Sunday, July 12 update

A much-needed look at how New York State counties have been communicating COVID data to their residents was published last week: Counties, COVID Data, and You. This is an excellent exploration of something that a lot of New Yorkers have been complaining about over the last several months — the confusing, sometimes maddening discrepancies between state-level data and local data, as well as the local differences in data reporting. Since New York’s reopening strategy has been so numbers-based, having the correct numbers is important. The bumps in the data road have ranged from merely annoying to genuinely distressing (like that time when our CE had to come out and announce 40 surprise nursing home deaths the state never got around to telling us about).

However, I’d also like to make the case that uniform data reporting — in the broader sense of “data,” which means all kinds of information, from quantitative to qualia — is only worth something if that data is good and up-to-date, and if the data is usefully applied.

It seems that in many other parts of the U.S. which are going through what New York went through in March and April, the public information and statistics on COVID come from a hodgepodge of outlets and dashboards. Especially from private or university hospital systems, as is (or it appears was) the case in Charleston, S.C.

MUSC officials announced an agreement with state and local officials to pause the use of the recently launched Charleston Area COVID-19 Warning Level system. MUSC said they will work together with state and local public safety agencies to explore the possibility of developing a statewide COVID-19 notification system. The previously announced schedule of warning level updates has been canceled. They want to remind the public to wear a mask, social distance, practice excellent hand hygiene and protect vulnerable populations.  Details are limited at this time.

One thing that New York State never wasted its time on was an “alert system” — mainly because there wasn’t enough time to devise one. Instead, the general state of alarm was felt more than it was read or heard. People in New York read articles in newspapers, heard about cancelled events, and most ominously, started to hear from the governor each day (though this was before his formal daily conferences). My recollection is that there was a rising sense of danger before any states of emergency had been declared either at the state or county level. They need to cancel the St. Patrick’s Day Parade, everyone started to murmur amongst themselves, before anyone openly would discuss the pandemic, or that there even was a pandemic.

As the state began to shut down in mid-March, there was no easy set of communication tools (such as “red alerts,” “orange alerts,” etc) put in place, but rather an informal set of communications strategies from the state to the local level. Most famously now, Cuomo’s daily slideshows; but down at the county level, some officials (like ours in Onondaga County) were also going on TV all the time. There was no official coordination of message, as we grit our teeth to remember. However, the message was uniform: We have a serious situation on our hands, and we must pay attention to the science. This was a notably non-partisan message.

I know about this news story from Charleston because I have a cousin who lives there. I also have relatives who live in Marion County, Florida (Ocala) and I was curious the other day to see what kind of information they had on their county dashboard. Well, they don’t have a county dashboard or report that gets updated daily; not much COVID information on their county website at all, just a link to the Master Florida Dashboard. Which does have county breakdowns, but this dashboard, as we’ve heard in the news, is now under strict state control.

The New York COVID data experience did indeed vary widely from county to county, and from county to state, and this did produce a lot of stress and controversy which still isn’t over. But I’d also say that while the basic information and messaging was the same — across regional and party lines — there was a richness and an interplay to it, I think, helped ensure that the state more or less moved forward together. Despite Cuomo’s top-down personality, in fact the local leaders were also competent and had a great deal of leeway to choose their own strategies for uncovering data. This was communicated back up to the top through a deeply flawed system (the “Regional Control Boards”), but it did appear to get communicated. There was some bottom-to-top flow. Some of it came in the form of late night shoe-bangers, but it did get heard.

The unsettling thing about the newly-stricken states is that some of them are now moving to standardize and smooth out COVID data, and also create not terribly useful messaging, like color-coded text alerts. As I’ve guessed before, some localities are probably coming up with effective data collection strategies, as well as effective community outreach — but if states like South Carolina are moving to “professionalize” the message, taking away initiative from localities, hospitals or health departments, that is cause for concern. Especially when so much of the Sun Belt population seems disinclined to pay attention to state-generated messaging, while simultaneously looking for guidance toward a personality (Trump) who seems to be actively trying to kill them.

It’s not hokey to say that to survive any kind of calamity, be it a natural disaster, war or pandemic, people who are affected have to be good at accurately reading the tea leaves. Official messaging helps, but there also has to be “herd instinct” before you can develop herd immunity. Citizens have to have enough information coming in on a regular basis — either hard numbers, or the words of their governor or local leaders or health departments — in order to assess the situation and feel their feelings of danger about it. The less rich the information sources are, the less responsive the public will be.

The successful public announcement about COVID or any other danger will merely be validating and focusing what the public already has begun to sense. You don’t have to speak the language of data or boil it down into color-coded alerts; that’s not really what “clarity” means. The sounds of many different drums seem most clear.