The pandemic has exposed the consequences of neglect. Countries with health systems like Israel and, to a lesser extent, Britain have been able to determine who is being hospitalised with Covid and how well vaccines are working.

American health officials, in contrast, have had to make do with extrapolations and educated guesses based on mishmash of data.

During the rapid spread of the highly contagious Omicron variant last December, for example, federal officials urgently need to know whether Omicron was more deadly than the Delta variant that had preceded it and whether hospitals would soon be flooded with patients.

But they could not get the answer from testing, hospitalization or death data, Dr. Walensky said, because the data failed to sufficiently distinguish cases by variant.

After a middle-aged woman tested positive for Covid-19 in January at her workplace in Fairbanks, Alaska, public health workers sought answers to questions vital to understanding how the virus was spreading in the state's rugged interior.

ALASKA and many other states have routinely collected that kind of information about people who test positive for the virus.

Part of the goal is to build a detailed picture of how one of the worst scourges in American history evolves and continues to kill hundreds of people daily, despite the determined efforts to stop it.

But most of the information about the woman in Fairbanks and tens of millions more infected Americans - remains effectively lost to state and federal epidemiologists. 

Decades of under investment in public health information systems has crippled efforts to understand the pandemic, stranding crucial data in compatible data systems so outmoded that information often must be reportedly typed in by hand.

Fixing the data failure, a salient lesson from a pandemic that has killed more than one million Americans, will be expensive and time consuming.

The precise cost in needless illness and death cannot be quantified. The comparatively low US vaccination rate is clearly a major factor in the nation's recording the highest Covid death rate among large, wealthy nations.

But federal experts are certain that the lack of comprehensive, timely data has also taken a heavy toll.

''It has been very harmful to our response,'' said Dr. Ashish K. Jha, who leads the White House effort to control the pandemic. ''It's made it much harder to respond quickly.''

Details of the Fairbanks woman's case were scattered among multiple state databases, none of which connect easily to others, much less to the Centers for Disease Control and Prevention, the agency in charge of tracking the virus.

Nine months after the woman fell ill, her information was largely useless to epidemiologists because it was impossible to integrate most of it with data on the roughly 300,000 other Alaskans and the 95 million-plus other Americans who have caught Covid.

The same antiquated data systems are now hampering the response to the monkeypox outbreak. Once again, state and federal officials are spending time trying to retrieve information from a digital pipeline riddle with holes and obstacles.

''We can't be in a position where we have to do this for every disease and every outbreak,'' Dr. Rochelle P Walensky, the C.D.C. director, said in an interview. 

''If we have to reinvent the wheel every time we have an outbreak, we will always be months behind.''

In the long run, officials hope to leverage electronic health records to modernize the disease surveillance system that all but collapsed under the weight of the pandemic.

Under the new system, if a doctor diagnoses a disease that is supposed to be flagged to the public health authorities, the patient's electronic health record will automatically generate a case report to local or state health departments.

The Essay continues. The World Students Society thanks Kitty Bennett for contributing research and author Sharon Lafraniere.


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