‘Tripledemic’ dashboards set health agencies up for flu season

As the chill of fall sets in, cold and flu season starts heating up. Reports of runny noses or sore throats could easily be chalked up to seasonal allergies or a mild cold, but if the last few years have taught public health agencies anything, it’s to be prepared for an influx of illnesses that could squeeze already limited health care resources and services. And this year, public health officials have their eyes set on three main threats: COVID, influenza and respiratory syncytial virus, or RSV. 

The viruses are making headlines as the Centers for Disease Control and Prevention recently warned of a “tripledemic” of the illnesses during the fall and winter. In fact, the southeast U.S. has seen an increase in positive cases of RSV, which is especially harmful to infants and older adults, since the summer.  

“Even a mild flu year, a mild RSV year and a mild COVID year can take up limited health care resources, whether that be hospital beds or other services,” said Adriane Casalotti, chief of government and public affairs at the National Association of County and City Health Officials. 

To help health care systems and communities prepare for a potential upswing in viral cases, some state health departments are refreshing their respiratory illness dashboards. An upgrade to the COVID dashboards that popped up nationwide during the pandemic, “tripledemic” dashboards track data on all three viruses together. 

Such dashboards have recently launched in Alabama, Massachusetts, Washington and West Virginia.  

The combined dashboards, featuring data such as the number of hospitalizations, deaths or positive cases can also show race, age and other patient characteristics, which can help public health agencies “get granularity as to where infections are occurring [to] guide disease control efforts,” said Georges Benjamin, executive director of the American Public Health Association. The three viruses can impact different populations, so having insights on when and to what extent certain demographics are being affected can help state and local officials manage available resources like hospital beds. 

The dashboards can also strengthen education and messaging about public health risks, Benjamin said. For example, dashboards that include geographical data showing an uptick in COVID, flu or RSV cases in a rural town but not an urban one could help state or local health officials more accurately target vaccination communications or outreach efforts. 

Plus, when data is easily accessible and readable, the general population can better grasp the virus’ prevalence in their community and more effectively protect their own health, Benjamin said. That means immunocompromised older adults, for example, who see COVID cases are increasing according to their local health department’s dashboard can take precautions like wearing a mask in public to reduce the risk of getting or transmitting the virus. 

“It’s the same thing [as] telling people what the weather’s going to be, so they can properly dress,” Benjamin said. 

Dashboards can encourage disease prevention and risk reduction measures that help communities limit strain on the public health care system, Casalotti said. “Even if [risk reduction measures] don’t prevent infections, they do prevent severity,” which is important for public health responses. Severe COVID, flu or RSV cases can “crush the hospitals and health care system” more than just a high volume of viral infections, she said. 

But to get residents to understand how respiratory illnesses are affecting their communities, dashboards should remain simple, Benjamin said. Given that the average resident likely does not have the expertise to comprehend complex data reports, he suggested using basic charts and avoiding graphics that are too wordy or contain complex medical jargon. 

“One of the things [the Washington Department of Health] learned from the pandemic is that we need to do a better job of sharing and explaining data … in a way that a nonscientist can understand,” Lora Davis, surveillance section manager at the health department’s Center for Data Science, said in an email to Route Fifty. When developing its respiratory illness dashboard, the department created a data visualization team, which included graphic designers and communications experts. 

The team suggested that the dashboard include an initial “splash” screen that summarizes whether COVID, flu and RSV cases are increasing, decreasing or staying the same, Davis said. The data table gives users a simple summary of virus trends, before they can dig into more specific data like the number of vaccines administered for each virus, which are represented in graph form for “those who want to view the data in different ways.” 

Davis said the data visualization team also recommended the dashboard use plain language and easily understandable color schemes. For instance, if the percentage of respiratory illness-related emergency department visits declined over the last week, the figure is paired with a green icon on the table. On Oct. 31, the table that showed the number of beds occupied by COVID patients in the intensive care unit was accompanied by a red icon, indicating an increase from the previous week. 

The Massachusetts Department of Public Health also launched a new data resource for tracking COVID, influenza and RSV, and includes one graph that maps the severity of influenza in the state by region. The department decided to display respiratory virus data from July to June, rather than just during peak disease activity season from November to March, to visualize the virus’ prevalence throughout the year, said State Epidemiologist Catherine Brown. That can help officials better understand long-term data trends. 

State and local public health agencies should also avoid inserting too many numbers or statistics into their dashboards, Benjamin said, as it might lead users to misinterpret what the data actually means. 

“People want to know: Is the disease going up or down? The best graphs are inherently understandable, and you don’t have to look up anything when you look at it,” Benjamin said.