The New York Times is releasing a series of data files with cumulative counts of coronavirus cases in the United States, at the state and county level, over time. We are compiling this time series data from state and local governments and health departments in an attempt to provide a complete record of the ongoing outbreak.

Since late January, The Times has tracked cases of coronavirus in real time as they were identified after testing. Because of the widespread shortage of testing, however, the data is necessarily limited in the picture it presents of the outbreak.

We have used this data to power our maps and reporting tracking the outbreak, and it is now being made available to the public in response to requests from researchers, scientists and government officials who would like access to the data to better understand the outbreak.

The data begins with the first reported coronavirus case in Washington State on Jan. 21, 2020. We will publish regular updates to the data in this repository.

On March 10, 2023, the Johns Hopkins Coronavirus Resource Center ceased its collecting and reporting of global COVID-19 data. For updated cases, deaths, and vaccine data please visit: World Health Organization (WHO)For more information, visit the Johns Hopkins Coronavirus Resource Center.COVID-19 Trends MethodologyOur goal is to analyze and present daily updates in the form of recent trends within countries, states, or counties during the COVID-19 global pandemic. The data we are analyzing is taken directly from the Johns Hopkins University Coronavirus COVID-19 Global Cases Dashboard, though we expect to be one day behind the dashboard’s live feeds to allow for quality assurance of the data.DOI: https://doi.org/10.6084/m9.figshare.125529863/7/2022 - Adjusted the rate of active cases calculation in the U.S. to reflect the rates of serious and severe cases due nearly completely dominant Omicron variant.6/24/2020 - Expanded Case Rates discussion to include fix on 6/23 for calculating active cases.6/22/2020 - Added Executive Summary and Subsequent Outbreaks sectionsRevisions on 6/10/2020 based on updated CDC reporting. This affects the estimate of active cases by revising the average duration of cases with hospital stays downward from 30 days to 25 days. The result shifted 76 U.S. counties out of Epidemic to Spreading trend and no change for national level trends.Methodology update on 6/2/2020: This sets the length of the tail of new cases to 6 to a maximum of 14 days, rather than 21 days as determined by the last 1/3 of cases. This was done to align trends and criteria for them with U.S. CDC guidance. The impact is areas transition into Controlled trend sooner for not bearing the burden of new case 15-21 days earlier.Correction on 6/1/2020Discussion of our assertion of an abundance of caution in assigning trends in rural counties added 5/7/2020. Revisions added on 4/30/2020 are highlighted.Revisions added on 4/23/2020 are highlighted.Executive SummaryCOVID-19 Trends is a methodology for characterizing the current trend for places during the COVID-19 global pandemic. Each day we assign one of five trends: Emergent, Spreading, Epidemic, Controlled, or End Stage to geographic areas to geographic areas based on the number of new cases, the number of active cases, the total population, and an algorithm (described below) that contextualize the most recent fourteen days with the overall COVID-19 case history. Currently we analyze the countries of the world and the U.S. Counties. The purpose is to give policymakers, citizens, and analysts a fact-based data driven sense for the direction each place is currently going. When a place has the initial cases, they are assigned Emergent, and if that place controls the rate of new cases, they can move directly to Controlled, and even to End Stage in a short time. However, if the reporting or measures to curtail spread are not adequate and significant numbers of new cases continue, they are assigned to Spreading, and in cases where the spread is clearly uncontrolled, Epidemic trend.We analyze the data reported by Johns Hopkins University to produce the trends, and we report the rates of cases, spikes of new cases, the number of days since the last reported case, and number of deaths. We also make adjustments to the assignments based on population so rural areas are not assigned trends based solely on case rates, which can be quite high relative to local populations.Two key factors are not consistently known or available and should be taken into consideration with the assigned trend. First is the amount of resources, e.g., hospital beds, physicians, etc.that are currently available in each area. Second is the number of recoveries, which are often not tested or reported. On the latter, we provide a probable number of active cases based on CDC guidance for the typical duration of mild to severe cases.Reasons for undertaking this work in March of 2020:The popular online maps and dashboards show counts of confirmed cases, deaths, and recoveries by country or administrative sub-region. Comparing the counts of one country to another can only provide a basis for comparison during the initial stages of the outbreak when counts were low and the number of local outbreaks in each country was low. By late March 2020, countries with small populations were being left out of the mainstream news because it was not easy to recognize they had high per capita rates of cases (Switzerland, Luxembourg, Iceland, etc.). Additionally, comparing countries that have had confirmed COVID-19 cases for high numbers of days to countries where the outbreak occurred recently is also a poor basis for comparison.The graphs of confirmed cases and daily increases in cases were fit into a standard size rectangle, though the Y-axis for one country had a maximum value of 50, and for another country 100,000, which potentially misled people interpreting the slope of the curve. Such misleading circumstances affected comparing large population countries to small population counties or countries with low numbers of cases to China which had a large count of cases in the early part of the outbreak. These challenges for interpreting and comparing these graphs represent work each reader must do based on their experience and ability. Thus, we felt it would be a service to attempt to automate the thought process experts would use when visually analyzing these graphs, particularly the most recent tail of the graph, and provide readers with an a resulting synthesis to characterize the state of the pandemic in that country, state, or county.The lack of reliable data for confirmed recoveries and therefore active cases. Merely subtracting deaths from total cases to arrive at this figure progressively loses accuracy after two weeks. The reason is 81% of cases recover after experiencing mild symptoms in 10 to 14 days. Severe cases are 14% and last 15-30 days (based on average days with symptoms of 11 when admitted to hospital plus 12 days median stay, and plus of one week to include a full range of severely affected people who recover). Critical cases are 5% and last 31-56 days. Sources:U.S. CDC. April 3, 2020 Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19). Accessed online. Initial older guidance was also obtained online. Additionally, many people who recover may not be tested, and many who are, may not be tracked due to privacy laws. Thus, the formula used to compute an estimate of active cases is: Active Cases = 100% of new cases in past 14 days + 19% from past 15-25 days + 5% from past 26-49 days - total deaths. On 3/17/2022, the U.S. calculation was adjusted to: Active Cases = 100% of new cases in past 14 days + 6% from past 15-25 days + 3% from past 26-49 days - total deaths. Sources: https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e4.htm https://covid.cdc.gov/covid-data-tracker/#variant-proportions If a new variant arrives and appears to cause higher rates of serious cases, we will roll back this adjustment. We’ve never been inside a pandemic with the ability to learn of new cases as they are confirmed anywhere in the world. After reviewing epidemiological and pandemic scientific literature, three needs arose. We need to specify which portions of the pandemic lifecycle this map cover. The World Health Organization (WHO) specifies six phases. The source data for this map begins just after the beginning of Phase 5: human to human spread and encompasses Phase 6: pandemic phase. Phase six is only characterized in terms of pre- and post-peak. However, these two phases are after-the-fact analyses and cannot ascertained during the event. Instead, we describe (below) a series of five trends for Phase 6 of the COVID-19 pandemic.Choosing terms to describe the five trends was informed by the scientific literature, particularly the use of epidemic, which signifies uncontrolled spread. The five trends are: Emergent, Spreading, Epidemic, Controlled, and End Stage. Not every locale will experience all five, but all will experience at least three: emergent, controlled, and end stage.This layer presents the current trends for the COVID-19 pandemic by country (or appropriate level). There are five trends:Emergent: Early stages of outbreak. Spreading: Early stages and depending on an administrative area’s capacity, this may represent a manageable rate of spread. Epidemic: Uncontrolled spread. Controlled: Very low levels of new casesEnd Stage: No New cases These trends can be applied at several levels of administration: Local: Ex., City, District or County – a.k.a. Admin level 2State: Ex., State or Province – a.k.a. Admin level 1National: Country – a.k.a. Admin level 0Recommend that at least 100,000 persons be represented by a unit; granted this may not be possible, and then the case rate per 100,000 will become more important.Key Concepts and Basis for Methodology: 10 Total Cases minimum threshold: Empirically, there must be enough cases to constitute an outbreak. Ideally, this would be 5.0 per 100,000, but not every area has a population of 100,000 or more. Ten, or fewer, cases are also relatively less difficult to track and trace to sources. 21 Days of Cases minimum threshold: Empirically based on COVID-19 and would need to be adjusted for any other event. 21 days is also the minimum threshold for analyzing the “tail” of the new cases curve, providing seven cases as the basis for a likely trend (note that 21 days in the tail is preferred). This is the minimum needed to encompass the onset and duration of a normal case (5-7 days plus 10-14 days). Specifically, a median of 5.1 days incubation time, and 11.2 days for 97.5% of cases to incubate. This is also driven by pressure to understand trends and could easily be adjusted to 28 days. Source

