COVID-19 Surveillance After Expiration of the Public Health Emergency Declaration - United States, May 11, 2023.

On January 31, 2020, the U.S. Department of Health and Human Services (HHS) declared, under Section 319 of the Public Health Service Act, a U.S. public health emergency because of the emergence of a novel virus, SARS-CoV-2.* After 13 renewals, the public health emergency will expire on May 11, 2023. Authorizations to collect certain public health data will expire on that date as well. Monitoring the impact of COVID-19 and the effectiveness of prevention and control strategies remains a public health priority, and a number of surveillance indicators have been identified to facilitate ongoing monitoring. After expiration of the public health emergency, COVID-19-associated hospital admission levels will be the primary indicator of COVID-19 trends to help guide community and personal decisions related to risk and prevention behaviors; the percentage of COVID-19-associated deaths among all reported deaths, based on provisional death certificate data, will be the primary indicator used to monitor COVID-19 mortality. Emergency department (ED) visits with a COVID-19 diagnosis and the percentage of positive SARS-CoV-2 test results, derived from an established sentinel network, will help detect early changes in trends. National genomic surveillance will continue to be used to estimate SARS-CoV-2 variant proportions; wastewater surveillance and traveler-based genomic surveillance will also continue to be used to monitor SARS-CoV-2 variants. Disease severity and hospitalization-related outcomes are monitored via sentinel surveillance and large health care databases. Monitoring of COVID-19 vaccination coverage, vaccine effectiveness (VE), and vaccine safety will also continue. Integrated strategies for surveillance of COVID-19 and other respiratory viruses can further guide prevention efforts. COVID-19-associated hospitalizations and deaths are largely preventable through receipt of updated vaccines and timely administration of therapeutics (1-4).

The Texas flood registry: a flexible tool for environmental and public health practitioners and researchers.

BACKGROUND: Making landfall in Rockport, Texas in August 2017, Hurricane Harvey resulted in unprecedented flooding, displacing tens of thousands of people, and creating environmental hazards and exposures for many more. OBJECTIVE: We describe a collaborative project to establish the Texas Flood Registry to track the health and housing impacts of major flooding events. METHODS: Those who enroll in the registry answer retrospective questions regarding the impact of storms on their health and housing status. We recruit both those who did and did not flood during storm events to enable key comparisons. We leverage partnerships with multiple local health departments, community groups, and media outlets to recruit broadly. We performed a preliminary analysis using multivariable logistic regression and a binomial Bayesian conditional autoregressive (CAR) spatial model. RESULTS: We find that those whose homes flooded, or who came into direct skin contact with flood water, are more likely to experience a series of self-reported health effects. Median household income is inversely related to adverse health effects, and spatial analysis provides important insights within the modeling approach. SIGNIFICANCE: Global climate change is likely to increase the number and intensity of rainfall events, resulting in additional health burdens. Population-level data on the health and housing impacts of major flooding events is imperative in preparing for our planet's future.