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Centers for Disease Control and PreventionCenter for Forecasting & Outbreak Analytics (CFA)Better Data, Better Analytics, Better ResponseCFA 101 for Industry EventThank you for joining us!Our broadcast will begin shortlyApril 21, 2022Washington, DC

Centers for Disease Control and PreventionCenter for Forecasting and OutbreakAnalytics (CFA)Opening Remarks – Alison Kelly, CDC/CFAApril 21, 2022Washington, DC

ParticipationParticipationOnline Participation Please email all questions toCFA@CDC.GOVIn-Person Participation Please raise your hand to ask a questionduring the designated Q&A sessions3

Today’s AgendaToday’s AgendaThursday April 21st, 2022Agenda10:00 – 10:15Welcome Address – Alison Kelly, CDC/CFA10:15 – 10:30Introduction to CFA: Purpose, Mission, Vision – Dylan George, CDC/CFA10:30 – 11:00Keynote Speaker – Nirav Shah, Stanford University11:00 – 11:10Predict Division Overview – Marc Lipsitch, CDC/CFA11:10 – 11:20Inform Division Overview – Caitlin Rivers, CDC/CFA11:20 – 11:30Technology & Innovation Division Overview – Rebecca Kahn, CDC/CFA11:30 – 12:00Q&A12:00 – 1:30Lunch on your own1:30 – 1:35Afternoon Session Overview – Alison Kelly, CDC/CFA1:35 – 2:20Industry Panel: Data, Analytics, and Technology Requirements to Transform Health Emergency Response2:20 – 2:55Lightning Talks by Industry Leaders2:55 - 3:00Closing Remarks – Dylan George, CDC/CFA4

Centers for Disease Control and PreventionCenter for Forecasting and OutbreakAnalytics (CFA)Analytics (CFA)Introduction to CFA: Purpose, Mission, Vision – Dylan George, CDC/CFAIntro to CFA: Purpose, Mission, Vision – Dylan GeorgeApril 21, 2022Washington, DC

CFA Leadership & Key PlayersCFA Leadership & Key PlayersDylan GeorgeDirector of OperationsMarc LipsitchDirector of ScienceAlison KellyDeputy DirectorCaitlin RiversAssociate DirectorRebecca KahnSenior ScientistKaren StameyManagement Officer6

Problem StatementProblem StatementData for Action in a Pandemic Disease outbreaks are becoming more frequent and more disruptive. The nation lacks data, analytical systems to identify and respond quickly, effectively. The U.S. must improve these systems and develop capabilities for producing forecasts and analytics that leaderscan use to make timely, informed decisions about how to best prepare for and respond to infectious diseasethreats. Models and analytics need to be responsive to concerns of underserved communities, and address issues ofhealth equity directly.7

What is Forecasting and Outbreak Analyticsand What is the Value?

Example COVID-19 Questions that Modeling Can InformExample COVID-19 Questions that Modeling Can Inform What is the probability of a future surge? What degree of immune escape in a variant would cause a surge? How many tests would be needed to support widespread diagnostic andscreening testing? What role will vaccine availability for young children play in changing theepidemic's trajectory? How would 50% booster coverage change the epidemic's trajectory?9

Proposed CFA Value in the Outbreak of Novel PathogenProposed CFA Value in the Outbreak of Novel PathogenMake sense of uncertaintyearly in an outbreak Assess epidemicpotential and severityQuantify risk andtiming of importedcasesAssess risk to thehomelandProvide early warning,situational awareness Develop good-badworst planningscenarios; bounduncertaintyGet critical data for theresponse Resource demandprojections Inform design andtargeting of prevention Assess expected impact measuresof interventions Monitor vax, treatment Produce short termforecastseffectiveness over time Provide data to updatescenarios and forecastsSupport policy andguidance Inform policy andguidance on: Border controls Testing, quarantine &isolation Countermeasuredemand Vaccine prioritization Surveillance design