Updates

• Notice of data discontinuation: Since the start of the pandemic, AP has reported case and death counts from data provided by Johns Hopkins University. Johns Hopkins University has announced that they will stop their daily data collection efforts after March 10. As Johns Hopkins stops providing data, the AP will also stop collecting daily numbers for COVID cases and deaths. The HHS and CDC now collect and visualize key metrics for the pandemic. AP advises using those resources when reporting on the pandemic going forward.

  • CDC Weekly case and death counts (national and state level)
  • CDC County level cases and deaths
  • HHS New hospital admissions
  • CDC NowCast COVID variant proportions (national and regional level)

• April 9, 2020

  • The population estimate data for New York County, NY has been updated to include all five New York City counties (Kings County, Queens County, Bronx County, Richmond County and New York County). This has been done to match the Johns Hopkins COVID-19 data, which aggregates counts for the five New York City counties to New York County.

• April 20, 2020

  • Johns Hopkins death totals in the US now include confirmed and probable deaths in accordance with CDC guidelines as of April 14. One significant result of this change was an increase of more than 3,700 deaths in the New York City count. This change will likely result in increases for death counts elsewhere as well. The AP does not alter the Johns Hopkins source data, so probable deaths are included in this dataset as well.

• April 29, 2020

  • The AP is now providing timeseries data for counts of COVID-19 cases and deaths. The raw counts are provided here unaltered, along with a population column with Census ACS-5 estimates and calculated daily case and death rates per 100,000 people. Please read the updated caveats section for more information.

• September 1st, 2020

  • Johns Hopkins is now providing counts for the five New York City counties individually.

• February 12, 2021

  • The Ohio Department of Health recently announced that as many as 4,000 COVID-19 deaths may have been underreported through the state’s reporting system, and that the "daily reported death counts will be high for a two to three-day period."
  • Because deaths data will be anomalous for consecutive days, we have chosen to freeze Ohio's rolling average for daily deaths at the last valid measure until Johns Hopkins is able to back-distribute the data. The raw daily death counts, as reported by Johns Hopkins and including the backlogged death data, will still be present in the new_deaths column.

• February 16, 2021

  - Johns Hopkins has reconciled Ohio's historical deaths data with the state.

  Overview

The AP is using data collected by the Johns Hopkins University Center for Systems Science and Engineering as our source for outbreak caseloads and death counts for the United States and globally.

The Hopkins data is available at the county level in the United States. The AP has paired this data with population figures and county rural/urban designations, and has calculated caseload and death rates per 100,000 people. Be aware that caseloads may reflect the availability of tests -- and the ability to turn around test results quickly -- rather than actual disease spread or true infection rates.

This data is from the Hopkins dashboard that is updated regularly throughout the day. Like all organizations dealing with data, Hopkins is constantly refining and cleaning up their feed, so there may be brief moments where data does not appear correctly. At this link, you’ll find the Hopkins daily data reports, and a clean version of their feed.

The AP is updating this dataset hourly at 45 minutes past the hour.

To learn more about AP's data journalism capabilities for publishers, corporations and financial institutions, go here or email kromano@ap.org.

Queries

Use AP's queries to filter the data or to join to other datasets we've made available to help cover the coronavirus pandemic

• Filter cases by state here

• Rank states by their status as current hotspots. Calculates the 7-day rolling average of new cases per capita in each state: https://data.world/associatedpress/johns-hopkins-coronavirus-case-tracker/workspace/query?queryid=481e82a4-1b2f-41c2-9ea1-d91aa4b3b1ac

• Find recent hotspots within your state by running a query to calculate the 7-day rolling average of new cases by capita in each county: https://data.world/associatedpress/johns-hopkins-coronavirus-case-tracker/workspace/query?queryid=b566f1db-3231-40fe-8099-311909b7b687&showTemplatePreview=true

• Join county-level case data to an earlier dataset released by AP on local hospital capacity here. To find out more about the hospital capacity dataset, see the full details.

