Division (CORVD).

“[CORVD] is committed to working with partners on the prevention of COVID-19 within a sustainable and integrated surveillance strategy that monitors circulating respiratory viruses and prevention measures, including vaccination,” Dr. Silk said.

To identify any changes in the disease or spikes in transmission, tracking hospital admissions and causes of death is key to the ongoing monitoring of COVID-19, Dr. Silk noted.

“Weekly COVID-19 hospital admission levels and the percentage of all COVID-19–associated deaths will be primary surveillance indicators that help monitor severe COVID-19, which is a prevention priority,” he said.

Dr. Silk reported no relevant financial disclosures.