As Americans are trying to keep up with current government guidelines and recommendations during the coronavirus pandemic, the Center for Disease Control and Prevention (CDC.gov) had almost 934 million pageviews in the preceding 30 days. The CDC is the most trusted source of information for the U.S. public regarding the current COVID-19 outbreak, followed by other government and public health websites.

Additional file 4. Confirmed and Deaths Data.

After May 3, 2024, this dataset and webpage will no longer be updated because hospitals are no longer required to report data on COVID-19 hospital admissions, and hospital capacity and occupancy data, to HHS through CDC’s National Healthcare Safety Network. Data voluntarily reported to NHSN after May 1, 2024, will be available starting May 10, 2024, at COVID Data Tracker Hospitalizations.

The following dataset provides facility-level data for hospital utilization aggregated on a weekly basis (Sunday to Saturday). These are derived from reports with facility-level granularity across two main sources: (1) HHS TeleTracking, and (2) reporting provided directly to HHS Protect by state/territorial health departments on behalf of their healthcare facilities.

The hospital population includes all hospitals registered with Centers for Medicare & Medicaid Services (CMS) as of June 1, 2020. It includes non-CMS hospitals that have reported since July 15, 2020. It does not include psychiatric, rehabilitation, Indian Health Service (IHS) facilities, U.S. Department of Veterans Affairs (VA) facilities, Defense Health Agency (DHA) facilities, and religious non-medical facilities.

For a given entry, the term “collection_week” signifies the start of the period that is aggregated. For example, a “collection_week” of 2020-11-15 means the average/sum/coverage of the elements captured from that given facility starting and including Sunday, November 15, 2020, and ending and including reports for Saturday, November 21, 2020.

Reported elements include an append of either “_coverage”, “_sum”, or “_avg”.

• A “_coverage” append denotes how many times the facility reported that element during that collection week.
• A “_sum” append denotes the sum of the reports provided for that facility for that element during that collection week.
• A “_avg” append is the average of the reports provided for that facility for that element during that collection week.

The file will be updated weekly. No statistical analysis is applied to impute non-response. For averages, calculations are based on the number of values collected for a given hospital in that collection week. Suppression is applied to the file for sums and averages less than four (4). In these cases, the field will be replaced with “-999,999”.

A story page was created to display both corrected and raw datasets and can be accessed at this link: https://healthdata.gov/stories/s/nhgk-5gpv

This data is preliminary and subject to change as more data become available. Data is available starting on July 31, 2020.

Sometimes, reports for a given facility will be provided to both HHS TeleTracking and HHS Protect. When this occurs, to ensure that there are not duplicate reports, deduplication is applied according to prioritization rules within HHS Protect.

For influenza fields listed in the file, the current HHS guidance marks these fields as optional. As a result, coverage of these elements are varied.

For recent updates to the dataset, scroll to the bottom of the dataset description.

On May 3, 2021, the following fields have been added to this data set.

• hhs_ids
• previous_day_admission_adult_covid_confirmed_7_day_coverage
• previous_day_admission_pediatric_covid_confirmed_7_day_coverage
• previous_day_admission_adult_covid_suspected_7_day_coverage
• previous_day_admission_pediatric_covid_suspected_7_day_coverage
• previous_week_personnel_covid_vaccinated_doses_administered_7_day_sum
• total_personnel_covid_vaccinated_doses_none_7_day_sum
• total_personnel_covid_vaccinated_doses_one_7_day_sum
• total_personnel_covid_vaccinated_doses_all_7_day_sum
• previous_week_patients_covid_vaccinated_doses_one_7_day_sum
• previous_week_patients_covid_vaccinated_doses_all_7_day_sum

On May 8, 2021, this data set has been converted to a corrected data set. The corrections applied to this data set are to smooth out data anomalies caused by keyed in data errors. To help determine which records have had corrections made to it. An additional Boolean field called is_corrected has been added.

On May 13, 2021 Changed vaccination fields from sum to max or min fields. This reflects the maximum or minimum number reported for that metric in a given week.

