Spatial Syndromic Surveillance and COVID-19 in the U.S.: Local Cluster Mapping for Pandemic Preparedness

Abstract

Maps have become the de facto primary mode of visualizing the COVID-19 pandemic, from identifying local disease and vaccination patterns to understanding global trends. In addition to their widespread utilization for public communication, there have been a variety of advances in spatial methods created for localized operational needs. While broader dissemination of this more granular work is not commonplace due to the protections under Health Insurance Portability and Accountability Act (HIPAA), its role has been foundational to pandemic response for health systems, hospitals, and government agencies. In contrast to the retrospective views provided by the aggregated geographies found in the public domain, or those often utilized for academic research, operational response requires near real-time mapping based on continuously flowing address level data. This paper describes the opportunities and challenges presented in emergent disease mapping using dynamic patient data in the response to COVID-19 for northeast Ohio for the period 2020 to 2022. More specifically it shows how a new clustering tool developed by geographers in the initial phases of the pandemic to handle operational mapping continues to evolve with shifting pandemic needs, including new variant surges, vaccine targeting, and most recently, testing data shortfalls. This paper also demonstrates how the geographic approach applied provides the framework needed for future pandemic preparedness.

The utility of Zip4 codes in spatial epidemiological analysis

“…From an infectious disease perspective, monitoring the spread of cases across space and time can help inform clinicians and health authorities about potential outbreaks and mobilize preventive strategies [ 31 – 33 ] or predict where upcoming surge could stress resources. For example, in northeast Ohio a spatial syndromic surveillance system [ 4 , 34 , 35 ] was used to identify emerging Covid-19 disease clusters at a granularity that includes care homes and congregate living buildings. The results were used to guide hospital intercept teams to limit further disease spread both within and between densely packed living areas.…”