Overview

The NSSP CoP held its monthly meeting on February 23, 2022. On average, 100 to 120 people attend these meetings. View recordings of the monthly CoP callsexternal icon. Or you may directly access the February 2022 “What’s New with NSSP?” recordingexternal icon.

Announcements and Reminders

• NSSP CoP Slack Workspace
  • New channel added: #sas-user
  • New users have immediate access to all channels; established Slack users can join new channels by opening
    Slack > More > Channel Browser > Join.

• Knowledge Repository Highlights: The recently added How to Use RStudio with ESSENCE Application Programming Interface (API) Guideexternal icon explains new keyring functionality.

• Technical Subcommittee Renamed Technical Workgroup
  The NSSP CoP Technical Subcommittee has been retitled and will now function as the Technical Workgroup. Members will continue to meet monthly and facilitate discussion between CDC NSSP and the community. The Technical Workgroup looks out for the community’s interests by making sure data management, analyses, visualization, and reporting needs are being communicated and met.
  • Workgroup members have asked to update the enhancement list to reflect the JIRA tickets submitted during the pandemic. In response, the NSSP team is working on how best to share this information with the workgroup and broader community.
  • Workgroup minutes are posted in the #technical Slack channel.
  • In February, the Technical Workgroup reviewed and prioritized 12 ESSENCE enhancement tickets (3 high, 1 medium, and 5 low). The workgroup closed out 3 tickets: (1) added state prefix to weather station names; (2) created a list of specific records (via tagging); and (3) moved from a time-series view to data details for two separate queries (Note: If data are slow to load, you can avoid this by going to data details queries, if that is your primary interest).

• Volunteers Needed! CSTE and Kahuina Consulting to Develop Training Series for Summer 2022
  Curriculum-based trainings on syndromic surveillance will be developed for novice and advanced learners. The on-demand training series will build knowledge and skills across the “data-to-action” continuum and include hands-on skill-building exercises. The intent is to build the participant’s ability to describe where data come from, assess data quality, apply standard methods and tools to a range of public health domains and foci, and interpret data for improved decision making.
  • CSTE seeks community help to identify training content, methods, and faculty.
  • To get involved, please email syndromic@cste.org.

• Registration Open for 2022 CSTE Annual Conference; Louisville, Kentucky; June 19–23, 2022. Conference will be a hybrid of in-person and virtual sessions; for details, visit csteconference.org.external icon

• Election of Core Committee Deputy Chair Coming Soon
  The Core Committee is seeking a new Deputy Chair. Duties will include:
  • assisting the Core Committee Chair by developing agendas and facilitating discussion during monthly meetings;
  • working closely with Core Committee members to achieve working goals;
  • supporting NSSP CoP group activities;
  • moderating monthly NSSP CoP calls; and
  • reviewing and commenting on documents pertaining to the NSSP CoP (e.g., administrative process documents, NSSP CoP group-developed products, and CSTE syndromic surveillance project deliverables).

Demonstrations

• New Capability of R-Shiny Environment for Report Sharing
  Presenter: Aaron Kite-Powell (CDC NSSP)
  The R-Shiny application enables NSSP to share reports with the community. These include daily reports and weekly reports on COVID-related state trajectories, maps, trends, and anomalies. Note: Only those with Access and Management Center (AMC) accounts can view these reports via the R-Shiny application.

• • To access reports, go to https://dashboards.syndromicsurveillance.org/external icon and log in with AMC credentials. Select Coronavirus Exploratory Dashboard. On the left-hand navigation pane, select Reports.

• • In addition to reports, community members can access ad hoc analyses:
    1. Go to https://dashboards.syndromicsurveillance.org/external icon and log in with AMC credentials.
    2. Select Coronavirus Exploratory Dashboard.
    3. From the left-hand navigation pane, select Reports, and under Ad Hoc Analyses, select the area you’re interested in.

• Syndrome Co-Occurrence with COVID Report
  Presenter: Kelly Carey (CDC NSSP)
  The Co-Occurring Chief Complaint and Discharge Diagnosis (CCDD) Categories, Syndromes, and Subsyndromes of COVID-Specific DD v1 Emergency Department Visits ad hoc analysis is now available to R-Shiny application users. The NSSP team demonstrated how this exploratory analytic method could be used to see the distribution of COVID-specific DD v1 encounters across CC and DD categories, syndromes, and subsyndromes during three periods: pre-Delta visits from December 20, 2020–January 09, 2021; Delta visits from August 15, 2021–September 04, 2021; and Omicron visits from December 19, 2021–January 08, 2022.