• Pull the 100 counties with the highest per-capita confirmed cases here

• Rank all the counties by the highest per-capita rate of new cases in the past 7 days here. Be aware that because this ranks per-capita caseloads, very small counties may rise to the very top, so take into account raw caseload figures as well.

Interactive

The AP has designed an interactive map to track COVID-19 cases reported by Johns Hopkins.

@(https://datawrapper.dwcdn.net/nRyaf/15/)

Interactive Embed Code

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Caveats

• This data represents the number of cases and deaths reported by each state and has been collected by Johns Hopkins from a number of sources cited on their website.
• In some cases, deaths or cases of people who've crossed state lines -- either to receive treatment or because they became sick and couldn't return home while traveling -- are reported in a state they aren't currently in, because of state reporting rules.
• In some states, there are a number of cases not assigned to a specific county -- for those cases, the county name is "unassigned to a single county"
• This data should be credited to Johns Hopkins University's COVID-19 tracking project. The AP is simply making it available here for ease of use for reporters and members.
• Caseloads may reflect the availability of tests -- and the ability to turn around test results quickly -- rather than actual disease spread or true infection rates.
• Population estimates at the county level are drawn from 2014-18 5-year estimates from the American Community Survey.
• The Urban/Rural classification scheme is from the Center for Disease Control and Preventions's National Center for Health Statistics. It puts each county into one of six categories -- from Large Central Metro to Non-Core -- according to population and other characteristics. More details about the classifications can be found here.

Johns Hopkins timeseries data - Johns Hopkins pulls data regularly to update their dashboard. Once a day, around 8pm EDT, Johns Hopkins adds the counts for all areas they cover to the timeseries file. These counts are snapshots of the latest cumulative counts provided by the source on that day. This can lead to inconsistencies if a source updates their historical data for accuracy, either increasing or decreasing the latest cumulative count. - Johns Hopkins periodically edits their historical timeseries data for accuracy. They provide a file documenting all errors in their timeseries files that they have identified and fixed here

Attribution

This data should be credited to Johns Hopkins University COVID-19 tracking project

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,

Abstract

JHU Coronavirus COVID-19 Global Cases, by country

Documentation

PHS is updating the Coronavirus Global Cases dataset weekly, Monday, Wednesday and Friday from Cloud Marketplace.

This data comes from the data repository for the 2019 Novel Coronavirus Visual Dashboard operated by the Johns Hopkins University Center for Systems Science and Engineering (JHU CSSE). This database was created in response to the Coronavirus public health emergency to track reported cases in real-time. The data include the location and number of confirmed COVID-19 cases, deaths, and recoveries for all affected countries, aggregated at the appropriate province or state. It was developed to enable researchers, public health authorities and the general public to track the outbreak as it unfolds. Additional information is available in the blog post.

Visual Dashboard (desktop): https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

Section 2

Included Data Sources are:

• World Health Organization (WHO): https://www.who.int/
• DXY.cn. Pneumonia. 2020. http://3g.dxy.cn/newh5/view/pneumonia.
• BNO News: https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/
• National Health Commission of the People’s Republic of China (NHC): http://www.nhc.gov.cn/xcs/yqtb/list_gzbd.shtml
• China CDC (CCDC): http://weekly.chinacdc.cn/news/TrackingtheEpidemic.htm
• Hong Kong Department of Health: https://www.chp.gov.hk/en/features/102465.html
• Macau Government: https://www.ssm.gov.mo/portal/
• Taiwan CDC: https://sites.google.com/cdc.gov.tw/2019ncov/taiwan?authuser=0
• US CDC: https://www.cdc.gov/coronavirus/2019-ncov/index.html
• Government of Canada: https://www.canada.ca/en/public-health/services/diseases/coronavirus.html
• Australia Government Department of Health: https://www.health.gov.au/news/coronavirus-update-at-a-glance
• European Centre for Disease Prevention and Control (ECDC): https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases
• Ministry of Health Singapore (MOH): https://www.moh.gov.sg/covid-19
• Italy Ministry of Health: http://www.salute.gov.it/nuovocoronavirus
• 1Point3Arces: https://coronavirus.1point3acres.com/en
• WorldoMeters: https://www.worldometers.info/coronavirus/

%3C!-- --%3E

Section 3

**Terms of Use: **

This GitHub repo and its contents herein, including all data, mapping, and analysis, copyright 2020 Johns Hopkins University, all rights reserved, is provided to the public strictly for educational and academic research purposes. The Website relies upon publicly available data from multiple sources, that do not always agree. The Johns Hopkins University hereby disclaims any and all representations and warranties with respect to the Website, including accuracy, fitness for use, and merchantability. Reliance on the Website for medical guidance or use of the Website in commerce is strictly prohibited.

Section 4

**U.S. county-level characteristics relevant to COVID-19 **

Chin, Kahn, Krieger, Buckee, Balsari and Kiang (forthcoming) show that counties differ significantly in biological, demographic and socioeconomic factors that are associated with COVID-19 vulnerability. A range of publicly available county-specific data identifying these key factors, guided by international experiences and consideration of epidemiological parameters of importance, have been combined by the authors and are available for use:

https://github.com/mkiang/county_preparedness/

Note: DPH is updating and streamlining the COVID-19 cases, deaths, and testing data. As of 6/27/2022, the data will be published in four tables instead of twelve.

The COVID-19 Cases, Deaths, and Tests by Day dataset contains cases and test data by date of sample submission. The death data are by date of death. This dataset is updated daily and contains information back to the beginning of the pandemic. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-Cases-Deaths-and-Tests-by-Day/g9vi-2ahj.

The COVID-19 State Metrics dataset contains over 93 columns of data. This dataset is updated daily and currently contains information starting June 21, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-State-Level-Data/qmgw-5kp6 .

The COVID-19 County Metrics dataset contains 25 columns of data. This dataset is updated daily and currently contains information starting June 16, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-County-Level-Data/ujiq-dy22 .