On June 7, 2021 Changed vaccination fields from max or min fields to Wednesday reported only. This reflects that the number reported for that metric is only reported on Wednesdays in a given week.

On September 20, 2021, the following has been updated: The use of analytic dataset as a source.

On January 19, 2022, the following fields have been added to this dataset:

• inpatient_beds_used_covid_7_day_avg
• inpatient_beds_used_covid_7_day_sum
• inpatient_beds_used_covid_7_day_coverage

On April 28, 2022, the following pediatric fields have been added to this dataset:

• all_pediatric_inpatient_bed_occupied_7_day_avg
• all_pediatric_inpatient_bed_occupied_7_day_coverage
• all_pediatric_inpatient_bed_occupied_7_day_sum
• all_pediatric_inpatient_beds_7_day_avg
• all_pediatric_inpatient_beds_7_day_coverage
• all_pediatric_inpatient_beds_7_day_sum
• previous_day_admission_pediatric_covid_confirmed_0_4_7_day_sum
• previous_day_admission_pediatric_covid_confirmed_12_17_7_day_sum
• previous_day_admission_pediatric_covid_confirmed_5_11_7_day_sum
• previous_day_admission_pediatric_covid_confirmed_unknown_7_day_sum
• staffed_icu_pediatric_patients_confirmed_covid_7_day_avg
• staffed_icu_pediatric_patients_confirmed_covid_7_day_coverage
• staffed_icu_pediatric_patients_confirmed_covid_7_day_sum
• staffed_pediatric_icu_bed_occupancy_7_day_avg
• staffed_pediatric_icu_bed_occupancy_7_day_coverage
• staffed_pediatric_icu_bed_occupancy_7_day_sum
• total_staffed_pediatric_icu_beds_7_day_avg
• total_staffed_pediatric_icu_beds_7_day_coverage
• total_staffed_pediatric_icu_beds_7_day_sum

On October 24, 2022, the data includes more analytical calculations in efforts to provide a cleaner dataset. For a raw version of this dataset, please follow this link: https://healthdata.gov/Hospital/COVID-19-Reported-Patient-Impact-and-Hospital-Capa/uqq2-txqb

Due to changes in reporting requirements, after June 19, 2023, a collection week is defined as starting on a Sunday and ending on the next Saturday.

This document outlines the recommended goals, objectives, and activities for surveillance of human infection with COVID-19 in Canada. These guidelines are based on current available scientific evidence and expert opinion and are subject to change as new information becomes available.

Reporting of Aggregate Case and Death Count data was discontinued May 11, 2023, with the expiration of the COVID-19 public health emergency declaration. Although these data will continue to be publicly available, this dataset will no longer be updated.

This archived public use dataset has 11 data elements reflecting United States COVID-19 community levels for all available counties.

The COVID-19 community levels were developed using a combination of three metrics — new COVID-19 admissions per 100,000 population in the past 7 days, the percent of staffed inpatient beds occupied by COVID-19 patients, and total new COVID-19 cases per 100,000 population in the past 7 days. The COVID-19 community level was determined by the higher of the new admissions and inpatient beds metrics, based on the current level of new cases per 100,000 population in the past 7 days. New COVID-19 admissions and the percent of staffed inpatient beds occupied represent the current potential for strain on the health system. Data on new cases acts as an early warning indicator of potential increases in health system strain in the event of a COVID-19 surge.

Using these data, the COVID-19 community level was classified as low, medium, or high.

COVID-19 Community Levels were used to help communities and individuals make decisions based on their local context and their unique needs. Community vaccination coverage and other local information, like early alerts from surveillance, such as through wastewater or the number of emergency department visits for COVID-19, when available, can also inform decision making for health officials and individuals.

For the most accurate and up-to-date data for any county or state, visit the relevant health department website. COVID Data Tracker may display data that differ from state and local websites. This can be due to differences in how data were collected, how metrics were calculated, or the timing of web updates.

