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Pandemic Preparedness Hinges on Quickly Sharing Accurate Data

The cornerstone of pandemic preparedness is building systems that quickly collect, analyze, and disseminate accurate data.

Experts predicted the likelihood of a pandemic years before COVID-19, and we can be certain there will be another one at some point in the future. Many times, we put the urgent before the important and ignore the fact that we must make systems more efficient as they grow.

Abt Associates showed the connections among preparedness, adaptability, and efficient data systems when we altered the national flu vaccine monitoring surveys to include COVID-19. We started the flu vaccine monitoring surveys in collaboration with the Centers for Disease Control and Prevention (CDC) right after the 2009 influenza A(H1N1) pandemic. We built a system that was highly adaptable for public health emergencies and once used it to respond to Zika. The surveys typically ask about flu vaccination among pregnant women and healthcare workers.  We publish the results every year, and sometimes the press picks them up. When you read the headline, for example, “half of pregnant women received a flu shot this year,” it is likely that the data came from Abt and CDC.

In the U.S., the flu season typically starts in October and ends in April. Before Thanksgiving every year, Abt works with CDC to prepare lengthy questionnaires to distribute online to specific groups in the U.S. population at the end of the flu season. The responses are anonymous but revealing. The questionnaires contain more than 100 questions about the people responding, their attitudes toward vaccination, and vaccination status. They ask about a person’s work setting, whether their employer required or a doctor recommended a flu shot, and what made them decide to get vaccinated. We improve the questionnaires every year, adding and deleting questions to ensure they are relevant and easy to answer. Today, they are an effective tool to collect accurate data about flu vaccination among risk groups.

In response to the COVID-19 pandemic, starting in 2020 we worked with CDC to modify the online surveys to ask respondents if they received a COVID-19 vaccine, what they thought of the vaccines, and the reasons why they did or did not get vaccinated. Four months after vaccines were available, we compiled information from a national sample of people about COVID-19 vaccine uptake and hesitancy, providing CDC with important data for policy decisions.

Pivoting a tool designed to collect seasonal flu vaccination data to gather information on COVID-19 vaccines is a perfect example of adapting an already in-place data collection system in response to a pandemic. Abt and CDC had years of experience collecting, analyzing, and sharing flu vaccination data, so it was easy to adapt the surveys to COVID-19. The coding to analyze the data and produce results was already done.

But much—maybe most--of the world lacks such systems. I spent several years working with partners in Sub-Saharan Africa building stronger surveillance systems to detect and respond to novel respiratory virus strains in preparation for the next pandemic. One of the biggest lessons I learned is that it takes decades to build systems that can respond to a global health emergency such as the COVID-19 pandemic. Collecting data on large numbers of people and, even more challenging, making sure those data are accurate is a complex job that demands effective communication across many disciplines. Unfortunately, what we did with the flu vaccine monitoring surveys—and our success—was a bit of an anomaly, even in the United States. Adaptability requires a system that’s in place and functional. We had that luxury, but in too many parts of the world healthcare and public health data systems face challenges that prevent them from reaching their full potential.

Patients need to talk with physicians, who need to talk with epidemiologists, who need to talk with lab technicians, who communicate test results back to hospitals. Community and local governments feed information to national governments who, in turn, report to the World Health Organization, which then publishes guidelines. You get the picture. The response to a pandemic is a complex living, breathing, ecosystem. And the keystone to this whole effort is data: effective collection, analysis, and sharing of accurate data.

The solutions are obvious: standardized reporting and efficient data systems. What is not obvious is whether we have the global political will and foresight to build those systems. The investment in preparedness is far less than the health and economic costs of dealing with an out-of-control pandemic. COVID-19 is Exhibit A. Changes in diets resulting in more vulnerable people with obesity and other co-morbidities, inequity in healthcare services, and further development that encroaches on habitats of animals that can infect humans—all of which are increasing—could lay the groundwork for another pandemic that won’t wait 100 years. Will we finally learn the lesson that we should focus on the important as well as the urgent? Is the human species—in particular our leaders—capable of doing so?  Only time will tell.

 
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