COVID-19 Case Surveillance Public Use Data with Geography

<b>Note:</b>
Reporting of new COVID-19 Case Surveillance data will be discontinued July 1, 2024, to align with the process of removing SARS-CoV-2 infections (COVID-19 cases) from the list of nationally notifiable diseases. Although these data will continue to be publicly available, the dataset will no longer be updated.

Authorizations to collect certain public health data expired at the end of the U.S. public health emergency declaration on May 11, 2023. The following jurisdictions discontinued COVID-19 case notifications to CDC: Iowa (11/8/21), Kansas (5/12/23), Kentucky (1/1/24), Louisiana (10/31/23), New Hampshire (5/23/23), and Oklahoma (5/2/23). Please note that these jurisdictions will not routinely send new case data after the dates indicated. As of 7/13/23, case notifications from Oregon will only include pediatric cases resulting in death.

This case surveillance public use dataset has 19 elements for all COVID-19 cases shared with CDC and includes demographics, geography (county and state of residence), any exposure history, disease severity indicators and outcomes, and presence of any underlying medical conditions and risk behaviors.

Currently, CDC provides the public with three versions of COVID-19 case surveillance line-listed data: this <a href="https://data.cdc.gov/Case-Surveillance/COVID-19-Case-Surveillance-Public-Use-Data-with-Ge/n8mc-b4w4">19 data element dataset with geography</a>, a <a href="https://data.cdc.gov/Case-Surveillance/COVID-19-Case-Surveillance-Public-Use-Data/vbim-akqf">12 data element public use dataset</a>, and a <a href="https://data.cdc.gov/Case-Surveillance/COVID-19-Case-Surveillance-Restricted-Access-Detai/mbd7-r32t">33 data element restricted access dataset</a>.

The following apply to the public use datasets and the restricted access dataset:
<ul><li>Data elements can be found on the COVID-19 case report form located at www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdf.</li><li>Data are considered provisional by CDC and are subject to change until the data are reconciled and verified with the state and territorial data providers.</li><li>Some data are suppressed to protect individual privacy.</li><li>Datasets will include all cases with the earliest date available in each record (date received by CDC or date related to illness/specimen collection) at least 14 days prior to the creation of the current datasets. This 14-day lag allows case reporting to be stabilized and ensure that time-dependent outcome data are accurately captured.</li><li>Datasets are updated monthly.</li><li>Datasets are created using CDC’s <a href="https://www.cdc.gov/grants/additional-requirements/ar-25.html">Policy on Public Health Research and Nonresearch Data Management and Access</a> and include protections designed to protect individual privacy.</li><li>For more information about data collection and reporting, please see <a href="https://www.cdc.gov/coronavirus/2019-ncov/covid-data/about-us-cases-deaths.html">https://www.cdc.gov/coronavirus/2019-ncov/covid-data/about-us-cases-deaths.html.</a></li><li>For more information about the COVID-19 case surveillance data, please see <a href="https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html"> https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html</a><br></li></ul>

<b>Overview</b>

The COVID-19 case surveillance database includes individual-level data reported to U.S. states and autonomous reporting entities, including New York City and the District of Columbia (D.C.), as well as U.S. territories and affiliates. On April 5, 2020, COVID-19 was added to the <a href="https://ndc.services.cdc.gov/search-results-year/">Nationally Notifiable Condition List</a> and classified as “immediately notifiable, urgent (within 24 hours)” by a Council of State and Territorial Epidemiologists (CSTE) Interim Position Statement (<a href="https://cdn.ymaws.com/www.cste.org/resource/resmgr/ps/positionstatement2020/Interim-20-ID-01_COVID-19_NO.pdf">Interim-20-ID-01</a>). CSTE updated the position statement on August 5, 2020, to clarify the interpretation of antigen detection tests and serologic test results within the case classification (<a href="https://cdn.ymaws.com/www.cste.org/resource/resmgr/ps/positionstatement2020/Interim-20-ID-02_COVID-19.pdf">Interim-20-ID-02</a>). The statement also recommended that all states and territories enact laws to make COVID-19 reportable in their jurisdiction, and that jurisdictions conducting surveillance should submit case notifications to CDC. COVID-19 case surveillance data are collected by jurisdictions and reported voluntarily to CDC.