Archived Data Notes:

This dataset was renamed from "United States COVID-19 Community Levels by County as Originally Posted" to "United States COVID-19 Community Levels by County" on March 31, 2022.

March 31, 2022: Column name for county population was changed to “county_population”. No change was made to the data points previous released.

March 31, 2022: New column, “health_service_area_population”, was added to the dataset to denote the total population in the designated Health Service Area based on 2019 Census estimate.

March 31, 2022: FIPS codes for territories American Samoa, Guam, Commonwealth of the Northern Mariana Islands, and United States Virgin Islands were re-formatted to 5-digit numeric for records released on 3/3/2022 to be consistent with other records in the dataset.

March 31, 2022: Changes were made to the text fields in variables “county”, “state”, and “health_service_area” so the formats are consistent across releases.

March 31, 2022: The “%” sign was removed from the text field in column “covid_inpatient_bed_utilization”. No change was made to the data. As indicated in the column description, values in this column represent the percentage of staffed inpatient beds occupied by COVID-19 patients (7-day average).

March 31, 2022: Data values for columns, “county_population”, “health_service_area_number”, and “health_service_area” were backfilled for records released on 2/24/2022. These columns were added since the week of 3/3/2022, thus the values were previously missing for records released the week prior.

April 7, 2022: Updates made to data released on 3/24/2022 for Guam, Commonwealth of the Northern Mariana Islands, and United States Virgin Islands to correct a data mapping error.

April 21, 2022: COVID-19 Community Level (CCL) data released for counties in Nebraska for the week of April 21, 2022 have 3 counties identified in the high category and 37 in the medium category. CDC has been working with state officials to verify the data submitted, as other data systems are not providing alerts for substantial increases in disease transmission or severity in the state.

May 26, 2022: COVID-19 Community Level (CCL) data released for McCracken County, KY for the week of May 5, 2022 have been updated to correct a data processing error. McCracken County, KY should have appeared in the low community level category during the week of May 5, 2022. This correction is reflected in this update.

May 26, 2022: COVID-19 Community Level (CCL) data released for several Florida counties for the week of May 19th, 2022, have been corrected for a data processing error. Of note, Broward, Miami-Dade, Palm Beach Counties should have appeared in the high CCL category, and Osceola County should have appeared in the medium CCL category. These corrections are reflected in this update.

May 26, 2022: COVID-19 Community Level (CCL) data released for Orange County, New York for the week of May 26, 2022 displayed an erroneous case rate of zero and a CCL category of low due to a data source error. This county should have appeared in the medium CCL category.

June 2, 2022: COVID-19 Community Level (CCL) data released for Tolland County, CT for the week of May 26, 2022 have been updated to correct a data processing error. Tolland County, CT should have appeared in the medium community level category during the week of May 26, 2022. This correction is reflected in this update.

June 9, 2022: COVID-19 Community Level (CCL) data released for Tolland County, CT for the week of May 26, 2022 have been updated to correct a misspelling. The medium community level category for Tolland County, CT on the week of May 26, 2022 was misspelled as “meduim” in the data set. This correction is reflected in this update.

June 9, 2022: COVID-19 Community Level (CCL) data released for Mississippi counties for the week of June 9, 2022 should be interpreted with caution due to a reporting cadence change over the Memorial Day holiday that resulted in artificially inflated case rates in the state.

July 7, 2022: COVID-19 Community Level (CCL) data released for Rock County, Minnesota for the week of July 7, 2022 displayed an artificially low case rate and CCL category due to a data source error. This county should have appeared in the high CCL category.

July 14, 2022: COVID-19 Community Level (CCL) data released for Massachusetts counties for the week of July 14, 2022 should be interpreted with caution due to a reporting cadence change that resulted in lower than expected case rates and CCL categories in the state.

July 28, 2022: COVID-19 Community Level (CCL) data released for all Montana counties for the week of July 21, 2022 had case rates of 0 due to a reporting issue. The case rates have been corrected in this update.

