WHAT POOP CAN TELL US — The federal government is turning to a familiar surveillance method to track avian flu: wastewater. The CDC, the FDA and the USDA plan to spend billions of dollars to contain the outbreak among cattle across the nation, hoping to keep the virus from mutating and jumping to humans. Among the federal efforts is $3 million to prop up a wastewater surveillance pilot program at 10 “livestock-adjacent sites” to track influenza A, the strain of flu that bird flu falls under. The CDC has used such surveillance to track Covid-19, and public health experts recently urged the agency to use it to trace avian flu. The CDC is expected to post the wastewater surveillance data publicly but didn’t respond to request for comment on when. Here’s what to know: — Can the surveillance tell us whether the virus is coming from humans? Not necessarily because the samples could reflect anything from human waste to cow waste to dairy milk dumped in sewers. “Wastewater is a signal,” Dr. Georges Benjamin, executive director of the American Public Health Association, told Pulse, explaining that it can pinpoint the presence of a viral infection but not the cause. — What can public health officials do with this information? Spikes of influenza A in wastewater can alert public health officials to a specific community that might be experiencing an avian flu outbreak. “You go into that area and start looking at people for signs,” Benjamin said. “For sites with unusual influenza A virus activity detected in wastewater data, we will notify relevant partners and continue to actively investigate,” the CDC said on its website. — What are the limitations? The system must be able to zero in on specific areas, which is why the CDC is targeting areas where livestock are. Federal officials, however, have had trouble gaining access to farms to collect data because of pushback from some state agricultural officials and farmers, who worry federal health officials are sidelining state agricultural experts. HOSPITALS STILL REPORT COVID DATA — After the CDC ended its requirement last month that hospitals report flu and Covid-19 data, most hospitals continue to report. A CMS data requirement that hospitals report certain Covid and respiratory illness data, including hospital bed capacity and the number of people who have confirmed or suspected respiratory illness, ended April 30, per the end of the public health emergency. The agency expects to resume reporting in October if a proposed regulation is finalized. A CDC spokesperson told Pulse that 5,000 hospitals, on average, report the data each day — but starting May 10, that number might fluctuate depending on how much hospitals voluntarily report. On Friday, the first day voluntary reports were publicly posted, data from 4,522 hospitals showed a continued downward trend in Covid hospitalizations. “Are we going to miss a summer surge [of Covid]? It’s possible, but I don’t think so,” Dr. Georges Benjamin, executive director of the American Public Health Association, told Pulse. “We have all kinds of existing surveillance systems in place.” What’s next: A proposed Medicare inpatient rule would resume in October, requiring hospitals to electronically report data on respiratory syncytial virus, Covid and flu. The new proposal reflects a push by the agency in recent months to zero in on those three respiratory diseases, which have spiked in recent years.
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