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What does your ideal, comprehensive COVID-19 dashboard look like? The decades-long experience with HIV surveillance gives us some guidance, I believe. Importantly, it suggests that multiple measures are key to giving us different lenses to view the same epidemic. 1/x
One measure is not wrong but rather different. We learn different lessons from it, and perhaps consider different actions based on it. And, of course, we might prioritize some metrics as most central based on national strategic goals (highlighting the need for such goals). 2/x
But the totality of the surveillance system is critical. The HIV surv system includes behavioral surv, PrEP and care access (& retention), incidence (incl recent, acute, & cumulative where possible), prevalence, diagnoses (incl late & % undiagnosed), viral suppression, 3/x
(continued) opportunitistic infections, fatalities, and disparities among all measures in terms of race, ethnicity, gender, age, LGBTQIA+, geography, housing status, insurance status, and other key socio-demographic factors (including stigma and racism). 4/x
Of course, selecting priorities among many such indicators ideally should be tied to a well described and evidence-based national strategy such as the 2015 Update of the National HIV/AIDS Strategy https://www.hiv.gov/federal-response/national-hiv-aids-strategy/overview 5/x
There are many COVID-19 dashboards emerging and now useful catalogues of dashboards are being developed as living documents ( https://guides.ucsf.edu/COVID19/data#s-lg-box-23508795). 6/x
My ideal COVID dashboard would include measures of exposure, infection (incl recent, acute, & cumulative), diagnoses (& % undiagnosed), access to needed care (incl hospitalizations, ICU admissions, intubation, and other evidence-based tx), recovery (incl rec time), fatality, 7/x
and disparities among these measures (and social conditions and policies relevant to these measures) broadly defined. The exposure measures would include "exposure" to local, state and national policies relevant to COVID. (Please do add your own metrics here.) 8/x
A starting place for such a dashboard might include the COVID-19 outcomes continuum noted here and build out from there: https://www.sciencedirect.com/science/article/pii/S1047279720302076?via%3Dihub 9/x
Again, the main point of this thread is not to present one COVID-19 dashboard on which all can agree. 10/x
Rather to reflect upon some lessons from the HIV surveillance experience, and to suggest that considering comprehensiveness and synergy among measures (preferably prioritized according to a national plan) may provide a productive conversation for COVID-19. 11/11