July 28, 2022: COVID-19 Community Level (CCL) data released for Alaska for all weeks prior to July 21, 2022 included non-resident cases. The case rates for the time series have been corrected in this update.

July 28, 2022: A laboratory in Nevada reported a backlog of historic COVID-19 cases. As a result, the 7-day case count and rate will be inflated in Clark County, NV for the week of July 28, 2022.

August 4, 2022: COVID-19 Community Level (CCL) data was updated on August 2, 2022 in error during performance testing. Data for the week of July 28, 2022 was changed during this update due to additional case and hospital data as a result of late reporting between July 28, 2022 and August 2, 2022. Since the purpose of this data set is to provide point-in-time views of COVID-19 Community Levels on Thursdays, any changes made to the data set during the August 2, 2022 update have been reverted in this update.

August 4, 2022: COVID-19 Community Level (CCL) data for the week of July 28, 2022 for 8 counties in Utah (Beaver County, Daggett County, Duchesne County, Garfield County, Iron County, Kane County, Uintah County, and Washington County) case data was missing due to data collection issues. CDC and its partners have resolved the issue and the correction is reflected in this update.

August 4, 2022: Due to a reporting cadence change, case rates for all Alabama counties will be lower than expected. As a result, the CCL levels published on August 4, 2022 should be interpreted with caution.

August 11, 2022: COVID-19 Community Level (CCL) data for the week of August 4, 2022 for South Carolina have been updated to correct a data collection error that resulted in incorrect case data. CDC and its partners have resolved the issue and the correction is reflected in this update.

August 18, 2022: COVID-19 Community Level (CCL) data for the week of August 11, 2022 for Connecticut have been updated to correct a data ingestion error that inflated the CT case rates. CDC, in collaboration with CT, has resolved the issue and the correction is reflected in this update.

August 25, 2022: A laboratory in Tennessee reported a backlog of historic COVID-19 cases. As a result, the 7-day case count and rate may be inflated in many counties and the CCLs published on August 25, 2022 should be interpreted with caution.

August 25, 2022: Due to a data source error, the 7-day case rate for St. Louis County, Missouri, is reported as zero in the COVID-19 Community Level data released on August 25, 2022. Therefore, the COVID-19 Community Level for this county should be interpreted with caution.

September 1, 2022: Due to a reporting issue, case rates for all Nebraska counties will include 6 days of data instead of 7 days in the COVID-19 Community Level (CCL) data released on September 1, 2022. Therefore, the CCLs for all Nebraska counties should be interpreted with caution.

September 8, 2022: Due to a data processing error, the case rate for Philadelphia County, Pennsylvania,

State and territorial executive orders, administrative orders, resolutions, and proclamations are collected from government websites and cataloged and coded using Microsoft Excel by one coder with one or more additional coders conducting quality assurance. Data were collected to determine when individuals in states and territories were subject to executive orders, administrative orders, resolutions, and proclamations for COVID-19 that require or recommend people stay in their homes. Data consists exclusively of state and territorial orders, many of which apply to specific counties within their respective state or territory; therefore, data is broken down to the county level. These data are derived from the publicly available state and territorial executive orders, administrative orders, resolutions, and proclamations (“orders”) for COVID-19 that expressly require or recommend individuals stay at home found by the CDC, COVID-19 Community Intervention and At-Risk Task Force, Monitoring and Evaluation Team & CDC, Center for State, Tribal, Local, and Territorial Support, Public Health Law Program from March 15, 2020 through May 31, 2021. These data will be updated as new orders are collected. Any orders not available through publicly accessible websites are not included in these data. Only official copies of the documents or, where official copies were unavailable, official press releases from government websites describing requirements were coded; news media reports on restrictions were excluded. Recommendations not included in an order are not included in these data. These data do not include mandatory business closures, curfews, or limitations on public or private gatherings. These data do not necessarily represent an official position of the Centers for Disease Control and Prevention.

State, territorial, and county executive orders, administrative orders, resolutions, and proclamations are collected from government websites and cataloged and coded using Microsoft Excel by one coder with one or more additional coders conducting quality assurance.

