Estimates of SARS-CoV-2 Hospitalization and Fatality Rates in the Prevaccination Period, United States.

Few precise estimates of hospitalization and fatality rates from COVID-19 exist for naive populations, especially within demographic subgroups. We estimated rates among persons with SARS-CoV-2 infection in the United States during May 1-December 1, 2020, before vaccines became available. Both rates generally increased with age; fatality rates were highest for persons >85 years of age (24%) and lowest for children 1-14 years of age (0.01%). Age-adjusted case hospitalization rates were highest for African American or Black, not Hispanic persons (14%), and case-fatality rates were highest for Asian or Pacific Islander, not Hispanic persons (4.4%). Eighteen percent of hospitalized patients and 44.2% of those admitted to an intensive care unit died. Male patients had higher hospitalization (6.2% vs. 5.2%) and fatality rates (1.9% vs. 1.5%) than female patients. These findings highlight the importance of collecting surveillance data to devise appropriate control measures for persons in underserved racial/ethnic groups and older adults.

Receipt and Timeliness of Newborn Hearing Screening and Diagnostic Services Among Babies Born in 2017 in 9 States.

CONTEXT: By providing timely services at all steps along the continuum of the early hearing detection and intervention (EHDI) process, providers may be able to lessen potential adverse effects of late identification of hearing loss on children's language development. OBJECTIVE: To examine the timeliness of key events in the EHDI process from birth through diagnosis of hearing loss among different populations. DESIGN: Retrospective, cross-sectional. SETTING: Data pooled from 9 states' EHDI information systems were used to determine the extent to which timely screening and diagnosis were achieved by 754 613 infants born in calendar year 2017. Enrollment into early intervention for children diagnosed is not examined here due to incomplete data. PARTICIPANTS: Nine state EHDI programs were selected to participate in this study for their successful experience in using EHDI-IS to collect detailed child-level data. MAIN OUTCOME MEASURES: Age of service, rate of service receipt. RESULTS: Median age of newborn hearing screening was 1 day, and median age of hearing loss diagnosis was 68 days. Early completion of newborn hearing screening was associated with maternal education, maternal race/ethnicity, and admission into a neonatal intensive care unit (NICU). Receiving and completing follow-up diagnostic services were associated with maternal education, maternal race/ethnicity, age of screening, and enrollment into the Women, Infants, and Children program. CONCLUSIONS: Timely completion of the newborn hearing screening is achieved by most of the population among the participating states. Increased efforts may be considered by state EHDI programs to provide additional follow-up and education to underrepresented racial/ethnic groups, mothers with less education, and NICU infants and their families as these groups appear to be at an increased risk for delayed diagnostic testing for hearing loss.

Likely Impact of the COVID-19 Pandemic on Newborn Hearing Screening and Follow-up Services in the United States in 2020.

This perspective aims to highlight aspects of the Early Hearing Detection and Intervention (EHDI) newborn hearing screening and follow-up processes that were impacted by the COVID-19 pandemic and considers factors that likely impacted follow-up after failing newborn hearing screening among infants born in the United States during 2020. Efforts to minimize the potential impact of missed or delayed identification of hearing loss in infants and young children will also be discussed to help guide future program improvement activities.

Assessing Impact of COVID-19 Pandemic on Receipt and Timeliness of Newborn Hearing Screening and Diagnostic Services Among Infants Born in Four States.

The study compares receipt and timeliness of newborn hearing screening and follow-up diagnostic services between the pre-pandemic birth cohort and the pandemic birth cohort in four participating states. Findings from this study will help inform state Early Hearing Detection and Intervention (EHDI) programs in the future should a major public health event occur again.

Evaluating Data Quality of Newborn Hearing Screening.

