How New York’s Decentralized Public Health System is a Firewall Against Data Chaos
Decentralized public health system
In the United States, our public health system is decentralized. This means that local and state health departments collect and own the data rather than the federal government. During the Covid-19 pandemic, limitations to this setup slowed our understanding of what was happening nationally — the Centers for Disease Control and Prevention had to knit all the local and state pieces together. However, with current uncertainties surrounding federal data sharing, this is a good thing, as it provides a sort of firewall.
All states have slightly different models of how this works. New York is a mostly decentralized state. Local health departments retain authority and are led by local government employees. They collect health data from their communities and share it with the state and then with the CDC. Data flow from the bottom up, and remain available to us regardless of what the feds do or don’t do with it. Importantly, states don’t have to send the majority of data to the CDC (really only hospitalizations).
While this is good news, there are some vulnerabilities associated with a potentially weakened CDC that epidemiologists like myself are paying close attention to:
- During big outbreaks or public health emergencies, like a measles outbreak or hurricane, coordination across states and with the CDC is absolutely essential. We often rely on CDC expertise when new or rare diseases pop up.
- Reduced funding for the CDC would affect local and state health department funding. Eighty percent of local and state public health funding comes from the CDC.
- Not all states have the resources to maintain their own health dashboards, like in North Dakota, for example. Many rely on CDC’s dashboards, and without them, residents of those states could be left without critical public health information.
What this means to you and New York communities
New York can (and continues to) publish its data for New Yorkers without interference from federal government chaos. For example, dashboards for influenza, RSV, Covid-19, and wastewater remain unaffected.
The flu: High and increasing
The number of people with flu in New York is abnormally high for this time of year, and the increase is widespread across all state regions. With so much flu, New York hospitals are being pushed to their limits. In Rochester, for example, recent spikes in flu hospitalizations have pushed the Strong Memorial Hospital beyond its capacity.
Covid-19: Minimal and holding steady
Covid-19 activity in New York has remained surprisingly low — this is our mildest Covid-19 winter to date.
RSV: Moderate and decreasing
RSV has peaked and continues to decline in New York. This season looks like a middle-of-the-road RSV season, like last year’s. The shape of the RSV seasonal curve in New York is similar to the past three years.
Emerging diseases: Avian flu
Two weeks ago, avian flu (bird flu, H5N1) was detected on a Long Island duck farm. This is important because, up to now, New York has been relatively spared the impacts of H5N1 compared to other states. We’ve had no reported cases among humans or cattle. The duck farm outbreak is only our second in a commercial flock statewide and our first in three years. Thankfully, New York agriculture and public health authorities are taking steps to prevent further spread.
Bottom line
These are uncertain times for federal public health agencies. I’m grateful we can rely on strong local and state public health systems in New York to keep us informed. For now, winter virus transmission, especially the flu, is still high. Stay healthy: Mask up, avoid social interactions when you’re sick, and get vaccinated.
Conclusion:
New York’s decentralized public health system serves as a firewall against data chaos, providing a reliable source of information for the public. While there are vulnerabilities associated with a potentially weakened CDC, New York’s system is well-equipped to handle the challenges. As the winter season continues, it’s essential to prioritize public health measures, such as getting vaccinated, wearing masks, and avoiding social interactions when sick.
Frequently Asked Questions:
- What is the current state of the flu in New York?
The number of people with flu in New York is abnormally high for this time of year, and the increase is widespread across all state regions. - What is the current state of Covid-19 in New York?
Covid-19 activity in New York has remained surprisingly low — this is our mildest Covid-19 winter to date. - What is the current state of RSV in New York?
RSV has peaked and continues to decline in New York. This season looks like a middle-of-the-road RSV season, like last year’s. - What is the current state of avian flu in New York?
Avian flu (bird flu, H5N1) was detected on a Long Island duck farm, but there have been no reported cases among humans or cattle. New York agriculture and public health authorities are taking steps to prevent further spread.