Data were collected to determine when individuals in states, territories, and counties were subject to executive orders, administrative orders, resolutions, and proclamations for COVID-19 that require or recommend people stay in their homes.

These data are derived from the publicly available state, territorial, and county executive orders, administrative orders, resolutions, and proclamations (“orders”) for COVID-19 that expressly require or recommend individuals stay at home found by the CDC, COVID-19 Community Intervention and At-Risk Task Force, Monitoring and Evaluation Team & CDC, Center for State, Tribal, Local, and Territorial Support, Public Health Law Program from March 15 through May 5, 2020. These data will be updated as new orders are collected. Any orders not available through publicly accessible websites are not included in these data. Only official copies of the documents or, where official copies were unavailable, official press releases from government websites describing requirements were coded; news media reports on restrictions were excluded. Recommendations not included in an order are not included in these data. These data do not include mandatory business closures, curfews, or limitations on public or private gatherings. These data do not necessarily represent an official position of the Centers for Disease Control and Prevention.

Note: 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 12 elements for all COVID-19 cases shared with CDC and includes demographics, any exposure history, disease severity indicators and outcomes, presence of any underlying medical conditions and risk behaviors, and no geographic data.

CDC has three COVID-19 case surveillance datasets:

• COVID-19 Case Surveillance Public Use Data with Geography: Public use, patient-level dataset with clinical data (including symptoms), demographics, and county and state of residence. (19 data elements)
• COVID-19 Case Surveillance Public Use Data: Public use, patient-level dataset with clinical and symptom data and demographics, with no geographic data. (12 data elements)
• COVID-19 Case Surveillance Restricted Access Detailed Data: Restricted access, patient-level dataset with clinical and symptom data, demographics, and state and county of residence. Access requires a registration process and a data use agreement. (33 data elements)

• Data elements can be found on the COVID-19 case report form located at www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdf.
• 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.
• Some data cells are suppressed to protect individual privacy.
• The 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 ensures that time-dependent outcome data are accurately captured.
• Datasets are updated monthly.
• Datasets are created using CDC’s Policy on Public Health Research and Nonresearch Data Management and Access and include protections designed to protect individual privacy.
• For more information about data collection and reporting, please see https://www.cdc.gov/coronavirus/2019-ncov/covid-data/about-us-cases-deaths.html.
• For more information about the COVID-19 case surveillance data, please see https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html
  

Overview

The COVID-19 case surveillance database includes individual-level data reported to U.S. states and aut

We have developed a guidance for managing COVID-19. This guidance is for: health professionals who manage clinical care, and infection prevention and control within health care facilities, health professionals who develop public health advice, policies and programs, and a broad range of sectors, including: industry, youth and child care settings, community-based services (for example, services for homeless people), death services and faith community leaders.

The U.S. Department of the Treasury through the Coronavirus Local Fiscal Recovery Fund provided a critical source of relief for smaller local governments, many of which have not received direct fiscal assistance from the federal government since the onset of the COVID-19 pandemic. Non-entitlement units of local government (NEUs) are cities serving populations less than 50,000. The State of Iowa is responsible for distributing these funds to NEUs within Iowa. Award amounts are based on the population of the NEU. Distributions from the Local Fiscal Recovery Fund to state, then subsequently NEUs are being done in two tranches. The first tranche payments were sent out in 2021 after the state received its payment on July 23, 2021. The second tranche payment to be made no earlier than July 23, 2022, following U.S. Department of Treasury requirements, which is 12 months after the date on which the first tranche payment was paid to the state.