CDC Plans for Building the Center forForecasting and Outbreak Analytics

CFA OrganizationCFA OrganizationPREDICT Analytics team – Real-Time Monitoring team, Analytics Response TeamTargeted studiesEngagement, strategic partnershipsINFORM Federal supportSTLT decision supportGeneral public risk communicationINNOVATE Science / contract managementProduct development – applications, enterpriseTest beds – STLT, payer/providerTECHNOLOGY Develop and Refine Technology for the Analytics PlatformBuild ProductsEstablish CFA Data Requirements12

Principles to Guide DecisionsPrinciples to Guide Decisions1Mission ImpactCFA will focus onsaving lives andprotecting peoplethrough outbreakdata, forecasts andanalytics.4Equity FocusedCFA will support efforts toachieve health equity byusing data to identify andtrack health disparities inoutbreaks and informpolicies to address thosedisparities.Open andTransparent2CFA will make data,analyses, and scientificmethods open to thepublic in human andmachine-readable formatsas much as possible.3Collaborative3CFA will work with partners,including in the public sector,private sector, academia, andcivil society to coordinateefforts and maximize impact.13

DevelopingAnalytics& ForecastingFY 2021OutbreakCFA FundedActivities,Cont.Will Take Time, ResourcesAdvancing Weather Forecasting:Took Time, Data, Models, and Resources to DevelopIncreases in numerical weather forecasting skill through time Forecasting Skill TimeDeveloping Outbreak Analytics & Forecasting Will Take Time, ResourcesAdvancing weather forecastingcapabilities took decadesNeeded ingredients:o Datao Modelso Peopleo Computational Powero Specific Use Caseso Sustained FundingDiseases forecasting, analytics still inearly stages14

Centers for Disease Control and PreventionCenter for Forecasting and OutbreakAnalyticsAnalytics (CFA)Keynote Speaker: Nirav Shah, Stanford UniversityKeynote Speaker: Nirav Shah, Stanford UniversityApril 21, 2022Washington, DC

Accelerators of Actionable DataCenter for Forecasting and Outbreak AnalyticsIndustry Day – April 21, 2022Great Hall, Washington, DCNirav R. Shah, MD, MPHSenior Scholar, Stanford UniversityChief Medical Officer, olea.health

Disclosures Senior Scholar at Stanford UniversityChief Medical Officer of olea.healthBoard Member at STERIS plc, CovidActNow.org, KinsaAdvisor to GSR Ventures Advisory Committee to the Director of the CDCCommissioner, Commonwealth Fund Commission on a National Public HealthSystemSenior Fellow of the Institute for Healthcare Improvement (IHI)Trustee of the John A. Hartford FoundationPrior Board Chair, Linux Foundation Public HealthPrior service as Commissioner, NY State Department of Health, andChief Operating Officer, Kaiser Permanente in Southern California All views expressed are my own

What metrics to follow?Hospital workers out with COVID New infectionsER visits (A/D/T feeds)HospitalizationsBeds available in ICUsMortalityAND Hospital workers out with COVIDWastewater surveillanceDaily average fever countsNew data sourcesWastewater surveillance

Graph title: Daily average share of population with a fever

Interactive graphic: New cases of COVID per 100k people over time

Sharecare Community Well-Being Index Score for Michigan

Digital Health Companies:Addiction treatment / opioid use disorderDigital health’s investments of 37.9 billion in 2021 793M invested in Substance Use Disorder startups

RECovERIn RECovER, researchers can performqueries across all institutions participatingin the consortium, without anycompromises on privacy or security.Data remains local and private withineach participating institution—no recordsever leave each institution. Softwaremodules from Onai run at each institutionand jointly construct a single aggregatestatistical result, without exposing anyinstitution's local results to any otherinstitution. This mechanism enablesgreater security and speed thantraditional approaches.

