Community of Practice Updates

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Policy for Federal Access to NSSP Data

During the November 2022 CoP Monthly meeting, Acting NSSP Lead Karl Soetebier informed the community of efforts to make NSSP data more accessible and to improve collaboration toward common goals.

In early December 2022, Soetebier updated site administrators of NSSP’s ongoing work related to data use. He explained how expanded access to NSSP data during the COVID-19 public health emergency enabled innovation in areas such as trend indicators and classification, anomaly detection, and text mining by age and geography. The ability to work this way routinely, outside the context of a public health emergency, is not permitted by the current data use agreement.

In early 2023, to build on public health response innovations and to continue to enhance data use, CDC began designing a new NSSP agreement to incorporate lessons learned from the COVID-19 response, enable close collaboration between sites and CDC, enable new innovations and services for sites, and maximize responsible use of data and provide timelier synthesis of findings and recommendations. Further, this agreement would help respond to the top concerns raised by public health departments in the Review of Federal Access to National Syndromic Surveillance Program Data: Findings and Implementation Strategies, posted by the Council of State and Territorial Epidemiologists (CSTE) in February 2023.

CDC has made a thoughtful choice to change from a data use agreement (DUA) to a memorandum of understanding (MOU) to better reflect the collaborative nature of the agreement. By refocusing the DUA as an MOU, the collaborative and participatory goals of the partnership across federal, state, and local public health authorities become more transparent. Details of the DUA/MOU are being worked through.

NSSP CoP Monthly Meeting

The National Syndromic Surveillance Program (NSSP) Community of Practice (CoP) met on April 26, 2023. On average, 100 to 120 people participate in these monthly meetings. Recordings for CoP monthly calls are posted in the Knowledge Repository.

NSSP Update

Subcommittee and User Group Updates

• Analytic Tools for Routine Health Surveillance Subcommittee: There was a guest presentation in March by Sara Chronister (WA) about working with rates. The April call featured a presentation on the moving epidemics method for estimating intensity thresholds for diagnostic definitions such as respiratory syncytial virus (RSV).
• Data Quality Subcommittee: During the April call, attendees discussed how to explore exceptions tables in Datamart and how ESSENCE collapses visits. In place of the May call, the subcommittee held a joint call on May 3, 2023, with the Syndrome Definition Subcommittee.
• NSSP–ESSENCE User Group: Reminder! This group is looking for topics related to ESSENCE that will improve members’ practice.
• NSSP R User Group: During the March call, attendees shared tips and tricks for custom CSS formatting in R Markdown. During the April call, attendees discussed regular expressions in detail and how to use with syndromic surveillance data. In May, presenters from Posit will give an overview of the NSSP instance of RStudio. They will present new features, recent upgrades, and information about the company’s transition from RStudio to Posit.
• Syndrome Definition Subcommittee: A joint subcommittee call with the Data Quality Subcommittee was held May 3, 2023. The subcommittees discussed ICD-9 codes—how often they appear in data, if they are used in combination with other coding systems, the overlap with ICD-10 codes, and how to handle them when drafting syndrome definitions. Syndrome definition and validation work is coming down the pipeline. Details will be provided on the Syndrome Definition Subcommittee call.
• Technical Workgroup: Rosa Ergas recently joined as a co-chair. The workgroup reviewed spatial alerts that users can customize and suggested improvements. Reminder! Please submit tickets if you want to see changes made to the BioSense Platform.

See the NSSP CoP calendar for upcoming meeting dates and times.

Site-level Respiratory Dashboard Demo

Syndromic Surveillance Post-COVID-19 Public Health Emergency Discussion

Anna Frick (AK Department of Health) initiated a discussion about syndromic surveillance’s transition from emergency to routine surveillance for COVID-19 at the end of the Public Health Emergency (PHE) (May 11, 2023). Attendees were polled to get their thoughts on:

• how the end of the COVID-19 PHE would impact their ability to conduct syndromic surveillance on COVID-19,
• how they currently use syndromic data for COVID-19 surveillance,
• how they plan to conduct surveillance of COVID-19 surveillance post-PHE,
• how important syndromic surveillance is to an ongoing COVID-19 surveillance strategy (e.g., use of emergency department data and NSSP’s ability to integrate data sources), and
• how the end of the PHE will affect syndromic surveillance for COVID-19.

Many attendees reported that any disruption in their ability to use syndromic surveillance for COVID-19 would be minimal. A few attendees reported that the end of the PHE would, in fact, make syndromic surveillance even more important because it is a long-term system implemented before the COVID-19 pandemic and will remain after the PHE ends. Although many attendees reported using syndromic surveillance to monitor COVID-19 trends, some attendees reported using syndromic surveillance to monitor for Long COVID or Post-COVID Conditions, reviewing deaths due to COVID-19, and determining changing symptom presentation of COVID-19.

Resources:

COVID-19 Surveillance After Expiration of the Public Health Emergency Declaration ― United States, May 11, 2023 | MMWR (cdc.gov)

Correlations and Timeliness of COVID-19 Surveillance Data Sources and Indicators ― United States, October 1, 2020–March 22, 2023 | MMWR (cdc.gov)

Long COVID or Post-COVID Conditions | CDC

Introduction to Syndromic Surveillance (SyS) Methodology