The COVID-19 Town Metrics dataset contains 16 columns of data. This dataset is updated daily and currently contains information starting June 16, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-Town-Level-Data/icxw-cada . To protect confidentiality, if a town has fewer than 5 cases or positive NAAT tests over the past 7 days, those data will be suppressed.

Count of COVID-19-associated deaths by date of death. Deaths reported to either the OCME or DPH are included in the COVID-19 data. COVID-19-associated deaths include persons who tested positive for COVID-19 around the time of death and persons who were not tested for COVID-19 whose death certificate lists COVID-19 disease as a cause of death or a significant condition contributing to death.

Data on Connecticut deaths were obtained from the Connecticut Deaths Registry maintained by the DPH Office of Vital Records. Cause of death was determined by a death certifier (e.g., physician, APRN, medical examiner) using their best clinical judgment. Additionally, all COVID-19 deaths, including suspected or related, are required to be reported to OCME. On April 4, 2020, CT DPH and OCME released a joint memo to providers and facilities within Connecticut providing guidelines for certifying deaths due to COVID-19 that were consistent with the CDC’s guidelines and a reminder of the required reporting to OCME.25,26 As of July 1, 2021, OCME had reviewed every case reported and performed additional investigation on about one-third of reported deaths to better ascertain if COVID-19 did or did not cause or contribute to the death. Some of these investigations resulted in the OCME performing postmortem swabs for PCR testing on individuals whose deaths were suspected to be due to COVID-19, but antemortem diagnosis was unable to be made.31 The OCME issued or re-issued about 10% of COVID-19 death certificates and, when appropriate, removed COVID-19 from the death certificate. For standardization and tabulation of mortality statistics, written cause of death statements made by the certifiers on death certificates are sent to the National Center for Health Statistics (NCHS) at the CDC which assigns cause of death codes according to the International Causes of Disease 10th Revision (ICD-10) classification system.25,26 COVID-19 deaths in this report are defined as those for which the death certificate has an ICD-10 code of U07.1 as either a primary (underlying) or a contributing cause of death. More information on COVID-19 mortality can be found at the following link: https://portal.ct.gov/DPH/Health-Information-Systems--Reporting/Mortality/Mortality-Statistics

Note the counts in this dataset may vary from the death counts in the other COVID-19-related datasets published on data.ct.gov, where deaths are counted on the date reported rather than the date of death

As of March 10, 2023, the state with the highest number of COVID-19 cases was California. Almost 104 million cases have been reported across the United States, with the states of California, Texas, and Florida reporting the highest numbers.

From an epidemic to a pandemic The World Health Organization declared the COVID-19 outbreak a pandemic on March 11, 2020. The term pandemic refers to multiple outbreaks of an infectious illness threatening multiple parts of the world at the same time. When the transmission is this widespread, it can no longer be traced back to the country where it originated. The number of COVID-19 cases worldwide has now reached over 669 million.

The symptoms and those who are most at risk Most people who contract the virus will suffer only mild symptoms, such as a cough, a cold, or a high temperature. However, in more severe cases, the infection can cause breathing difficulties and even pneumonia. Those at higher risk include older persons and people with pre-existing medical conditions, including diabetes, heart disease, and lung disease. People aged 85 years and older have accounted for around 27 percent of all COVID-19 deaths in the United States, although this age group makes up just two percent of the U.S. population

Note: DPH is updating and streamlining the COVID-19 cases, deaths, and testing data. As of 6/27/2022, the data will be published in four tables instead of twelve. The COVID-19 Cases, Deaths, and Tests by Day dataset contains cases and test data by date of sample submission. The death data are by date of death. This dataset is updated daily and contains information back to the beginning of the pandemic. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-Cases-Deaths-and-Tests-by-Day/g9vi-2ahj. The COVID-19 State Metrics dataset contains over 93 columns of data. This dataset is updated daily and currently contains information starting June 21, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-State-Level-Data/qmgw-5kp6 . The COVID-19 County Metrics dataset contains 25 columns of data. This dataset is updated daily and currently contains information starting June 16, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-County-Level-Data/ujiq-dy22 . The COVID-19 Town Metrics dataset contains 16 columns of data. This dataset is updated daily and currently contains information starting June 16, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-Town-Level-Data/icxw-cada . To protect confidentiality, if a town has fewer than 5 cases or positive NAAT tests over the past 7 days, those data will be suppressed. COVID-19 cases and associated deaths that have been reported among Connecticut residents, broken out by age group. All data in this report are preliminary; data for previous dates will be updated as new reports are received and data errors are corrected. Deaths reported to the either the Office of the Chief Medical Examiner (OCME) or Department of Public Health (DPH) are included in the daily COVID-19 update. Data are reported daily, with timestamps indicated in the daily briefings posted at: portal.ct.gov/coronavirus. Data are subject to future revision as reporting changes. Starting in July 2020, this dataset will be updated every weekday. Additional notes: A delay in the data pull schedule occurred on 06/23/2020. Data from 06/22/2020 was processed on 06/23/2020 at 3:30 PM. The normal data cycle resumed with the data for 06/23/2020. A network outage on 05/19/2020 resulted in a change in the data pull schedule. Data from 5/19/2020 was processed on 05/20/2020 at 12:00 PM. Data from 5/20/2020 was processed on 5/20/2020 8:30 PM. The normal data cycle resumed on 05/20/2020 with the 8:30 PM data pull. As a result of the network outage, the timestamp on the datasets on the Open Data Portal differ from the timestamp in DPH's daily PDF reports. Starting 5/10/2021, the date field will represent the date this data was updated on data.ct.gov. Previously the date the data was pulled by DPH was listed, which typically coincided with the date before the data was published on data.ct.gov. This change was made to standardize the COVID-19 data sets on data.ct.gov.