For more information:
<a href="https://www.cdc.gov/nndss/action/stories/covid-19-response.html">NNDSS Supports the COVID-19 Response | CDC</a>.<br>

<b>COVID-19 Case Reports</b>
COVID-19 case reports are routinely submitted to CDC by public health jurisdictions using nationally standardized case reporting forms. On April 5, 2020, CSTE released an Interim Position Statement with national surveillance case definitions for COVID-19. Current versions of these case definitions are available at: https://ndc.services.cdc.gov/case-definitions/coronavirus-disease-2019-2021/. All cases reported on or after were requested to be shared by public health departments to CDC using the standardized case definitions for lab-confirmed or probable cases. On May 5, 2020, the standardized case reporting form was revised. States and territories continue to use this form.

<h4><b>Data are Considered Provisional</b></h4>
<ul><li>The COVID-19 case surveillance data are dynamic; case reports can be modified at any time by the jurisdictions sharing COVID-19 data with CDC. CDC may update prior cases shared with CDC based on any updated information from jurisdictions. For instance, as new information is gathered about previously reported cases, health departments provide updated data to CDC. As more information and data become available, analyses might find changes in surveillance data and trends during a previously reported time window. Data may also be shared late with CDC due to the volume of COVID-19 cases.</li><li>Annual finalized data: To create the final NNDSS data used in the annual tables, CDC works carefully with the reporting jurisdictions to reconcile the data received during the year until each state or territorial epidemiologist confirms that the data from their area are correct.</li></ul>

Access <a href="https://preparedness.cste.org/wp-content/uploads/2022/04/RaceEthnicityData_FINAL.pdf">Addressing Gaps in Public Health Reporting of Race and Ethnicity for COVID-19</a>, a report from the Council of State and Territorial Epidemiologists, to better understand the challenges in completing race and ethnicity data for COVID-19 and recommendations for improvement.

<h3><b>Data Limitations</b></h3>
To learn more about the limitations in using case surveillance data, visit <a href="https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html">FAQ: COVID-19 Data and Surveillance</a>.

<h4><b>Data Quality Assurance Procedures</b></h4>
CDC’s Case Surveillance Section routinely performs data quality assurance procedures (i.e., ongoing corrections and logic checks to address data errors). To date, the following data cleaning steps have been implemented:
<ul><li>Questions that have been left unanswered (blank) on the case report form are reclassified to a Missing value, if applicable to the question. For example, in the question "Was the individual hospitalized?" where the possible answer choices include "Yes," "No," or "Unknown," the blank value is recoded to "Missing" because the case report form did not include a response to the question.</li><li>Logic checks are performed for date data. If an illogical date has been provided, CDC reviews the data with the reporting jurisdiction. For example, if a symptom onset date in the future is reported to CDC, this value is set to null until the reporting jurisdiction updates the date appropriately.</li><li>Additional data quality processing to recode free text data is ongoing. Data on symptoms, race, ethnicity, and healthcare worker status have been prioritized.</li></ul>

<h4><b>Data Suppression</b></h4>
To prevent release of data that could be used to identify people, data cells are suppressed for low frequency (<11 COVID-19 case records with a given values). Suppression includes low frequency combinations of case month, geographic characteristics (county and state of residence), and demographic characteristics (sex, age group, race, and ethnicity). Suppressed values are re-coded to the NA answer option; records with data suppression are never removed.

