COVID-19 related EPI data
I am trying to get clarity around these data element that Janet sent out regarding COVID-19:
These were the consensus questions arrived on by the CSTE membership that should be required and submitted to the state health department:
These were the consensus questions arrived on by the CSTE membership that should be required and submitted to the state health department:
- Employed in healthcare? Y/N/U
- QUESTION: Employed in healthcare - Is that meant to identify health care providers / anyone who works in a healthcare setting, or more general ANYONE who works in a work setting that has a high risk of exposure like: healthcare providers, patient contact support personnel in health care, first responders, consumer-facing personnel in essential businesses (grocery). Please clarify.
- QUESTION: Would it be acceptable to instead ask this question:
Worker in a setting with exposed risk and then list the acceptable settings?
- Symptomatic? Y/N/U
- QUESTION: I assume this is defined as symptomatic for the suspected disease, which is this case would be at least 2 of fever, cough, shortness of breath, fatigue
- QUESTION: Would it be acceptable to ask for a list of symptoms instead?
- Pregnant? Y/N/U
- We have vocabulary for this - yeah!!!
- Underlying health conditions – this was of interest but if this could not be collected explicitly by condition it may not lead to effective data
- QUESTION: So with the comment does that mean the expected answer was going to be free-text? Should it not be included?
- These were prioritized of interest but would not be relevant to the drive through sites: Hospitalized? Y/N/U; ICU? Y/N/U
- QUESTION: Would it be acceptable to ask about Patient Location and provide a list of settings of interest like hospitalized, in ICU, in long-term care facility, etc?
- For all Y/N/U valueset:
- QUESTION: What is the reasoning behind including U = Unknown, compared to leaving the question unanswered?
Thanks for any feedback you can provide - I plan to post the approriate LOINCs and other codes once I have clarity.
Remind me -- submitted with lab results? If so my comments below are relatd to that.
During Zika, I know Quest included a few AOE including symptom/symptomatic and pregnant, but we received very, very few of these answers. Honestly, I'd rather get complete patient demographic info including race/ethnicity. However, for CoV and these unusual test settings, it would be useful to get some of this minimal info. Within the limitations of a 5 -10? min drive through encounter or rapid test encounter outside of a hospital/resident facility setting.
HCW to me means someone employed in a healthcare setting and working in direct patient care -- hospitals, nursing homes, EDs, EMTs, perhaps urgent care. Other exposures you list for me are "routine possible exposure due to encounters in the community" -- retail workers etc. Not needed for an initial AOE. see comment below re: symptomatic in the community.
Symptomatic - Y/N based on does the person have any of the following symptoms (short list)? Hospitals/nursing homes and the like are going to send us more details or we will be working with them closely. If someone in the community is positive, local health will be contacting at least at this point for contact tracing. BTW, some local health folks have told me they call positive people who are ill at home and those folks are too sick to even be interviewed a lot of the time.
I would skip underlying conditions. Too complicated for the data collection setting we are talking about. Aren't most states using some sort of provider reporting to get at questions like hospitalized and underlying conditions?
Unknown is always a question of did it mean - not asked, not answered, don't know? I'm neutral on this one.
Just my $0.20 and I will give change back.
I missed the email from Janet H. When was that sent? I would add date of symptom onset to essential fields!
Agree about the underlying conditions. We are getting killed here in NYC for not having race/ethnicity info on our almost 100,000 cases now. Prob too late for us but just wanted to register those data elements as important to decision-makers for equity purposes. Justifiably so.