The new COVID data frontier: Making evidence-based decisions in an era with less evidence

Two years into the pandemic, Manitoba has put an end to the daily disclosure of COVID-19 data. On Friday,public health updated itsfamiliar COVID cases and riskdashboard for the final time andnow plans to delete the page from the provincial website.

For some Manitobans, checking that dashboard was part of a daily ritual, especially in the days when the number of confirmed COVID-19 cases and the percentage of tests coming back positive served as reliable indicators about the state of the pandemic.

Those measures ceased to be relevant by the end of 2021, when the highly transmissable Omicron variant overwhelmed the province's ability to test the populace for COVID.

By the first week of January, COVID hospitalizations, COVID ICU cases and COVID deaths were the onlyuseful numberson that page, even though they are what epidemiologists call lagging indicators: Figures that tell us something about the way COVID was spreading several weeks in the past.

That's because it takes a few days to get infected with COVID, longer to get sick and even longer to get sick enough to require hospital care or die. A picture of COVID transmission can be deduced in part by how the hospitalization and fatality numbers are changing.

That means these numberscontinue to serve a purpose, especially in conjunction with other measures suchasworkplace absenteeism reports and monitoring Winnipeg wastewater for signs of the virus that causes COVID.

Manitoba Public Health has never published data about absenteeism reports. Public health also insists it cannot release Winnipeg wastewater data because that analysis is conducted by the federal government, which publishes its data once a month.

COVID hospitalization and death numbers, meanwhile, will only be reported once a week due to public health's determination that COVID-19 is in the process of becoming an endemic disease.

"Real-time data is less critical with endemic reporting. Instead, we would shift our focus to key pieces of information that will provide the most relevant epidemiological evidence and data for both the public and for decision makers," said Dr. Jazz Atwal, Manitoba's deputy provincial public health officer, on March 2.

"Manitobans will see this shift in the days ahead as we focus on reporting on key trends, more vulnerable settings and other important indicators of COVID activity and severity in our province. Information about COVID will continue to be transparent and publicly available, but this is a part of a response that has to shift as well."

Restoring trust

The transparency of the data remains to be seen. While it is true a single day's worth of hospitalization numbers or the death count for a single day does not tell the public much of anything, the compilation of daily statistics allows journalists, public health scientists outside of government and other academics to discern meaningful long-term trends.

Holding back, managing or even massaging this data would not serve the task of restoring the public trust in government. That trust has been severely diminished in this province after Manitoba failed tomanage the spread of COVID-19 during the second and third waves of the pandemic.

Nonetheless, public health is suggesting the weekly release of data will suffice for the purposesof Manitobans who remain vulnerable to COVID-19 and have to determine for themselves the safety of any activity outside their homes.

Dr. Brent Roussin, the chief provincial public health officer,has stated it is up to individuals to make that determination on their own.

"We've been able to change our approach from strict public health measures to public health recommendations. That guidance is now available online to help support people in their own decision making to assess their level of risk when it comes to things like mask wearing, physical distancing and how many people are comfortable gathering along with," Roussin said on March 16.

The province declined CBC News requests to speak to Roussin and Atwal this week about how individuals are supposed to assess the COVID-19 risk and the transparency of COVID-19 data.

The province also declined repeated requests to release at least a summary of the interim wastewater-monitoring data the federal government has been providing Manitoba. All the province will say is it expects another month's worth of Winnipeg data to be posted on a federal website on March 31.

To be clear, the province releases information collected by federal entities all the time. Provincial flood outlooks incorporate Environment Canada forecasts. Provincial budgets include notes about Bank of Canada expectations.

The concentration of COVID viral loads in Winnipeg sewage is not a state secret. Is it up? Is it down? Is itflat?Who knows. Manitoba won't evenreleasea general characterization.

In any case, wastewater monitoringdata alone is just one indicator that paints a broader picture of COVID transmission. It just so happens to be the only indicator that tells us anything in real time.

In the end, public health officials promised more transparency to help Manitobans make decisions,offered less of it instead and then refused to explain thedisjunction.