<h4><b>Additional COVID-19 Data</b></h4>
COVID-19 data are available to the public as summary or aggregate count files, including total counts of cases and deaths by state and by county. These and other COVID-19 data are available from multiple public locations: <a href="https://www.cdc.gov/covid-data-tracker/">COVID Data Tracker</a>; <a href="https://data.cdc.gov/Case-Surveillance/Weekly-United-States-COVID-19-Cases-and-Deaths-by-/pwn4-m3yp">United States COVID-19 Cases and Deaths by State</a>; <a href="https://www.cdc.gov/vaccines/covid-19/reporting/index.html">COVID-19 Vaccination Reporting Data Systems</a>; and <a href="https://www.cdc.gov/nchs/nvss/covid-19.htm">COVID-19 Death Data and Resources</a>.

<b>Notes:</b>

<b>March 1, 2022:</b> The "COVID-19 Case Surveillance Public Use Data with Geography" will be updated on a monthly basis.

<b>April 7, 2022:</b> An adjustment was made to CDC’s cleaning algorithm for COVID-19 line level case notification data. An assumption in CDC's algorithm led to misclassifying deaths that were not COVID-19 related. The algorithm has since been revised, and this dataset update reflects corrected individual level information about death status for all cases collected to date.

<b>June 25, 2024:</b> An adjustment was made to CDC’s cleaning algorithm for COVID-19 line level case notification data. An assumption in CDC's algorithm led to misclassification of pediatric deaths from New York State. The algorithm has since been revised, and this dataset update reflects corrected individual level information about death status for all cases collected to date for New York State.

<b>June 26, 2024:</b> Reported COVID-19 cases resulting in death of Texas residents should be interpreted with caution. In November 2023, CDC and Texas Department of State Health Services (DSHS) identified an unresolved issue in the demographics of COVID-19 patient case deaths as reported to CDC by Texas DSHS. As a result, Texas case deaths reported to COVID-19 line level case notification data are disproportionate compared with reporting by Texas DSHS and National Center for Health Statistics (NCHS). Because of this issue, an adjustment could not be implemented to correct the misclassifications. However, provisional COVID-19 death counts from the National Center for Health Statistics (NCHS) are updated with information from death certificates and offers accurate death counts.”

<b>注意：</b>

自2024年7月1日起，将停止报告新的COVID-19病例监测数据，以与从国家报告疾病名单中移除SARS-CoV-2感染（COVID-19病例）的过程保持一致。尽管这些数据将继续对外公开，但数据集将不再更新。

在2023年5月11日美国公共卫生紧急声明结束之际，某些公共卫生数据的收集授权已到期。以下司法管辖区已停止向美国疾病控制与预防中心（CDC）报告COVID-19病例：爱荷华州（2021年11月8日）、堪萨斯州（2023年5月12日）、肯塔基州（2024年1月1日）、路易斯安那州（2023年10月31日）、新罕布什尔州（2023年5月23日）和俄克拉荷马州（2023年5月2日）。请注意，这些司法管辖区在所指示日期之后将不会例行发送新的病例数据。截至2023年7月13日，俄勒冈州的病例报告仅包括导致死亡的儿童病例。

本病例监测公共使用数据集包含19个元素，涵盖了与CDC共享的所有COVID-19病例，包括人口统计学、地域（居住县和州）、任何暴露史、疾病严重程度指标和结果，以及任何潜在的医疗状况和风险行为。

目前，美国疾病控制与预防中心（CDC）向公众提供三种COVID-19病例监测行列表数据版本：此<a href="https://data.cdc.gov/Case-Surveillance/COVID-19-Case-Surveillance-Public-Use-Data-with-Ge/n8mc-b4w4">包含地域的19个数据元素数据集</a>、一个<a href="https://data.cdc.gov/Case-Surveillance/COVID-19-Case-Surveillance-Public-Use-Data/vbim-akqf">12个数据元素公共使用数据集</a>，以及一个<a href="https://data.cdc.gov/Case-Surveillance/COVID-19-Case-Surveillance-Restricted-Access-Detai/mbd7-r32t">33个数据元素受限访问数据集</a>。

