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CDC visual summary, May 5, 2023
On January 31, 2020, the Department of Health and Human Services declared a public health emergency over the new virus, SARS-CoV-2. After 13 renewals, it expired on May 11, 2023 — and with it the authority to collect some public health data. This CDC report, released on May 5, 2023, explained how national COVID-19 monitoring would continue.
Where things stood
COVID-19 was no longer the emergency of 2020, but it was still a public health problem.
| By April 26, 2023 | |
|---|---|
| Cases reported to CDC | more than 104 million |
| Hospitalizations | 6 million |
| Deaths | 1.1 million |
| Vaccine doses given | about 675 million, including 55 million updated (bivalent) boosters |
COVID-19 was the third leading cause of death in 2020 and 2021 and the fourth in 2022. By December 2021, population immunity from infection and vaccination had reached 95%, and since March 2022 hospitalization and death rates had fallen substantially. Yet about 1,000 people a week were still dying of COVID-19 in early April 2023 — deaths largely preventable with updated vaccines and timely treatment.
The new main measures
| Purpose | Measure | Source |
|---|---|---|
| Primary indicator of trends, to guide community and personal decisions | hospital admissions per 100,000 people, weekly, by county, state, region and nation | National Healthcare Safety Network (NHSN) — hospitals had reported daily since December 15, 2022; weekly reporting brings some lag |
| Primary indicator of deaths | share of all reported deaths that involve COVID-19, weekly | provisional death certificates, National Vital Statistics System (NVSS). Because COVID-19 deaths and all deaths are reported with similar delays, the share isn't distorted by late reports; it matches an equivalent influenza measure |
| Early warning | share of emergency department visits diagnosed as COVID-19 | National Syndromic Surveillance Program (NSSP): 6,300 facilities in all 50 states, D.C. and Guam, covering 75% of U.S. ED visits (coverage limited in Minnesota and Oklahoma, diagnosis completeness in Missouri) |
| Early warning | share of positive tests, by HHS region | the National Respiratory and Enteric Virus Surveillance System (NREVSS), about 450 laboratories — one to 31 per state, hence regional figures only |
Watching variants, severity and vaccines
- Genomic surveillance of variant proportions continues every two weeks, with new weighting methods and, as fewer samples are sequenced, a scaled-down network of public health laboratories for regional estimates.
- Wastewater surveillance (NWSS) and traveler-based genomic surveillance (TGS) continue, for early trends and new variants arriving from abroad.
- Severity: COVID-NET — active surveillance in 98 counties in 13 states — estimates hospitalization rates and collects clinical detail; three large health-record databases (BD Insights, PCORnet and Premier) track ICU admission, ventilation and deaths among hospitalized patients.
- Vaccination: the data agreements with states, territories and cities ended with the emergency, but most jurisdictions extended them. The National Immunization Survey keeps measuring coverage and intent; vaccine-effectiveness networks such as IVY and VISION continue, though they may need other sources of vaccination records if registries become incomplete.
- Case surveillance: SARS-CoV-2 infection remains nationally notifiable, and line-level case data stay public at data.cdc.gov.
A redesigned COVID Data Tracker was to launch on May 11, 2023, with weekly updates, county hospital data (admissions and inpatient and ICU bed use), state death and ED-visit data, regional test positivity, variants, wastewater, vaccination and severity — with levels pegged to the hospital-admission thresholds of the old Community Levels.
What stopped
| Discontinued | Why |
|---|---|
| National test positivity from lab reporting (CELR) | HHS could no longer require labs to report negative results. Weekly NAAT testing had fallen from about 17.4 million at the Omicron peak in January 2022 to under 1 million by April 26, 2023, as antigen and home tests took over, and data quality had become patchy |
| COVID-19 Community Transmission Levels | partly built on CELR data |
| Weekly aggregate case and death counts from jurisdictions | many states and localities had already stopped publishing them; case counts no longer reflected real infections because of less lab testing, more home testing, changed reporting and asymptomatic infections. Death certificate data were now as timely, and deaths are now dated by date of death rather than report date |
| COVID-19 Community Levels | depended on those case counts; hospital admission levels, which align closely with them, replace them |
| Monthly rates by vaccination status | cases, hospitalizations and deaths by vaccination status ended with the emergency |
Archived data remain on the COVID Data Tracker.
From emergency to routine
The pandemic forced rapid improvements in collecting, reporting and displaying timely, detailed surveillance data on an unprecedented scale. In 2023, CDC set up the Coronavirus and Other Respiratory Viruses Division to fold COVID-19 into a sustainable, integrated system watching other respiratory viruses too — building on dashboards that already show hospitalizations and ED visits for COVID-19, influenza and RSV. Monitoring COVID-19 and how well prevention works remained a priority.
Sources
Based on Silk BJ, Scobie HM, Duck WM, et al., "COVID-19 Surveillance After Expiration of the Public Health Emergency Declaration — United States, May 11, 2023," MMWR Morbidity and Mortality Weekly Report volume 72, number 19, Centers for Disease Control and Prevention, first posted as an Early Release on May 5, 2023; a work of the United States government in the public domain.
Licens: CC0 1.0 (offentligt eje) · Bearbejdet efter www.cdc.gov
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