Lessons Learned & Next Actions Measurement needs and reporting needs change in real timeCommunicate about data in ways that the public can receive & understand itThere’s more than enough data, we have to look for it and accept it from theprivate sector and othersTechnology can already address many privacy and security concernsWhat you can do Standardization is Innovation, e.g. for interoperability Embrace private and nontraditional data Support people doing great work: Kenneth Mandl, Rick Hawes, AneeshChopra, Bala Hota, many others on the stage today, and of course Dylan, Marc,Rebecca, and Caitlin

Centers for Disease Control and PreventionCenter for Forecasting and OutbreakAnalytics (CFA)Analytics (CFA)CFA 201 – Breakdown by DivisionCFA 201 – Breakdown by DivisionApril 21, 2022Washington, DC

Centers for Disease Control and PreventionPredict Division OverviewPredict Division OverviewMarc Lipsitch, DPhilDirector for ScienceCenter for Forecasting and OutbreakAnalytics

Predict: The Engine for Better Data and Better AnalyticsPredict: The Engine for Better Data and Better AnalyticsGOALSPREDICT Generate forecasts and analyses to supportoutbreak preparedness and response efforts Support critical data collection efforts to addressresponse priorities Respond to needs of Federal, State, Tribal,Territorial and local leaders for analytical,forecasting results27

Analytics Inform Response Efforts Across an EpidemicAnalytics Inform Response Efforts Across an EpidemicExamples of Outbreak AnalyticsProspective ScenarioAnalysesRisk Assessment ToolsPhylogeneticsPathogenCharacterizationGraphic courtesy of bnext/iqtParameter EstimationsOutbreak ManagementScenario AnalysesDisease ForecastingDisease Risk MappingVaccine EffectivenessBurden, ImpactAssessmentsDraft / Pre-DecisionalTherapeuticEffectiveness28

Planned Analytic ProductsPlanned Analytic ProductsReal-Time Monitoring (Routine, Periodic) Forecasting, Nowcasting Scenario Analysis Natural History / Parameter EstimationTopical Analytics (As Needed per Response Priorities) Health Equity and Vulnerable PopulationsCommunity MitigationVaccinesTherapeuticsTesting and DiagnosticsPathogen VariantsMobility and BordersSetting-specific Transmission29

Planned Critical Data Collection ActivitiesPlanned Critical Data Collection ActivitiesTargeted Studies toAnswer Key Questions Transmissibility Viral Kinetics Severity Immune escape Vaccine escape DiagnosticsensitivityRandom Sample ofthe Population forVirologic Testing Possible models: UK’sReal-time Assessment ofCommunity Transmission(REACT) and Office forNational Statistics (ONS)studies Continuoussampling with multiplexassays and sequencing ofpositivesPotential PartnersInclude but notLimited to: Payer-providernetworks/managedcare Nursing homes Academia Industry30

Work to Date & Early Successes

Early Evaluation of Omicron SurgeEarly Evaluation of Omicron SurgeScenarios developed in November/early December 2021 asSouth African surge was under wayInherenttransmissibilityrelative to DeltaImmune escaperelative to all priorstrainsFaster growth(Highertransmission**.Mid escape)1.6x43%Slower growth(Highertransmission. Lowescape)1.5x10%Faster growth(Unchangedtransmission. Highescape)1.0x85%Slower growth(Lowertransmission. Midescape)0.8x50%Scenario **Parameters were chosen to span a range of apparent growth rate advantage for Omicron over Delta of 2-3.5x in an environment where 75% of the population has immunity to infection due to vaccination orprior infection.**Relative to Delta

Omicron SeverityOmicron SeverityAssessed Omicron severity relative to Delta using datafrom Kaiser Permanente Southern California52% reduction in hospitalizationFor latest 22.01.11.22269045v274% reduction in ICU admission

COVID-19 Response SupportCFA’s COVID-19 Response Support CFA, in collaboration with teams in academia and experts in the office ofthe Assistant Secretary for Preparedness and Response, have contributedanalyses related to:School test-to-stay guidanceTravel policyNursing home guidanceVaccine guidance34

Centers for Disease Control and PreventionInform Division OverviewInform Division OverviewCaitlin Rivers, PhDAssociate DirectorCenter for Forecasting and OutbreakAnalytics