COVID-19 Outbreaks: State Reporting By Setting

This resource was developed to identify states that have defined and are reporting setting-specific outbreaks as of November 2020 and highlight promising examples that others can look to as they consider adapting and expanding COVID-19 reporting.

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Introduction

Data about the settings where COVID-19 infection occurs are critically important to understanding disease spread and informing policy decisions that promote public safety. These data will be particularly important as states roll out vaccination campaigns and look to target effective outreach, testing, and immunization in places where active disease-spread remains. To date, states vary widely in terms of whether and how they report COVID-related outbreak data, and what thresholds they use to define an outbreak. Additionally, there are no federal standards on the case thresholds for what constitutes an “outbreak” or for notifying the public of setting-specific outbreaks (other than in nursing homes).

Since COVID-19 emerged in early 2020, the term “outbreak” has been used several different ways in reference to this novel disease (see box of definitions). On a macro-level, the term outbreak has been used to describe the spread of the COVID-19 disease as it has progressed from a sudden increase in cases in one geographic area, to an epidemic, and ultimately to a global pandemic. On a micro-level, the term outbreak has commonly been used to describe new and concentrated COVID-19 cases, hospitalizations, and/or deaths occurring at lower levels of geography, such as at the state, territory, or municipal level.

Setting-specific outbreak reporting (sometimes also called “cluster reporting”) has been used by states to describe the amount of disease occurring in a specific setting, such as schools or workplaces. On behalf of the National Governors Association (NGA), and with support from the Robert Wood Johnson Foundation (RWJF), the State Health Access Data Assistance Center (SHADAC) developed this resource to identify states that have defined and are reporting setting-specific outbreaks as of November 2020 and highlight promising examples that others can look to as they consider adapting and expanding COVID-19 reporting. This resource also includes a summary of the status of related reporting on contact tracing and discussion of the impact of increasing levels of community spread on states’ abilities to collect and report outbreak data.