以下规定适用于公共使用数据集和受限访问数据集：
<ul><li>数据元素可在位于www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdf的COVID-19病例报告表中找到。</li><li>CDC认为数据为临时数据，并可能在数据与州和地区数据提供者核对并验证之前发生变化。</li><li>为保护个人隐私，某些数据被压制。</li><li>数据集将包括所有病例，每个记录中最早的可供日期至少在当前数据集创建前14天之前（收到CDC或与疾病/样本采集相关的日期）。这14天的滞后期允许病例报告稳定，并确保时间依赖性结果数据准确捕捉。</li><li>数据集每月更新。</li><li>数据集是根据CDC的<a href="https://www.cdc.gov/grants/additional-requirements/ar-25.html">公共卫生研究和非研究数据管理和访问政策</a>创建的，并包括旨在保护个人隐私的保护措施。</li><li>有关数据收集和报告的更多信息，请参阅<a href="https://www.cdc.gov/coronavirus/2019-ncov/covid-data/about-us-cases-deaths.html">https://www.cdc.gov/coronavirus/2019-ncov/covid-data/about-us-cases-deaths.html</a>。</li><li>有关COVID-19病例监测数据的更多信息，请参阅<a href="https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html">https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html</a></li></ul>

<b>概述</b>

COVID-19病例监测数据库包括报告给美国各州和自主报告实体的个人级别数据，包括纽约市和哥伦比亚特区（D.C.），以及美国领土和附属机构。2020年4月5日，COVID-19被添加到<a href="https://ndc.services.cdc.gov/search-results-year/">国家报告条件名单</a>，并被州和地区流行病学家委员会（CSTE）的临时立场声明（<a href="https://cdn.ymaws.com/www.cste.org/resource/resmgr/ps/positionstatement2020/Interim-20-ID-01_COVID-19_NO.pdf">Interim-20-ID-01</a>）归类为“立即报告，紧急（24小时内）”。CSTE于2020年8月5日更新了立场声明，以阐明病例分类中对抗原检测和血清学检测结果的理解（《Interim-20-ID-02》）。该声明还建议所有州和地区制定法律，使其辖区内的COVID-19可报告，并建议进行监测的辖区向CDC提交病例通知。COVID-19病例监测数据由辖区收集，并自愿报告给CDC。

更多信息：
<a href="https://www.cdc.gov/nndss/action/stories/covid-19-response.html">NNDSS支持COVID-19响应 | CDC</a>。

<b>COVID-19病例报告</b>
COVID-19病例报告通常由公共卫生辖区使用国家标准化病例报告表提交给CDC。2020年4月5日，CSTE发布了一份临时立场声明，其中包含COVID-19的国家监测病例定义。这些病例定义的当前版本可在以下网址找到：https://ndc.services.cdc.gov/case-definitions/coronavirus-disease-2019-2021/。要求所有报告的病例，自报告之日起，公共卫生部门应使用标准化的病例定义与CDC共享实验室确诊或疑似病例。2020年5月5日，标准化的病例报告表进行了修订。各州和地区继续使用此表。

<h4><b>数据被视为临时数据</b></h4>
<ul><li>COVID-19病例监测数据是动态的；与CDC共享COVID-19数据的辖区可以随时修改病例报告。CDC可能会根据辖区提供的任何更新信息更新与CDC共享的先前病例。例如，随着关于先前报告病例的新信息的收集，卫生部门向CDC提供更新数据。随着更多信息和数据的可用，分析可能会在先前报告的时间窗口中发现监测数据和趋势的变化。由于COVID-19病例的数量，数据也可能延迟与CDC共享。</li><li>年度最终数据：为了创建用于年度表的最终NNDSS数据，CDC与美国报告辖区仔细合作，核对年度期间接收到的数据，直到每个州或地区流行病学家确认其区域的数据是正确的。</li></ul>