Infectious disease experts have predicted a pandemic, saying it was not a question of if but when. Drawing on experiences with severe acute respiratory syndrome (SARS), avian influenza (H5N1), and novel influenza A (H1N1), the World Health Organization (WHO) and other health authorities, such as the Centers for Disease Control and Prevention (CDC), urged nations and local governments to prepare pandemic response plans. Many ministries of health and subnational departments of health around the world have activated those plans in response to coronavirus and are sharing data as required by the updated International Health Regulations.Esri's work with health organizations and government leaders has proven location intelligence from geographic information system (GIS) technology and data to be critical for the following:Assessing risk and evaluating threatsMonitoring and tracking outbreaksMaintaining situational awarenessEnsuring resource allocationNotifying agencies and communitiesThe current coronavirus disease pandemic presents an opportunity to build on the experience and readiness of Esri's existing global user community in health and human services. Through real-time maps, apps, and dashboards, GIS will also facilitate a seamless flow of relevant data as a component of the response from local to global levels. A compelling case exists for building on top of the public health GIS foundation that is already in place both in the United States and around the world.After reading this paper, leadership and senior staff should understand the following:The necessity to apply location intelligence to public health processes in coronavirus responseHow GIS can support immediate and long-term actionWhat resources Esri provides its customers

The Citizens' Pulse surveys examine Finnish attitudes and opinions in the context of the coronavirus pandemic (COVID-19). Main themes in the surveys include the activity and communication of authorities, compliance with regulations, future expectations, trust, and the respondents' own state of mind. The 12th collection round of 2021 surveyed the respondents' opinions on the reliability of the information provided by various Finnish authorities (e.g. the Finnish Institute for Health and Welfare) and members of various groups (e.g. health care employees, researchers) on the coronavirus crisis. The respondents were asked to evaluate how fair or unfair they thought Finnish society was at present and how well Finnish authorities (including the Government, Ministries, and other authorities such as the police and the Finnish Institute for Health and Welfare) had been prepared for epidemics such as COVID-19. The respondents' state of mind was examined with questions on various matters relating to health and well-being. The questions covered, for example, whether the respondents were worried about their own risk or the risk of people close to them contracting COVID-19, the availability of health care for them and people close to them for issues unrelated to COVID-19, and their own mental well-being. Additionally, the respondents' concerns were charted with questions regarding livelihood and everyday life (e.g. whether they were worried about the adequacy of their income or the income of people close to them, the uncertainty regarding how long the exceptional circumstances would last, and their children's schooling). Next, the respondents' confidence in their future and experiences of stress were surveyed. The respondents were asked to evaluate whether an atmosphere of crisis prevailed amongst Finns. The availability and findability of relevant information on the coronavirus crisis was charted. Compliance with coronavirus restrictions was examined by asking the respondents whether they had followed the restrictions and recommendations set by authorities for preventing transmission of the virus, including maintaining safe distances, washing hands regularly, wearing a face mask, avoiding touching the eyes, nose or mouth with unwashed hands, using a hand sanitiser when it was available in public places, and minimising contacts with people outside immediate family and friends. Finally, the respondents' views on the coronavirus vaccine were surveyed. The respondents were asked whether they had gotten vaccinated against COVID-19 and what had influenced their decision to get or to not get vaccinated. Additionally, the respondents were asked whether various COVID-19-related issues had influenced their use of services (e.g. shopping, going to concerts, eating at restaurants). Background variables included the respondent's gender, age group, NUTS3 region of residence, highest level of education, household composition, and perceived financial situation of household.

State and territorial executive orders, administrative orders, resolutions, proclamations, and other official publicly available government communications are collected from government websites and cataloged and coded using Microsoft Excel by one or more coders with one or more additional coders conducting quality assurance.

Data were collected to determine when individuals in states and territories were subject to executive orders, administrative orders, resolutions, proclamations, and other official publicly available government communications related to COVID-19 banning gatherings of various sizes either (1) generally, or specified that the gathering limit applied only when social distancing was not possible, or (2) even if participants practiced social distancing.

