Over the past few years, checking the number of weekly covid-19 cases on a health department online tracker became second nature for a lot of people concerned about how the virus impacted their communities.
The type of data available is now a lot different in much of Pennsylvania.
“The covid-19 pandemic, as well as how public health officials track the disease, has evolved since the first cases of the illness were reported in Pennsylvania during the spring of 2020,” said Neil Ruhland, a spokesperson for the Pennsylvania Department of Health. “Health care providers are no longer required to report covid-19 cases to the Pennsylvania Department of Health since the lapsing of the federal government’s public health emergency order in May 2023.”
With the availability of at-home covid tests and a formal end to the emergency declaration in May, information on the number of infections is more limited than it was at the height of the pandemic.
“At the state level, it’s no longer mandatory to report infections, but it is still reported in Allegheny County, and we’re still receiving the PCR tests through the reportable disease system,” said LuAnn Brink, chief epidemiologist
and deputy director of the Allegheny County Health Department.
Still, the state continues to track emergency department visits, hospitalizations and deaths on its Respiratory Virus Dashboard, which is updated weekly. The department also publishes a covid-19 Monthly Tracking Report, the Department of Health noted.
“Due to effective vaccinations and treatments, and the evolution of the virus, covid-19 has become a much less severe illness for most of the population, and the number of hospitalizations and deaths have dropped dramatically since the height of the pandemic,” Ruhland said.
The Centers for Disease Control and Prevention is also watching the numbers, recording metrics such as positive tests, wastewater, emergency room visits, hospitalizations and deaths.
“The overarching point is that as the context of covid changes so will the monitoring,” said Dr. Amesh Adalja, a Pittsburgh-based infectious disease expert at Johns Hopkins Center for Health Security. “In the early days of the pandemic, when there was no immunity in the population, little knowledge of the virus and no countermeasures such as vaccines and antivirals, it was important to have a granular view of cases. Today, the infection is much more manageable and cases are largely decoupled from hospital capacity concerns, so that type of monitoring is no longer of the same import.”
He said wastewater tracking has turned into a key measuring tactic.
“The advent of community wastewater monitoring is an important way covid and other infections are increasingly being tracked, and that type of information is more important at this time than daily case counts, which always were an undercount,” Adalja said. “Additionally, variant tracking still occurs.”
Dr. Amy Crawford-Faucher, a family medicine physician and vice chair of the Allegheny Health Network Primary Care Institute, noted that testing centers that popped up around the region at the beginning of the pandemic are gone.
“We test people when they come into the hospital, but it’s become more common for a patient to call me to say, ‘I tested positive. What do I do?’ ”
Dr. Donald Yealy, UPMC’s chief medical officer and senior vice president of the Health Services Division, said the ability to test was limited at the outset of the pandemic. That’s no longer the case.
“We were learning a lot about not only how to do a test, but how to respond to a positive test,” Yealy said. “In other words, what should we do when someone has symptoms and when they don’t have symptoms?”
With the availability of testing through health care sites and other sources like wastewater, “we had lots of rich information from health care providers, from the community and from wastewater,” Yealy said.
When at-home tests came along, people had a more convenient way to see if the symptoms they were experiencing were covid-related.
“People have access to get a pretty good test, not a perfect test, but a pretty good test,” Yealy said. “And we won’t know much about what that test shows unless they either tell someone involved with public health or health care where they present for care.”
So, in 2023, the data is largely what is coming into health care facilities.
“The community-based data is such a small fraction of what’s really happening out there,” Yealy said. “It’s hard to draw accurate conclusions about it.”
Yealy said covid-19 seems to be at a point where it “will not be a threat to the broad population’s health or the ability of the health care system to respond adequately — and that’s really what makes a pandemic.”
These days, there are more tools to handle an infection, such as vaccines, better testing and treatments like paxlovid.
“When people contract it, not only are they better prepared now with both testing and advice on masking, but we have tools to fight the virus now that three years ago we didn’t have,” Yealy said. “People, in general, are doing better because they built up their immunity from either vaccines or having recovered and they have these other tools.”
But it’s still a “significant threat” to people whose health is compromised, the elderly and those who have other risk factors, he cautioned.
Heading into the winter months, Crawford-Faucher said, it’s still important to take precautions, especially for those at risk.
“Covid is a respiratory viral illness, like RSV and the flu, so any of those viral infections are going to be more likely in enclosed places where we’re close to people, whether we’re driven indoors because of the cold or in crowds at parties,” she said.
“If you are somebody who has severe chronic diseases, lung disease or a compromised immune system, be careful in crowded places and wear a mask,” Crawford-Faucher said. “And of course, get the appropriate flu, covid and RSV vaccines.”
Crawford-Faucher said we’re in a kind of limbo period with covid-19.
“The pandemic is over, but it hasn’t gotten to the same place as the flu,” she said. “So we have to be a little more careful of these precautions. Hopefully, as we go through another season, it will become one of many viruses, and we won’t have as many precautions to take.”
Stephanie Ritenbaugh is a Tribune-Review staff writer. You can contact Stephanie at [email protected].