访问<a href="https://preparedness.cste.org/wp-content/uploads/2022/04/RaceEthnicityData_FINAL.pdf">州和地区流行病学家委员会关于解决COVID-19公共卫生报告种族和民族数据差距的报告</a>，以更好地了解完成COVID-19种族和民族数据所面临的挑战以及改进建议。

<h3><b>数据局限性</b></h3>
要了解更多关于使用病例监测数据局限性的信息，请访问<a href="https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html">COVID-19数据和监测常见问题解答</a>。

<h4><b>数据质量保证程序</b></h4>
CDC的病例监测部门定期执行数据质量保证程序（即，持续进行更正和逻辑检查，以解决数据错误）。迄今为止，已实施了以下数据清理步骤：
<ul><li>在病例报告表上留下未回答的问题（空白）被重新分类为缺失值，如果适用的话。例如，在“个人是否住院？”这个问题中，可能的答案选项包括“是”、“否”或“未知”，空白值被重新编码为“缺失”，因为病例报告表没有对这个问题提供回答。</li><li>对日期数据进行逻辑检查。如果提供了不合理的日期，CDC将与报告辖区审查数据。例如，如果向CDC报告的症状出现日期在将来，则此值被设置为null，直到报告辖区适当更新日期。</li><li>正在进行对自由文本数据进行重新编码的额外数据质量处理。症状、种族、民族和医护人员状况的数据已被优先处理。</li></ul>

<h4><b>数据压制</b></h4>
为防止发布可用于识别个人的数据，对低频（<11 COVID-19病例记录具有给定值）的数据单元进行压制。压制包括病例月份、地理特征（居住县和州）以及人口统计学特征（性别、年龄组、种族和民族）的低频组合。压制值被重新编码为NA答案选项；压制数据的记录永远不会被删除。

<h4><b>其他COVID-19数据</b></h4>
COVID-19数据作为汇总或汇总计数文件向公众提供，包括按州和按县的总病例和死亡计数。这些和其他COVID-19数据可在多个公共位置获得：<a href="https://www.cdc.gov/covid-data-tracker/">COVID数据追踪器</a>；<a href="https://data.cdc.gov/Case-Surveillance/Weekly-United-States-COVID-19-Cases-and-Deaths-by-/pwn4-m3yp">美国COVID-19病例和死亡按州</a>；<a href="https://www.cdc.gov/vaccines/covid-19/reporting/index.html">COVID-19疫苗接种报告数据系统</a>；以及<a href="https://www.cdc.gov/nchs/nvss/covid-19.htm">COVID-19死亡数据资源</a>。

<b>备注：</b>

<b>2022年3月1日：</b>“COVID-19病例监测公共使用数据（含地域）”将按月更新。

<b>2022年4月7日：</b>对CDC的COVID-19行级病例通知数据清理算法进行了调整。CDC算法中的一个假设导致了与COVID-19无关的死亡被错误分类。该算法已得到修订，此数据集更新反映了迄今为止收集的所有病例的纠正后的死亡状态的个人级别信息。

<b>2024年6月25日：</b>对CDC的COVID-19行级病例通知数据清理算法进行了调整。CDC算法中的一个假设导致了纽约州儿童死亡被错误分类。该算法已得到修订，此数据集更新反映了迄今为止收集的所有病例的纠正后的死亡状态的个人级别信息，针对纽约州。

<b>2024年6月26日：</b>应对得克萨斯州居民死亡报告的COVID-19病例应谨慎解读。2023年11月，CDC和得克萨斯州州卫生与公共服务部（DSHS）确定了得克萨斯州向CDC报告的COVID-19患者病例死亡人数中的未解决人口统计学问题。因此，与得克萨斯州DSHS和国家卫生统计中心（NCHS）的报告相比，得克萨斯州的病例死亡人数在COVID-19行级病例通知数据中不成比例。由于这个问题，无法实施调整以纠正错误分类。然而，国家卫生统计中心（NCHS）的临时COVID-19死亡计数已更新为来自死亡证明的信息，并提供了准确的死亡计数。