Every public health agency, from small town to the federal government, strived to do the best they could with the available tools during the pandemic. Despite those efforts, data collection and delivery of information to the public was widely criticized. Public health agencies are the first to critique processes and learn from mistakes made.
Initially, we did not have enough testing. Then all testing was not captured. Testing results from emergency departments and hospitals were connected to tracking systems. Independent urgent cares, clinics and primary care offices were not included in the numbers. Home testing was not included. This led to reporting less cases than there actually were and a higher case-to-death ratio. Our previous, traditional public health surveillance system was able to collect, analyze and disseminate only some of the information.
Infectious disease tracking systems have been updated over the years. In our lifetime, it has not been in the forefront of public health. Over the last 50 years, infectious diseases and associated deaths were well controlled compared to previous times before immunizations and antibiotics were available. Funding was not generous to develop these systems because, except for public health experts and researchers, no one really thought we would ever have a pandemic similar to the historically deadly pandemics we read about in history books. The beginning of the pandemic found this country with new but not fully developed or tested tools.