This map shows recent COVID-19 Trends with arrows that represent each county's recent trend history, and weekly new case counts for U.S. counties. The map data is updated weekly and featured in this storymap.It shows COVID-19 Trend for the most recent Monday with a colored arrow for each county. The larger the arrow, the longer the county has had this trend. An up arrow indicates the number of active cases continue upward. A down arrow indicates the number of active cases is going down. The intent of this map is to give more context than just the current day of new data because daily data for COVID-19 cases is volatile and can be unreliable on the day it is first reported. Weekly summaries in the counts of new cases smooth out this volatility.Click or tap on a county to see a history of trend changes and a weekly graph of new cases going back to February 1, 2020. This map is updated every Tuesday based on data through the previous Sunday. See also this version of the map for additional perspective.COVID-19 Trends show how each county is doing and are updated daily. We base the trend assignment on the number of new cases in the past two weeks and the number of active cases per 100,000 people. To learn the details for how trends are assigned, see the full methodology. There are five trends:Emergent - New cases for the first time or in counties that have had zero new cases for 60 or more days.Spreading - Low to moderate rates of new cases each day. Likely controlled by local policies and individuals taking measures such as wearing masks and curtailing unnecessary activities.Epidemic - Accelerating and uncontrolled rates of new cases.Controlled - Very low rates of new cases.End Stage - One or fewer new cases every 5 days in larger populations and fewer in rural areas.For more information about COVID-19 trends, see the full methodology.Data Source: Johns Hopkins University CSSE US Cases by County dashboard and USAFacts for Utah County level Data.

As of May 2, 2023, the outbreak of the coronavirus disease (COVID-19) had been confirmed in almost every country in the world. The virus had infected over 687 million people worldwide, and the number of deaths had reached almost 6.87 million. The most severely affected countries include the U.S., India, and Brazil.

COVID-19: background information COVID-19 is a novel coronavirus that had not previously been identified in humans. The first case was detected in the Hubei province of China at the end of December 2019. The virus is highly transmissible and coughing and sneezing are the most common forms of transmission, which is similar to the outbreak of the SARS coronavirus that began in 2002 and was thought to have spread via cough and sneeze droplets expelled into the air by infected persons.

Naming the coronavirus disease Coronaviruses are a group of viruses that can be transmitted between animals and people, causing illnesses that may range from the common cold to more severe respiratory syndromes. In February 2020, the International Committee on Taxonomy of Viruses and the World Health Organization announced official names for both the virus and the disease it causes: SARS-CoV-2 and COVID-19, respectively. The name of the disease is derived from the words corona, virus, and disease, while the number 19 represents the year that it emerged.

This public use dataset has 11 data elements reflecting United States COVID-19 community levels for all available counties. This dataset contains the same values used to display information available on the COVID Data Tracker at: https://covid.cdc.gov/covid-data-tracker/#county-view?list_select_state=all_states&list_select_county=all_counties&data-type=CommunityLevels The data are updated weekly.

CDC looks at the 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 — to determine the COVID-19 community level. The COVID-19 community level is 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 is classified as low, medium, or high. COVID-19 Community Levels can 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.

See https://www.cdc.gov/coronavirus/2019-ncov/science/community-levels.html for more information.

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.

For more details on the Minnesota Department of Health COVID-19 thresholds, see COVID-19 Public Health Risk Measures: Data Notes (Updated 4/13/22). https://mn.gov/covid19/assets/phri_tcm1148-434773.pdf

Note: 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.

As of April 26, 2023, the number of both confirmed and presumptive positive cases of the COVID-19 disease reported in the United States had reached over 104 million with over 1.1 million deaths reported among these cases.

Coronavirus deaths by age in the U.S. Daily new cases of COVID-19 hit record highs in the United States at the beginning of 2022. Underlying health conditions can worsen cases of coronavirus, and case fatality rates among confirmed COVID-19 patients increase with age. The highest number of deaths from COVID-19 have been among those aged 85 years and older, with this age group accounting for over 300 thousand deaths.

Where has this coronavirus come from? Coronaviruses are a large group of viruses transmitted between animals and people that cause illnesses ranging from the common cold to more severe diseases. The novel coronavirus that is currently infecting humans was already circulating among certain animal species. The first human case of this new coronavirus strain was reported in China at the end of December 2019. The coronavirus was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and its associated disease is known as COVID-19.

The complete COVID-19 dataset is a collection of the COVID-19 data maintained by Our World in Data that is updated throughout the duration of COVID-19. It includes information related to confirmed cases and deaths, hospitalization, intensive care unit admissions, testing for COVID-19, and vaccination for COVID-19.Confirmed cases and deaths: this data is collected from the World Health Organization Coronavirus Dashboard. The cases & deaths dataset is updated daily.Note 1: Time/date stamps reflect when the data was last updated by WHO. Due to the time required to process and validate the incoming data, there is a delay between reporting to WHO and the update of the dashboard.Note 2: Counts and corrections made after these times will be carried forward to the next reporting cycle for that specific region. Delayed reporting for any specific country, territory or area may result in pooled counts for multiple days being presented, with a retrospective update to counts on previous days to accurately reflect trends. Significant data errors detected or reported to WHO may be corrected at more frequent intervals.Hospitalizations and intensive care unit (ICU) admissions: our data is collected from official sources and collated by Our World in Data. The complete list of country-by-country sources is available here.Testing for COVID-19: this data is collected by the Our World in Data team from official reports; you can find further details in our post on COVID-19 testing, including our checklist of questions to understand testing data, information on geographical and temporal coverage, and detailed country-by-country source information. On 23 June 2022, we stopped adding new datapoints to our COVID-19 testing dataset. You can read more here.Vaccinations against COVID-19: this data is collected by the Our World in Data team from official reports.Other variables: this data is collected from a variety of sources (United Nations, World Bank, Global Burden of Disease, Blavatnik School of Government, etc.). More information is available in our codebook.

Note: In these datasets, a person is defined as up to date if they have received at least one dose of an updated COVID-19 vaccine. The Centers for Disease Control and Prevention (CDC) recommends that certain groups, including adults ages 65 years and older, receive additional doses.

On 6/16/2023 CDPH replaced the booster measures with a new “Up to Date” measure based on CDC’s new recommendations, replacing the primary series, boosted, and bivalent booster metrics The definition of “primary series complete” has not changed and is based on previous recommendations that CDC has since simplified. A person cannot complete their primary series with a single dose of an updated vaccine. Whereas the booster measures were calculated using the eligible population as the denominator, the new up to date measure uses the total estimated population. Please note that the rates for some groups may change since the up to date measure is calculated differently than the previous booster and bivalent measures.

