CDC publishes article about Ky. monitoring system to guide decisions about reopening, which says it could help other states

Kentucky's daily covid-19 status, as calculated with tool developed by state health department.

By Melissa Patrick
Kentucky Health News

As health departments across the nation help states safely reopen their economies and schools, the monitoring system Kentucky officials use to guide their decisions has been lauded in a recent federal report as an example for other states to follow.

The report, published in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, comes at a time when many Republicans and some commentators have said they need to know more about how Gov. Andy Beshear and his public-health chief are making their decisions around reopening, mitigation and response.

Health Commissioner Steven Stack has said he uses a variety of sources to guide his recommendations, but this report reveals the nitty-gritty of how one tool created by Kentucky's epidemiologists helps guide the state's decision-making on covid-19.

The lead author and six of the other 11 listed authors work for the CDC. Five work for the state Department for Public Health, which developed the tool, called the "indicator monitoring report."

The IMR combines multiple data elements that measure the prevalence and severity of the coronavirus, along with the state's readiness to respond to it. The report says this information is use to generate a daily covid-19 status score that can be used to asses the state's ability to safely reopen. 

The report says state epidemiologists "developed the IMR after recognizing the need for a plain-language assessment that could facilitate reopening and ongoing response decision-making addressing multiple stakeholders." 

The assessment is compiled Monday through Saturday and distributed to about 90 stakeholders in and out of state government, including the governor's office and local health-department directors. 

The system monitors five primary indicators: new coronavirus cases, deaths from covid-19, health-care capacity, contact-tracing capacity and syndromic surveillance, which allows the state to track symptoms before a covid-19 diagnosis is confirmed. It was implemented on May 19. 

The indicators are scored on a three-point scale, from excellent to poor, and are given equal weight in producing the composite status score, and the analysis is "combined with publicly available data into a user-friendly composite status that KDPH and local policy makers use to assess state-level covid-19 hazard status," the report says.

The composite status score, which assesses the ability of the state to safely reopen and remain open, is reported at five levels: 5 = excellent (reopen/remain open); 4 = good (monitor); 3 = moderate (caution); 2 = fair (increase mitigation); 1 = poor (reopening risky, slow reopening or close); 0 = poor (reopening risky, slow reopening or close).

The report shows how the state's score worsened between May 19 and July 15, dropping to "fair" between June 17 and July 15, indicating the need for increased mitigation. Beshear issued an executive order for a mask mandate in certain settings on July 9.

The report says this user-friendly system could help other states "guide decision-making for covid-19 mitigation, response, and reopening," and is easily adoptable because its data sources "are publicly available, data are analyzed with familiar software, and a standardized method is used to compile the report."

Click here to see a table of each of the indicators and how they are scored.