These data are derived from on the publicly available state and territorial executive orders, administrative orders, resolutions, and proclamations (“orders”) for COVID-19 that expressly ban gatherings found by the CDC, COVID-19 Community Intervention and Critical Populations Task Force, Monitoring and Evaluation Team & CDC, Center for State, Tribal, Local, and Territorial Support, Public Health Law Program from March 11, 2020 through May 31, 2021. These data will be updated as new orders are collected. Any orders not available through publicly accessible websites are not included in these data. Only official copies of the documents or, where official copies were unavailable, official press releases from government websites describing requirements were coded, as well as official government communications such as announcements that counties have progressed through new phases of reopening pursuant to an executive order, directive, or other executive branch action, and posted to government websites; news media reports on restrictions were excluded. Recommendations and guidance documents not included or adopted by reference in an order are not included in these data. These data do not include mandatory business closures, curfews, or requirements/recommendations for people to stay in their homes. Due to limitations of the National Environmental Public Health Tracking Network Data Explorer, these data do not include tribes or cities, nor was a distinction made between county orders that applied county-wide versus those that were limited to unincorporated areas of the county. Effective and expiration dates were coded using only the date provided; no distinction was made based on the specific time of the day the order became effective or expired. These data do not necessarily represent an official position of the Centers for Disease Control and Prevention.

During health emergencies such as the COVID-19 pandemic, healthcare workers face numerous ethical challenges while catering to the needs of patients in healthcare settings. Although the data recapitulating high-income countries ethics frameworks are available, the challenges faced by clinicians in resource-limited settings of low- and middle-income countries are not discussed widely due to a lack of baseline data or evidence. The Nepali healthcare system, which is chronically understaffed and underequipped, was severely affected by the COVID-19 pandemic in its capacity to manage health services and resources for needy patients, leading to ethical dilemmas and challenges during clinical practice. This study aimed to develop a standard guideline that would address syndemic ethical dilemmas during clinical care of COVID-19 patients who are unable to afford standard-of-care. A mixed method study was conducted between February and June of 2021 in 12 government designated COVID-19 treatment hospitals in central Nepal. The draft guideline was discussed among the key stakeholders in the pandemic response in Nepal. The major ethical dilemmas confronted by the study participants (50 healthcare professionals providing patient care at COVID-19 treatment hospitals) could be grouped into five major pillars of ethical clinical practice: rational allocation of medical resources, updated treatment protocols that guide clinical decisions, standard-of-care regardless of patient's economic status, effective communication among stakeholders for prompt patient care, and external factors such as political and bureaucratic interference affecting ethical practice. This living clinical ethics guideline, which has been developed based on the local evidence and case stories of frontline responders, is expected to inform the policymakers as well as the decision-makers positioned at the concerned government units. These ethics guidelines could be endorsed with revisions by the concerned regulatory authorities for the use during consequent waves of COVID-19 and other epidemics that may occur in the future. Other countries affected by the pandemic could conduct similar studies to explore ethical practices in the local clinical and public health context.

The Database of Government Actions on COVID-19 in Developing Countries collates and tracks national policies and actions in response to the pandemic, with a focus on developing countries.

The database provides information for 20 Global South countries – plus 6 Global North countries for reference – that Dalberg staff are either based in or know well. The database content is drawn from publicly available information combined, crucially, with on-the-ground knowledge of Dalberg staff.

The database contains a comprehensive set of 100 non-pharmaceutical interventions – organized in a framework intended to make it easy to observe common variations between countries in the scope and extent of major interventions. Interventions we are tracking include:
• Health-related: strengthening of healthcare systems, detection and isolation of actual / possible cases, quarantines
• Policy-related: government coordination and legal authorization, public communications and education, movement restrictions
• Distancing and hygiene: social distancing measures, movement restrictions, decontamination of physical spaces
• Economic measures: economic and social measures, logistics / supply chains and security.

We hope the database will be a useful resource for several groups of users: (i) governments and policymakers looking for a quick guide to actions taken by different countries—including a range of low- and middle-income countries, (ii) policy analysts and researchers studying the data to identify patterns of actions taken and compare the effectiveness of different interventions in curbing the pandemic, and (iii) media and others seeking to quickly access facts about the actions taken by governments in the countries covered in the database.

Comments on the data can be submitted to covid.database.comments@dalberg.com
Questions can be submitted to covid.database.questions@dalberg.com

www.dalberg.com