This data is from the same source as the Vaccine Progress Dashboard at https://covid19.ca.gov/vaccination-progress-data/ which summarizes vaccination data at the county level by county of residence. Where county of residence was not reported in a vaccination record, the county of provider that vaccinated the resident is included. This applies to less than 1% of vaccination records. The sum of county-level vaccinations does not equal statewide total vaccinations due to out-of-state residents vaccinated in California.

These data do not include doses administered by the following federal agencies who received vaccine allocated directly from CDC: Indian Health Service, Veterans Health Administration, Department of Defense, and the Federal Bureau of Prisons.

Totals for the Vaccine Progress Dashboard and this dataset may not match, as the Dashboard totals doses by Report Date and this dataset totals doses by Administration Date. Dose numbers may also change for a particular Administration Date as data is updated.

Previous updates:

• On March 3, 2023, with the release of HPI 3.0 in 2022, the previous equity scores have been updated to reflect more recent community survey information. This change represents an improvement to the way CDPH monitors health equity by using the latest and most accurate community data available. The HPI uses a collection of data sources and indicators to calculate a measure of community conditions ranging from the most to the least healthy based on economic, housing, and environmental measures.

• Starting on July 13, 2022, the denominator for calculating vaccine coverage has been changed from age 5+ to all ages to reflect new vaccine eligibility criteria. Previously the denominator was changed from age 16+ to age 12+ on May 18, 2021, then changed from age 12+ to age 5+ on November 10, 2021, to reflect previous changes in vaccine eligibility criteria. The previous datasets based on age 16+ and age 5+ denominators have been uploaded as archived tables.

• Starting on May 29, 2021 the methodology for calculating on-hand inventory in the shipped/delivered/on-hand dataset has changed. Please see the accompanying data dictionary for details. In addition, this dataset is now down to the ZIP code level.

Collection of scholarly articles about COVID-19 and coronavirus family of viruses for use by global research community. Dataset is updated on weekly basis.

COVID-19 Cases information is reported through the Pennsylvania State Department’s National Electronic Disease Surveillance System (PA-NEDSS). As new cases are passed to the Allegheny County Health Department they are investigated by case investigators. During investigation some cases which are initially determined by the State to be in the Allegheny County jurisdiction may change, which can account for differences between publication of the files on the number of cases, deaths and tests. Additionally, information is not always reported to the State in a timely manner, delays can range from days to weeks, which can also account for discrepancies between previous and current files. Test and Case information will be updated daily. This resource contains individuals who received a COVID-19 test and individuals whom are probable cases. Every day, these records are overwritten with updates. Each row in the data reflects a person that is tested, not tests that are conducted. People that are tested more than once will have their testing and case data updated using the following rules:

1. Positive tests overwrite negative tests.
2. Polymerase chain reaction (PCR) tests overwrite antibody or antigen (AG) tests.
3. The first positive PCR test is never overwritten. Data collected from additional tests do not replace the first positive PCR test.

Note: On April 4th 2022 the Pennsylvania Department of Health no longer required labs to report negative AG tests. Therefore aggregated counts that included AG tests have been removed from the Municipality/Neighborhood files going forward. Versions of this data up to this cut-off have been retained as archived files.

Individual Test information is also updated daily. This resource contains the details and results of individual tests along with demographic information of the individual tested. Only PCR and AG tests are included. Every day, these records are overwritten with updates. This resource should be used to determine positivity rates.

The remaining datasets provide statistics on death demographics. Demographic, municipality and neighborhood information for deaths are reported on a weekly schedule and are not included with individual cases or tests. This has been done to protect the privacy and security of individuals and their families in accordance with the Health Insurance Portability and Accountability Act (HIPAA). Municipality or City of Pittsburgh Neighborhood is based off the geocoded home address of the individual tested.

Individuals whose home address is incomplete may not be in Allegheny County but whose temporary residency, work or other mitigating circumstance are determined to be in Allegheny County by the Pennsylvania Department of Health are counted as "Undefined".

Since the start of the pandemic, the ACHD has mapped every day’s COVID tests, cases, and deaths to their Allegheny County municipality and neighborhood. Tests were mapped to patient address, and if this was not available, to the provider location. This has recently resulted in apparent testing rates that exceeded the populations of various municipalities -- mostly those with healthcare providers. As this was brought to our attention, the health department and our data partners began researching and comparing methods to most accurately display the data. This has led us to leave those with missing home addresses off the map. Although these data will still appear in test, case and death counts, there will be over 20,000 fewer tests and almost 1000 fewer cases on the map. In addition to these map changes, we have identified specific health systems and laboratories that had data uploading errors that resulted in missing locations, and are working with them to correct these errors.

Due to minor discrepancies in the Municipal boundary and the City of Pittsburgh Neighborhood files individuals whose City Neighborhood cannot be identified are be counted as “Undefined (Pittsburgh)”.

On May 19, 2023, with the rescinding of the COVID-19 public health emergency, changes in data and reporting mechanisms prompted a change to an annual data sharing schedule for tests, cases, hospitalizations, and deaths. Dates for annual release are TBD. The weekly municipal counts and individual data produced before this changed are maintained as archive files.

Support for Health Equity datasets and tools provided by Amazon Web Services (AWS) through their Health Equity Initiative.

