By: Dr. Ryan Duncombe

Last week, a puzzling new monkeypox outbreak appeared in the United States after new cases popped up in the United Kingdom, Portugal, Spain, and Canada. As of May 20, there are now a total of over 70 confirmed cases in multiple countries. Public health officials are working hard to understand how these cases, which are unusual in volume and geography compared to past outbreaks of the disease, are being transmitted and understand what precautions may be warranted.

Luckily for the United States, the nation has a new tool in its arsenal that it never had in the past. The Centers for Disease Control and Prevention (CDC) officially launched its highly anticipated new Center for Forecasting and Outbreak Analytics (CFA) at the recent White House Summit on Strengthening the Nation’s Early Warning System for Health Threats. CFA’s mission is to improve the nation’s ability to prepare for and respond to infectious disease outbreaks, which it first began working towards in August 2021. 

During its pre-launch phase, CFA already demonstrated its potential in the winter of 2021 by forecasting the trajectory of the COVID-19 Omicron variant and producing the first U.S. estimates of Omicron disease severity compared to the Delta variant. It used this information to alert federal, state, and local public health partners, as well as the public, of Omicron’s impending surge. This gave the United States a critical advanced warning, by several weeks, of the timing and magnitude of the Omicron wave. Thus, in only its first few months and before its official launch, the CFA had already displayed its promise to use data, modeling, and analytics to determine outbreak risk, thereby enabling more effective response measures and improved public health security. 

The White House Summit highlighted four aspects of CFA’s mission and operations that make it unique from other U.S. government agency efforts.

First, the CFA’s scope is not limited to the CDC. Rather, as a national center, it will synthesize public health and infectious disease data streams across all U.S. government agencies to serve as a centralized source of health information that can be used by all Americans. A major issue in past U.S. government biosecurity efforts, most recently seen throughout the COVID-19 pandemic, has been a lack of inter-agency communication and collaboration – an issue that CFA hopes to remedy. By assimilating data from national, local, and tribal agencies, and working across data silos, CFA seeks to vertically integrate data-sharing to allow for a more streamlined response. This will be crucial in establishing a national, trusted resource for early warning that alerts the public and the U.S. government of future public health threats.

Second, Jake Sullivan, the National Security Advisor to President Biden, was an opening speaker at the summit and highlighted the crucial importance of CFA’s mission as a national security imperative in promoting biodefense efforts and health security. CFA’s integration with both public health and defense agencies will be especially valuable for informing biodefense efforts. This aspect of biosecurity has to date been underappreciated.

Third, CFA will focus on improving the capabilities of local governments. CFA seeks to develop a trusted network comprising national, state, and local partners, and maintain bidirectional information flows to better inform local governments during outbreaks. Local governments, Departments of Health, and hospitals are key in responding to public health threats, but improved communication of information in both directions is needed for better  decision-making in communities across the nation. CFA’s access to local and national outbreak data and connections to local communities will enable it to fill this need and improve local responses in the case of an outbreak.

Finally, a top priority of CFA is developing workforce diversity and dismantling health inequities. The CFA is committed to improving the collection of data that better represents diverse and previously under-counted populations, and will also designate experts specifically with the task of engaging with communities that do not have easy access to the internet. Without these improvements, the CFA will be unable to generate or distribute forecasts that support the communities which may be most vulnerable to potential outbreaks. CFA has already awarded $26 million to academic and government partners to advance modeling and forecasting capabilities and has placed an emphasis in all cases on developing a diverse workforce to best cultivate equitable, community-based response efforts. 

Dr. Sandy Ford, the Special Assistant to the President for Public Health and Science, provided the closing remarks at the summit and stressed how CFA was built upon lessons learned throughout the COVID-19 pandemic, and its role as a single, trusted source of health information during a public health crisis will be crucial for navigating the nation through future outbreaks. Not only will CFA provide more rapid forecasting and analytics than the CDC was historically designed for, but it will also serve to support and benefit from partnerships at the national and local levels to best serve the public.