• Weighted Log Odds Symptom Change Analysis Across Variant Periods
  Presenter: Michael Sheppard (CDC NSSP)
  An ad hoc analysis available to R-Shiny application users is the Weighted Log Odds Symptom Change Analysis Across Variant Periods. Using this method, national data are pulled from the Facility Location (Full Details) data source by CDC COVID-Specific DD v1 CCDD category. Encounters are limited to emergency department (ED) visits from January 1, 2021–January 30, 2022. Standard stop words included in “stop_words from tidytext” are removed as are uninformative terms in chief complaints (i.e., encounters, unspecified, and patient). This analysis aims to identify chief complaint symptom-based terms potentially indicative of the Omicron COVID-19 variant relative to pre-Delta and Delta periods spanning January–December 5, 2021.

The following analyses are included: Top 10 weighted log odds ratios comparing pre-Delta, Delta, and Omicron periods (weighted log odds ratios computed for CC and DD unigrams and bigrams) and weekly time series showing n-gram proportions for top 10 n-grams in each period.

• Impacts of COVID-19 on National Pediatric Volume and Pediatric Mental Health Visits
  Presenter: Lakshmi Radhakrishnan (CDC NSSP)
  Radhakrishnan, lead author for two Morbidity and Mortality Weekly Report (MMWR) articles that use NSSP data, explained how the reports use NSSP data to assess health-seeking behaviors of adolescents before and during the pandemic. Both reports highlight the need for increased awareness of health concerns among children and adolescents that could arise due to delayed medical care and heightened emotional distress.  Links to the MMWRs follow:
  • Pediatric Emergency Department Visits Before and During the COVID-19 Pandemic — United States, January 2019–January 2022
  • Pediatric Emergency Department Visits Associated with Mental Health Conditions Before and During the COVID-19 Pandemic — United States, January 2019–January 2022

One symptom that stood out among adolescent females is atypical increases in visits related to tic disorders. More on the complexity of tic disorders can be found in “Rising Incidence of Functional Tic-Like Behaviors. What’s happening? Why now?”external iconexternal icon

• User Interface Redesign
  Presenter: Wayne Loschen (Johns Hopkins University–Applied Physics Laboratory, JHU–APL)
  • The JHU–APL development team is working on the user interface and experience (UIUX) redesign for NSSP–ESSENCE.
  • The team is conducting interviews to solicit feedback on the redesign.
  • Community members are encouraged to share their ESSENCE “wish lists” with the NSSP team by emailing nssp@cdc.gov.

Join the NSSP CoP Slack Workspace

It’s easy to join.external icon And the community is always exchanging ideas, exploring possibilities, and discussing topics relevant to today’s surveillance challenges.

So what are your colleagues discussing?

• #covid19
• #data-lab
• #data-sharing
• #data-quality
• #drug-overdose-use
• #environmental-health
• #essence-user
• #general
• #hospital-admissions
• #planned-analyses-and-publications
• #national-data-requests-sop
• #nssp-cop
• #race-and-ethnicity
• #random
• #r-user
• #sas-user
• #severe-weather
• #spherr
• #syndrome-definitions
• #training
• #violence-surveillance

Find and Join Channels

• • 1. Hover cursor over “Channels” on left side of Slack space.
    2. Click the three dots icon that appears next to “Channels” titled “Section Options.”
    3. Select “Browse Channels.”
    4. Find and join any channel that looks interesting!

“Modernization” of our public health data and surveillance systems is one way in which CDC invests in the future of public health.

The CDC Public Health Data Modernization Initiative lays out a path to move us toward integrated systems that provide data more efficiently for public health action. This framework guides decisions for allocating resources to create interoperable systems (federal, state, local, and healthcare), coordinate investments across CDC (and with partners), develop next-generation tools (e.g., modeling, visualization, machine learning), and strengthen predictive analytics and forecasting. One objective of DMI is for syndromic surveillance to give a faster understanding of emerging health threats through electronic reporting of emergency department visits.

“This is a moment in time when our national leaders will seek to identify or build platforms to detect and monitor future health threats,” NSSP Lead Loren Rodgers said during a 2021 NSSP Community of Practice call. “I’d like to challenge the NSSP community to consider our place in a new public health infrastructure. I don’t know of another program that is so purpose-built for this task with the ability to scale to include new data sources and analytics and to share these data with allied [public health] jurisdictions and trusted partners. Our syndromic community exemplifies innovative approaches that other surveillance systems aim to implement.”

CDC’s earlier modernization efforts laid the groundwork that supports NSSP’s current approach to surveillance and—bolstered by CDC’s Data Modernization Initiative—positions the program to better protect our country from all types of public health threats.