Note: 11/1/2023: Publication of the COVID data will be delayed because of technical difficulties. Note: 9/20/2023: With the end of the federal emergency and reporting requirements continuing to evolve, the Indiana Department of Health will no longer publish and refresh the COVID-19 datasets after November 15, 2023 - one final dataset publication will continue to be available. Vaccination demographics data by county/region, by race, by ethnicity, by gender, and by age. Fields with less than 5 results have been marked as suppressed. Note: 3/22/2023: Due to a technical issue updates are delayed for COVID data. New files will be published as soon as they are available. Historical Changes: 1/5/2023: Due to a technical issue the COVID datasets were not updated on 1/4/23. Updates will be published as soon as they are available. 9/29/22: Due to a technical difficulty, the weekly COVID datasets were not generated yesterday. They will be updated with current data today - 9/29 - and may result in a temporary discrepancy with the numbers published on the dashboard until the normal weekly refresh resumes 10/5. 9/27/2022: As of 9/28, the Indiana Department of Health (IDOH) is moving to a weekly COVID update for the dashboard and all associated datasets to continue to provide trend data that is applicable and usable for our partners and the public. This is to maintain alignment across the nation as states move to weekly updates. 8/19/2022 - The first and second dose columns are being removed as of 8/22/22 as the Health department has transitioned to reporting on Fully/Partially vaccinated. The final historical file including these columns from 8/19 will continue to be available. 2/10/2022: Data was not published on 2/9/2022 due to a technical issue, but updated data was released 2/10/2022. 10/13/2021: This dataset now includes columns for new and total booster shots administered. Please see the data dictionary for additional details. 08/06/2021: There are updates today to county-level vaccination rates to reflect a correction to records that were assigned to the wrong location based on ZIP code. 06/23/2021: COVID Hub files will no longer be updated on Saturdays. The normal refresh of these files has been changed to Mon-Fri. 06/10/2021: COVID Hub files will no longer be updated on Sundays. The normal refresh of these files has been changed to Mon-Sat. 06/07/2021: Today’s new counts include doses newly reported to the Indiana Department of Health on Saturday and Sunday. 06/03/2021: Individuals are able to update their personal and demographic information during the vaccination registration process. Today’s data reflects changes made by individuals to their race, ethnicity, or county of residence over the course of their vaccination series. 05/13/2021: The 12-15 year-old age group has been added into the dataset as of today. 05/06/2021: On Monday 5/3, individuals classified as "Unknown" county of residence were inadvertently converted to "Out of State." These individuals have been corrected in today's dataset. 03/11/2021: This dataset has been updated to include totals and newly administered single dose vaccination data. Additionally the existing age groups have been further stratified into a 16-19 year old age group, and 5 year groups for 20-79 year olds.

COVID-19 Trends MethodologyOur goal is to analyze and present daily updates in the form of recent trends within countries, states, or counties during the COVID-19 global pandemic. The data we are analyzing is taken directly from the Johns Hopkins University Coronavirus COVID-19 Global Cases Dashboard, though we expect to be one day behind the dashboard’s live feeds to allow for quality assurance of the data.Revisions added on 4/23/2020 are highlighted.Revisions added on 4/30/2020 are highlighted.Discussion of our assertion of an abundance of caution in assigning trends in rural counties added 5/7/2020. Correction on 6/1/2020Methodology update on 6/2/2020: This sets the length of the tail of new cases to 6 to a maximum of 14 days, rather than 21 days as determined by the last 1/3 of cases. This was done to align trends and criteria for them with U.S. CDC guidance. The impact is areas transition into Controlled trend sooner for not bearing the burden of new case 15-21 days earlier.Reasons for undertaking this work:The popular online maps and dashboards show counts of confirmed cases, deaths, and recoveries by country or administrative sub-region. Comparing the counts of one country to another can only provide a basis for comparison during the initial stages of the outbreak when counts were low and the number of local outbreaks in each country was low. By late March 2020, countries with small populations were being left out of the mainstream news because it was not easy to recognize they had high per capita rates of cases (Switzerland, Luxembourg, Iceland, etc.). Additionally, comparing countries that have had confirmed COVID-19 cases for high numbers of days to countries where the outbreak occurred recently is also a poor basis for comparison.The graphs of confirmed cases and daily increases in cases were fit into a standard size rectangle, though the Y-axis for one country had a maximum value of 50, and for another country 100,000, which potentially misled people interpreting the slope of the curve. Such misleading circumstances affected comparing large population countries to small population counties or countries with low numbers of cases to China which had a large count of cases in the early part of the outbreak. These challenges for interpreting and comparing these graphs represent work each reader must do based on their experience and ability. Thus, we felt it would be a service to attempt to automate the thought process experts would use when visually analyzing these graphs, particularly the most recent tail of the graph, and provide readers with an a resulting synthesis to characterize the state of the pandemic in that country, state, or county.The lack of reliable data for confirmed recoveries and therefore active cases. Merely subtracting deaths from total cases to arrive at this figure progressively loses accuracy after two weeks. The reason is 81% of cases recover after experiencing mild symptoms in 10 to 14 days. Severe cases are 14% and last 15-30 days (based on average days with symptoms of 11 when admitted to hospital plus 12 days median stay, and plus of one week to include a full range of severely affected people who recover). Critical cases are 5% and last 31-56 days. Sources:U.S. CDC. April 3, 2020 Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19). Accessed online. Initial older guidance was also obtained online. Additionally, many people who recover may not be tested, and many who are, may not be tracked due to privacy laws. Thus, the formula used to compute an estimate of active cases is: Active Cases = 100% of new cases in past 14 days + 19% from past 15-30 days + 5% from past 31-56 days - total deaths.We’ve never been inside a pandemic with the ability to learn of new cases as they are confirmed anywhere in the world. After reviewing epidemiological and pandemic scientific literature, three needs arose. We need to specify which portions of the pandemic lifecycle this map cover. The World Health Organization (WHO) specifies six phases. The source data for this map begins just after the beginning of Phase 5: human to human spread and encompasses Phase 6: pandemic phase. Phase six is only characterized in terms of pre- and post-peak. However, these two phases are after-the-fact analyses and cannot ascertained during the event. Instead, we describe (below) a series of five trends for Phase 6 of the COVID-19 pandemic.Choosing terms to describe the five trends was informed by the scientific literature, particularly the use of epidemic, which signifies uncontrolled spread. The five trends are: Emergent, Spreading, Epidemic, Controlled, and End Stage. Not every locale will experience all five, but all will experience at least three: emergent, controlled, and end stage.This layer presents the current trends for the COVID-19 pandemic by country (or appropriate level). There are five trends:Emergent: Early stages of outbreak. Spreading: Early stages and depending on an administrative area’s capacity, this may represent a manageable rate of spread. Epidemic: Uncontrolled spread. Controlled: Very low levels of new casesEnd Stage: No New cases These trends can be applied at several levels of administration: Local: Ex., City, District or County – a.k.a. Admin level 2State: Ex., State or Province – a.k.a. Admin level 1National: Country – a.k.a. Admin level 0Recommend that at least 100,000 persons be represented by a unit; granted this may not be possible, and then the case rate per 100,000 will become more important.Key Concepts and Basis for Methodology: 10 Total Cases minimum threshold: Empirically, there must be enough cases to constitute an outbreak. Ideally, this would be 5.0 per 100,000, but not every area has a population of 100,000 or more. Ten, or fewer, cases are also relatively less difficult to track and trace to sources. 21 Days of Cases minimum threshold: Empirically based on COVID-19 and would need to be adjusted for any other event. 21 days is also the minimum threshold for analyzing the “tail” of the new cases curve, providing seven cases as the basis for a likely trend (note that 21 days in the tail is preferred). This is the minimum needed to encompass the onset and duration of a normal case (5-7 days plus 10-14 days). Specifically, a median of 5.1 days incubation time, and 11.2 days for 97.5% of cases to incubate. This is also driven by pressure to understand trends and could easily be adjusted to 28 days. Source used as basis:Stephen A. Lauer, MS, PhD *; Kyra H. Grantz, BA *; Qifang Bi, MHS; Forrest K. Jones, MPH; Qulu Zheng, MHS; Hannah R. Meredith, PhD; Andrew S. Azman, PhD; Nicholas G. Reich, PhD; Justin Lessler, PhD. 2020. The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Annals of Internal Medicine DOI: 10.7326/M20-0504.New Cases per Day (NCD) = Measures the daily spread of COVID-19. This is the basis for all rates. Back-casting revisions: In the Johns Hopkins’ data, the structure is to provide the cumulative number of cases per day, which presumes an ever-increasing sequence of numbers, e.g., 0,0,1,1,2,5,7,7,7, etc. However, revisions do occur and would look like, 0,0,1,1,2,5,7,7,6. To accommodate this, we revised the lists to eliminate decreases, which make this list look like, 0,0,1,1,2,5,6,6,6.Reporting Interval: In the early weeks, Johns Hopkins' data provided reporting every day regardless of change. In late April, this changed allowing for days to be skipped if no new data was available. The day was still included, but the value of total cases was set to Null. The processing therefore was updated to include tracking of the spacing between intervals with valid values.100 News Cases in a day as a spike threshold: Empirically, this is based on COVID-19’s rate of spread, or r0 of ~2.5, which indicates each case will infect between two and three other people. There is a point at which each administrative area’s capacity will not have the resources to trace and account for all contacts of each patient. Thus, this is an indicator of uncontrolled or epidemic trend. Spiking activity in combination with the rate of new cases is the basis for determining whether an area has a spreading or epidemic trend (see below). Source used as basis:World Health Organization (WHO). 16-24 Feb 2020. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). Obtained online.Mean of Recent Tail of NCD = Empirical, and a COVID-19-specific basis for establishing a recent trend. The recent mean of NCD is taken from the most recent fourteen days. A minimum of 21 days of cases is required for analysis but cannot be considered reliable. Thus, a preference of 42 days of cases ensures much higher reliability. This analysis is not explanatory and thus, merely represents a likely trend. The tail is analyzed for the following:Most recent 2 days: In terms of likelihood, this does not mean much, but can indicate a reason for hope and a basis to share positive change that is not yet a trend. There are two worthwhile indicators:Last 2 days count of new cases is less than any in either the past five or 14 days. Past 2 days has only one or fewer new cases – this is an extremely positive outcome if the rate of testing has continued at the same rate as the previous 5 days or 14 days. Most recent 5 days: In terms of likelihood, this is more meaningful, as it does represent at short-term trend. There are five worthwhile indicators:Past five days is greater than past 2 days and past 14 days indicates the potential of the past 2 days being an aberration. Past five days is greater than past 14 days and less than past 2 days indicates slight positive trend, but likely still within peak trend time frame.Past five days is less than the past 14 days. This means a downward trend. This would be an

