In the first months of the pandemic, our health department leadership and community partners became highly concerned about the disproportionate impact of COVID-19 on vulnerable communities. In April 2020, we released a first of its kind Report on LA County COVID-19 Data Disaggregated by Race/ethnicity and Socioeconomic Status.1 The report identified a social gradient in COVID-19, with the highest age-adjusted death rates and lowest testing rates in the highest poverty areas. Similarly, the data also revealed racial/ethnic disproportionalities in COVID-19 disease outcomes.
One of the key strategies to reducing the inequities revealed in this report was the use of timely, reliable, inclusive data to coordinate and tailor the COVID-19 response, and to focus on the county’s most vulnerable communities. It was essential, however, that this data not only be accessible to our department, but also to all the stakeholders and communities that needed transparent data sharing to effectively engage in the difficult task of mitigating the pandemic. Our department embarked on a multi-pronged strategy of data transparency and communication, to make local data accessible to multiple audiences, in user-friendly ways.
An important tool in data transparency has been the launch of public-facing COVID-19 data dashboards to provide detailed surveillance and vaccination data to the public. One of the first dashboards we created, the LA County COVID-19 Surveillance Dashboard, features interactive maps and charts to display case rates, deaths, and persons tested by age, area poverty, gender, and race/ethnicity as well as interactive hospitalization data visualizations. This dashboard contains daily data from as early as March 2020 which can be downloaded and further analyzed as needed.
Once vaccinations became available, the COVID-19 Vaccinations in LA County Dashboard was constructed to publicize vaccination coverage data at the city/community level. Features include vaccination coverage rate by age group, race/ethnicity, and gender. Unique features include a time series component, where an interactive map demonstrates evolution in vaccination coverage in cities/communities across time. Visitors to the data dashboard can easily download all data tables for direct use or conduct additional analyses that meet their needs.
Additional dashboards have since been added to increase the breadth and depth of publicly available data. The LA County Daily COVID-19 Data Dashboard features county-level trends in cases, hospitalizations, deaths, and testing that can be viewed at-a-glance. The Locations & Demographics Dashboard has in-depth data on case rates by age, gender, race/ethnicity, city/community, and outbreak data by sector. The Contact Tracing Dashboard shows weekly and cumulative data on case and contact tracing interview progression.
Residents in some settings are particularly vulnerable to COVID-19, therefore, we developed dashboards specifically focused on these settings. The Skilled Nursing Facility (SNF) Dashboard summarizes COVID-19 testing, case, and vaccine coverage in SNFs across the county. In September 2021, the TK-12 Schools and Youth Programs COVID-19 Data Dashboard was published to provide real-time data on school testing, cases, and outbreaks. This data assists schools in targeting their COVID-19 prevention measures. Data includes weekly number of tests and test positivity, testing volume by school district, epidemiologic curves of TK-12 cases by student/staff and school, cumulative cases since August 2021, and active outbreaks. Cases are also superimposed on a map of community case and vaccination rates.
The Reopening LA County Dashboard was launched in mid-2021 and was designed so the public could track metrics used by our departmental leadership in assessing the impact of reopening being considered during periods of reduced community transmission.
In addition to the public-facing data dashboards, our department conducts telebriefings and media briefings at daily to weekly intervals. Media briefings include data on COVID-19 cases, hospitalizations, deaths, and vaccinations, including post-vaccination outcomes. Additional data is presented on what is most essential to communicate at a given point in time, such as school sector data in the fall, and variant-specific data during the emergence of Omicron. Departmental leadership began conducting sector-specific telebriefings in January 2020 and continue to do so. Over 500 telebriefings, to over 40 sectors, have been conducted, with over 130,000 attendees. Examples of sectors include skilled nursing facilities, schools, institutes of higher education, day camps, youth sports, ticketed event venues, fitness centers, elected officials, chambers of commerce, restaurants/bars/wineries, and food and agriculture workers. The most current COVID-19 data are presented at the beginning of every telebriefing including, where possible, sector-specific data. Safety protocols and recommendations for each of these sectors are discussed in the context of the evolving data.
There is also ongoing bi-directional data sharing with partners to help them improve vaccination and COVID-19 mitigation efforts. Our education sector team meets regularly with local school districts, including the Los Angeles Unified School District (LAUSD), where data is shared and used to inform local decision-making. Recently, an analysis of school district-specific secondary attack rates helped support LAUSD’s decision to adopt Modified Quarantine (Test to Stay) in 2022. Our Persons Experiencing Homelessness sector team similarly works with partners to share data to improve surveillance and vaccination efforts among this highly vulnerable population; data reports were initially shared daily and now are weekly.
The data are also used to identify communities and population groups most vulnerable to severe COVID-19 outcomes and where inequities are most pronounced. For example, in early 2021 we developed a vaccine equity metric based on the state’s equity metric but with added local case data to better identify communities most at risk of COVID-19. This metric was used to determine the locations of static and mobile vaccination sites and helped guide community vaccination efforts. Progress and gaps in vaccination coverage among the most vulnerable communities identified by this metric were shared weekly in media briefings and on an ongoing basis with our vast network of vaccination providers. The data have been used to tailor vaccination efforts to better meet the needs of residents in our most vulnerable communities.
Citations
Los Angeles County Department of Public Health, Chief Science Office. COVID-19 - Racial, Ethnic & Socioeconomic Data & Strategies Report. Published April 28, 2020.