SCOPE: Jurisdictional-based Early Hearing Detection and Intervention Information Systems (EHDI-IS) collect data on the hearing screening and follow-up status of infants across the United States. These systems serve as tools that assist EHDI programs' staff and partners in their tracking activities and provide a variety of data reports to help ensure that all children who are deaf/hard of hearing (DHH) are identified early and receive recommended intervention services. The quality and timeliness of the data collected with these systems are crucial to effectively meeting these goals. METHODOLOGY: Forty-eight EHDI programs, funded by the Centers for Disease Control and Prevention (CDC), successfully evaluated the accuracy, completeness, uniqueness, and timeliness of the hearing screening data as well as the acceptability (i.e., willingness to report) of the EHDI-IS among data reporters (2013-2016). This article describes the evaluations conducted and presents the findings from these evaluation activities. CONCLUSIONS: Most state EHDI programs are receiving newborn hearing screening results from hospitals and birthing facilities in a consistent way and data reporters are willing to report according to established protocols. However, additional efforts are needed to improve the accuracy and completeness of reported demographic data, results from infants transferred from other hospitals, and results from infants admitted to the Neonatal Intensive Care Unit.

Measuring Early Hearing Detection and Intervention (EHDI) Quality across the Continuum of Care.

Improving quality measurement while reducing costs helps public health programs identify and better support critical aspects of the care and services delivered to the patients they serve. This is true for state-based early hearing detection and intervention (EHDI) programs as they strive to develop robust clinical quality measures to help track the quality of hearing health services provided during the EHDI processes. Leveraging today's electronic health records and public health surveillance system functionalities, state reporting requirements facilitate and yield efficient collection and analysis of data for quality measurement. In this study, we tested three EHDI quality measures endorsed by the National Quality Forum using a retrospective sample of more than 1,100,000 newborns from 3 states using electronic health data available in the state EHDI Information Systems (EHDI-IS). The results of the analysis reported herein from a large multi-state cohort provide a "real life" benchmark for future quality improvement projects and of where EHDI stands today. Reflecting on these findings, suggestions are posed for enhancing the EHDI quality measures in future updates.

Restructuring Data Reported from Jurisdictional Early Hearing Detection and Intervention (EHDI) Programs: A Pilot Study.

OBJECTIVE: To assess the feasibility, benefits, and challenges surrounding individual-level versus aggregate data reporting by jurisdictional EHDI programs to the Centers for Disease Control and Prevention (CDC). METHOD: Using data reported to CDC by three jurisdictions in 2011, descriptive statistics were used to assess the feasibility of collecting and reporting individual-level data. Comparisons were made on what can be learned from individual-level data as opposed to CDC's aggregate survey data. RESULTS: Individual-level data provided a detailed overview of the population served, services received, and variations across jurisdictions in data collection, reporting, and quality monitoring practices. Several challenges and areas needing improvement were identified: variations in (1) data standardization; (2) data collection and reporting procedures; and (3) protocols for recommended follow-up services. CONCLUSIONS: Using individual-level data, CDC was able to perform in-depth statistical analyses and learn more about each jurisdiction's population, their EHDI process, and challenges to data collection, tracking, and surveillance efforts. As a result, CDC was able to provide more targeted technical assistance. All of the above would not be feasible using aggregate survey data. The pilot study demonstrated that individual-level data reporting to CDC is feasible and offers many opportunities for both CDC and jurisdictional EHDI programs.

Progress in Standardization of Reporting and Analysis of Data from Early Hearing Detection and Intervention (EHDI) Programs.

Congenital hearing loss affects one to three of every 1,000 live born infants. If left undetected, it may negatively impact children through delayed speech and language development. To help avoid developmental delays and ensure that deaf or hard of hearing (DHH) infants are identified and receiving services as early as possible, complete and accurate data are crucial. Despite substantial progress made over the years, some children are still delayed in identification and/or lost to the early hearing detection and intervention (EHDI) surveillance and tracking systems. Lack of standardization in data reporting contributes to this issue. This article discusses reasons for lack of standardization in data reporting and gives suggestions for how the situation could be improved.