Reporting of new Aggregate Case and Death Count data was discontinued May 11, 2023, with the expiration of the COVID-19 public health emergency declaration. This dataset will receive a final update on June 1, 2023, to reconcile historical data through May 10, 2023, and will remain publicly available.

Aggregate Data Collection Process Since the start of the COVID-19 pandemic, data have been gathered through a robust process with the following steps:

• A CDC data team reviews and validates the information obtained from jurisdictions’ state and local websites via an overnight data review process.
• If more than one official county data source exists, CDC uses a comprehensive data selection process comparing each official county data source, and takes the highest case and death counts respectively, unless otherwise specified by the state.
• CDC compiles these data and posts the finalized information on COVID Data Tracker.
• County level data is aggregated to obtain state and territory specific totals.

This process is collaborative, with CDC and jurisdictions working together to ensure the accuracy of COVID-19 case and death numbers. County counts provide the most up-to-date numbers on cases and deaths by report date. CDC may retrospectively update counts to correct data quality issues.

Methodology Changes Several differences exist between the current, weekly-updated dataset and the archived version:

• Source: The current Weekly-Updated Version is based on county-level aggregate count data, while the Archived Version is based on State-level aggregate count data.
• Confirmed/Probable Cases/Death breakdown:  While the probable cases and deaths are included in the total case and total death counts in both versions (if applicable), they were reported separately from the confirmed cases and deaths by jurisdiction in the Archived Version.  In the current Weekly-Updated Version, the counts by jurisdiction are not reported by confirmed or probable status (See Confirmed and Probable Counts section for more detail).
• Time Series Frequency: The current Weekly-Updated Version contains weekly time series data (i.e., one record per week per jurisdiction), while the Archived Version contains daily time series data (i.e., one record per day per jurisdiction).
• Update Frequency: The current Weekly-Updated Version is updated weekly, while the Archived Version was updated twice daily up to October 20, 2022.

Important note: The counts reflected during a given time period in this dataset may not match the counts reflected for the same time period in the archived dataset noted above. Discrepancies may exist due to differences between county and state COVID-19 case surveillance and reconciliation efforts.

Confirmed and Probable Counts In this dataset, counts by jurisdiction are not displayed by confirmed or probable status. Instead, confirmed and probable cases and deaths are included in the Total Cases and Total Deaths columns, when available. Not all jurisdictions report probable cases and deaths to CDC.* Confirmed and probable case definition criteria are described here:

Council of State and Territorial Epidemiologists (ymaws.com).

Deaths CDC reports death data on other sections of the website: CDC COVID Data Tracker: Home, CDC COVID Data Tracker: Cases, Deaths, and Testing, and NCHS Provisional Death Counts. Information presented on the COVID Data Tracker pages is based on the same source (to