CFA 2023 Annual Report: Implementations and Accomplishments Update

CFA delivered four technical reports on the mpox outbreak in the United States, which served as a first-of-their-kind product, focused on providing potential future scenarios in a timely and actionable manner.

The technical reports were developed and published quickly, matching the pace of response. They provided key data regarding the mpox outbreak in the United States, including incidence rates, factors affecting incidence, transmission levels, and potential future outbreak trajectory. They were shared widely to provide timely updates on CDC’s response to the outbreak and projections of the potential course the disease could take.

State-specific analyses were also developed as a part of these reports for the jurisdictions with the highest incidence of mpox cases to help with decision-making and actions at the state and local level. These reports supported active response planning with up-to-date and timely analyses that shared what was known about the outbreak, along with CDC’s projections of where the outbreak was headed.

CFA is pioneering a virtual analyst platform in close collaboration with other CDC programs.

The effort is focused on developing a common suite of software, tools, and file and code-sharing capabilities for collaborating modelers. This common operating environment is currently in the pilot stage and will allow modelers to work with the data together in real-time and create a trusted, connected pathway for data analysis to be used by decision makers.

CFA is engaging with industry partners to translate data and analytical capabilities used in the private sector and engineer innovation into CFA’s work.

In April 2022, CFA hosted its first Industry Day to engage with potential partners from private sector companies in a joint mission to strengthen public health infrastructure. The event featured nearly 250 attendees and included robust discussions on what is essential to transform public health emergency response. CFA, in collaboration with CDC’s Data Modernization Initiative (DMI) and the CDC Foundation, held a second Industry Day in February 2023 to continue conversations around ways to strengthen our public health infrastructure.

During winter of 2021, CFA performed a scenario analysis to predict the caseload associated with the COVID-19 Omicron variant.

Within days of recognizing the potential seriousness of the variant, CFA alerted federal leaders, state, and local public health partners, and the public that a surge in cases could be severe enough to disrupt our daily lives and essential services. This early warning allowed leaders at all levels to prepare for a surge in cases, engage in prevention planning, and minimize impact of the virus. In parallel, CFA awarded a contract to Kaiser Permanente to quickly analyze COVID-19 hospital data to assess the clinical severity of the Omicron variant. This project showed that while case numbers would be large as the variant swept the country, typical severity would be lower for each case. CDC shared these data with policy makers throughout the Biden Administration within a month of initiating the study and published the results online in December 2021.

CFA is working within CDC by leveraging advancements made as part of CDC’s Data Modernization Initiative (DMI), collaborating with other programs to improve CDC’s outbreak response.

CFA is focused on creating innovative solutions for using and sharing data in new ways. For example, the Administration for Strategic Preparedness and Response (ASPR) has a modeling team that is focused on addressing specific questions and assessing medical countermeasure needs within the Strategic National Stockpile. CFA recognized the value of ASPR’s single agent-based model for COVID-19 and, in close partnership, is transforming this from a single model to a suite of models and additional tools accessible to U.S. Government partners, enabled by CDC’s DMI advancements in cloud computing infrastructure. Because of these advancements, collaborators can access and run the models directly and effectively in the cloud environment and at a much swifter pace than previous computing environments allowed.

These types of models are designed to be iterative, allowing for modelers to view others’ updates and assumptions. This level of transparent collaboration keeps everyone informed. As this pilot continues, CFA will work to make model code and rigorous documentation available so the work can be reviewed, refined, and replicated.

CFA is partnering with public health leaders and data scientists to advance outbreak analytics and disease forecasting.

CFA is supporting the development of new approaches for mathematical modeling and is identifying strategies to optimize accuracy in disease forecasting. For example, CFA contracted with several universities throughout the country to evaluate and improve disease forecasting methods. This research is intended to provide insight into techniques that CDC can implement to increase precision in our models and forecasts. CFA will also evaluate different approaches to disease surveillance and forecasting in the United States and will help identify areas where CFA is best positioned to improve disease analytics.

• CFA contracted with Harvard University, Johns Hopkins University, and the University of Utah to create Modeling Centers of Excellence that work to improve forecasting and outbreak analytics for emergency decision-making. Additionally, the Modeling Centers of Excellence assess drivers of inequity and include these factors into future models and potential intervention strategies. Utilizing modeling to inform public health actions like this has the potential to impact overall outcomes and encourage equity. These centers are focused on expanding and upskilling the public health workforce and are working to embed modeling experts in state, territorial, local, tribal, federal, and international public health institutions. Creating applied modeling training and building capacity will help accelerate the development of the public health workforce.
• CFA partnered with CDC’s Division of Healthcare Quality Promotion to establish the Nursing Home Public Health Response Network with funding provided through the Safety and Healthcare Epidemiology Prevention Research Development (SHEPheRD) Program to address health disparities of nursing home residents who have an increased susceptibility to infectious diseases. This geographically dispersed network of nursing homes will conduct rapid-response data collection of infectious pathogens.

CFA partners with public health organizations to determine how best to communicate with leaders on the ground.

• CFA partnered with the National Association of County and City Health Officials, the Association of State and Territorial Health Officials, and the National Conference of State Legislatures to establish a forum for open and reciprocal communication to engage and hear from state, tribal, local, and territorial (STLT) partners. Through these engagements, CFA is developing approaches to help meet the needs of state and local decision makers. Within these partnerships, CFA is holding regular listening sessions to help optimize disease forecasting products that decision makers can use. CFA is also supporting the development of trainings and demonstration sites to test these products.
• Through CFA’s cooperative agreement with the Council of State and Territorial Epidemiologists, CFA is engaging with state and local epidemiologists to create decision support tools, evaluate the utility of new and existing products, and identify methods to make forecasting tools accessible to on-the-ground public health leaders.
• CFA, in collaboration with CDC’s DMI, aims to develop a partnership with STLT jurisdictions to iteratively develop, test, provide feedback on, and scale products to be used in infectious disease outbreaks. ​These products could include forecasting, analytic, communications, visualization, or decision support tools. ​The goal is to innovate analytical capabilities and partnerships with state and local public health agencies, healthcare organizations, the private sector, and academia.​ Project objectives include: ​
  • Develop a community of practice to evaluate, share, and scale what works.​
  • Integrate new data sources or technologies into outbreak analytics. Examples include integrating wastewater and genomic data into outbreak analyses and forecasts.
  • Create and enhance analytical tools for outbreak response. Examples include tools to improve what we know about the present situation during an outbreak and what the immediate forecast is (nowcasting), targeting specific interventions by geography or group and strategies for implementing large-scale interventions.
  • Develop and enhance visualization and other techniques to communicate outbreak analyses and forecasts to decision makers​.