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Why It’s Important to Track COVID-19, ZIP Code by ZIP Code

Patti Singer

An image promoting the RocCOVID-19 survey, where residents can respond about any symptoms they have. Provided by Common Ground Health

How are you feeling?

Do you have a cough? Fever? Are you able to smell the barbecue coming from your neighbor’s yard?

No, no and yes mean it’s unlikely you have COVID-19. At least today. But symptoms change, and as the community continues to cope with the pandemic, it’s helpful to monitor things on individual and neighborhood levels.

In May, residents got a method to do just that. The online survey allowed people in Rochester and the 13-county Finger Lakes region to record whether they had any symptoms and if so, what they were. The survey was a partnership among the city, Monroe County and Common Ground Health. Rochester Regional Health and UR Medicine also are involved.

In the two months since launched, about 23,500 people have signed up. They receive either a daily email or a text message reminding them to report their symptoms. Health officials use the data – which is not tied to any specific person – to identify potential hotspots and deploy resources for education and testing.

Responses are linked only to ZIP code, not to an individual, and employers, health care providers and the government don’t know how you answered. Race, ethnicity and age are asked to understand patterns of illness.

By far, most of the participants are in Monroe County. But they are clustered in the eastern suburbs, meaning swaths of the city and the western towns are underrepresented. What that means is that a spike in symptoms may go undetected, potentially contributing to a spread of illness.

Recently, the city mailed a postcard to every residence, encouraging everyone 18 and older to sign up and take the daily survey to, in the words of Mayor Lovely Warren, “protect your circle.”

Statisticians said that having at least 5% to 10% of every ZIP code represented provides enough data for health officials to make reasonable assumptions. In some crescent neighborhoods, about 1% of people signed up.

Dr. Linda Clark. Provided by Common Ground Health

Dr. Linda Clark, president of the Black Physicians Network and senior health advisor to Common Ground Health, answered questions about The conversation has been edited for space and clarity.

Why is it important to get participation from every ZIP code?

We’re always trying to focus on the people with the least resources and we want those people to be heard so we can target testing and other resources to those areas. It’s very important to hear from those areas and make sure they understand the importance of it. … I think it’s hard when somebody says report your cough or report or your sore throat . What’s it going to do for me? First of all, it helps you check for stuff. It’s a daily reminder of what might be COVID. It’s still protecting your circle. It’s looking out for the other people that you come in contact with. It’s good reminder that if you feel sick, maybe I shouldn’t go visit Grandma. Maybe something is going on that I need to check out.

So far, data show the number of cases here is flat. We’re reopening. Would someone say why do this?

I say look South and West. We’re seeing record numbers of new cases as soon as we relax our standards. It’s so hard for people to think preventively … It’s hard when everyone looks healthy and things seem great. All it takes is a few people who are sick spreading disease in the community and it can be rapid.

So we’re doing this not only for ourselves but for others?

That’s the story of COVID. We can’t beat this if we don’t respect each other and care for each other.

The city sent out a postcard in late June, asking residents to sign up. When did the team realize that a lot of people were getting left behind?

Some of the early data made it very obvious that we spoke very well to white suburban women on the east side of town. As the data come in, it’s informing us about where we need to target.

Is there a reluctance you need to overcome because early in COVID-19 response, needs of Black and Latino communities were overlooked?

I think it’s a legitimate question. I think the Black and brown community has known for a long time that they didn’t have equitable outcomes, even if nobody had a fancy graph showing it. … The only surprise may be we’re finally deploying resources to the underserved instead of sending resources to the overserved, which is often what seems to happen.

What can people expect when they sign up?

We’ll see a bit of change in the mesaging in the next week to reflect updated symptoms. … Some of the symptoms by themselves may not have as much power. Then are a group that are indicative of this problem – loss of taste, loss of smell. There are a lot of general symptoms – nausea, vomiting, cough, sore throat, shortnesss of breath. That’s why lot of this I feel like we need more education to determine if this is the virus or is it not.

This is all about real time, correct?

It helps if people can do it every day. It’s more powerful if you have data that shows this uptick – look at all those people with cough and sore throat in 14626. What’s going on? … A couple days of symptoms is more significant than one day of symptoms.

So you’re trying to make this a habit for people? Like brushing your teeth?

Brushing my teeth, I get that benefit right away. If somehow it’s tied to a reward or something, interesting information or whatnot. … That’s what the engagement and marketing team needs to help work on, to keep it fresh and keep it interesting.