Glut in data, dearth of information shackles PH anti-Covid program

By Yen Makabenta, Manila Times, 13 Aug 2020

First word

THE Philippine response to the coronavirus pandemic would not be so jumpy and erratic if our decision-makers and implementers were more cognizant of the difference between data and information.

As things stand today, the nation is literally drowning in a glut of data about the viral outbreak, which pour in daily from the Department of Health (DoH), and from different levels of government (national, regional, provincial, city-municipal and barangay).

Yet strangely, the whole program against Covid-19 is woefully short of meaningful information and knowledge about the virus and the prevailing situation. It cannot explain to the nation why the Covid-19 infections or cases keep surging every day, although the entire country has been locked down again since August 4.

The DoH in its daily briefings unfailingly provides statistics on confirmed Covid-19 cases, increases in infections, fatalities and recoveries.

But it gives no information on what the statistics mean or how the country is doing with stopping the pandemic. There is no breakdown of the statistics, no information on who are the fatalities, and how the different age groups are being afflicted. The briefing is bland to a fault.

Data and information: The subtle difference

There is a subtle difference between data and information. Data are the facts or details from which information is derived. Individual pieces of data are rarely useful alone. For data to become information, data needs to be put into context.

Data is raw, unorganized facts that need to be processed. Data can be something simple and seemingly random and useless until it is organized. When data is processed, organized, structured or presented in a given context so as to make it useful, it is called information.

The statistician and author Nate Silver writes in his book, The Signal and the Noise: “The numbers have no way of speaking for themselves. We speak for them. We imbue them with meaning.”

“Data” and “information” are intricately tied together, whether one is recognizing them as two separate words or using them interchangeably, as is common today.

The history of temperature readings all over the world for the past 100 years is data. If this data is organized and analyzed to find that global temperature is rising, then that is information.

Because data needs to be interpreted and analyzed, it is quite possible — indeed, very probable — that it will be interpreted incorrectly. When this leads to erroneous conclusions, it is said that the data are misleading. Often this is the result of incomplete data or a lack of context.

The DoH does nothing with all the data it is accumulating.

PH situation

This brings me to the pandemic situation in the Philippines.

Here, both government officials and ordinary citizens are bewildered by the recent trajectory of the pandemic.

Counting from March 16, when President Duterte first imposed the community quarantine to control the virus, the nation has now known 149 days of lockdown. There was a brief time when the lockdown was lifted, and the economy was reopened. But on August 4, after the sudden surge of infections, Duterte, backed by the Inter-Agency Task Force for the Management of Emerging Infectious Diseases quickly returned the country to economic lockdown, particularly the National Capital Region and Cebu City.

The official belief is that a lockdown would work to slow down the virus. But since August 4, the new infections have averaged over 3, 000 daily, and even over 4,000 cases at one time.

The surge has led the DoH to adopt a new battle plan against Covid-19, in a strategy that would partner more with local governments in the fight. Individual local governments, including the barangay, would be allowed to design their own specific response to the pandemic, depending on their situation.

On Wednesday, top officials, led by Palace spokesman Harry Roque Jr. acknowledged that the government is at its wit’s end in slowing down the viral surge. They are bewildered.

US seeks better data and information

The Philippines is not alone in trying to surmount a surge in virus cases. The United States, too, is today scrambling for an effective way to control a surge in virus cases in some states.

Ali Mokdad, an epidemiologist at the University of Washington, has been trying to make sense of this summer’s Covid-19 surge. As a global health expert at the university’s Institute for Health Metrics and Evaluation, Dr. Mokdad strives to provide more nuanced answers to the questions

“Why can’t we figure out what’s contributing to the recent spread? It is very simple,” he said. “No access to data.”

In a move seen as potentially obstructing access to Covid-19 information even more, the Trump administration last month ordered hospitals to stop sending data to the Centers for Disease Control and Prevention (CDC), and instead send them to a private data firm under contract with the Department of Health and Human Services.

Skyrocketing cases, clashes among federal leaders and a hodgepodge of state data have left many Americans asking how the United States will get back to anything resembling normal life.

The answer is straightforward, Mokdad and other epidemiologists say: wearing masks, social distancing, more testing — and better data.

Epidemiologists insist that standardizing the Covid-19 data that states and localities publish is essential to helping people navigate their daily lives and enabling political leaders to make science-based decisions that the public can support.

“This virus isn’t disappearing,” said Dr. William Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University’s medical school. “Covid will be here three years from now in some form. We hope we get a vaccine soon. But even when we do, people will need data to see the impact of vaccinations.”

State and local health officials say providing better data isn’t so simple. Meager budgets, stodgy technology and disjointed state and local reporting systems make standardizing data an arduous undertaking.

“It’s a nice idea,” said Oscar Alleyne, chief of programs and services at the National Association of County and City Health Officials. “But it’s not the highest priority in most jurisdictions right now.”

“Local health departments are focused on what’s in front of them, and that’s the data they need to decide how to open schools without getting caught up in a whirlwind of amplifying disease.”

Still, epidemiologists point out that every other developed country battling the virus has been able to publish the kind of data average people and scientists need to track the course of the disease each day and pivot their individual behavior and public response accordingly.

America’s lack of federal leadership has caused it to fall behind other countries in combating the virus, said Dr. Tom Frieden, former CDC chief.

He and other public health experts urged state and local health agencies to adopt a uniform system of reporting on testing, positive cases, hospitalizations and deaths, as well as on the effectiveness of contact tracing efforts and the percentage of people wearing masks.

Detailed case and contact-tracing data from state and county health authorities, they said, could point to more effective, targeted approaches to slowing the pandemic. Without the data, the scientists said, little more can be done.

“It’s a matter of trying to present data in ways that get people to make behavior changes, which usually happens when people are impacted personally or when they have local information,” Frieden said. “We want to provide data as locally as possible without violating privacy rights or confusing people. But we know we have information gaps.”

Public health officials and advocates argued in a new report that without uniform data, the US will continue to lag behind the rest of the world in fighting the pandemic.

Public health agencies need to tell the public what the local data means. Five cases could be a crisis in a tiny rural town, while 50 could be manageable in a medium-sized city. The average person doesn’t know that on their own.

Better data and information can help guide businesses and residents to plan their days.

To let people know how well their local health department is controlling the virus, cities and states should report the percentage of new cases arising from so-called community spread, outside of known transmission chains, said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.

“How many new cases were already on their radar and how many weren’t? That’s really important, because if too many cases have unknown sources, the virus could be spiraling out of control,” Adalja said. “People need to know that.”