America's disease surveillance system is going dark. Here's what we can build to replace it [View all]
A study published recently in Annals of Internal Medicine confirmed what many clinicians had begun to suspect: Nearly half of the Centers for Disease Control and Preventions regularly updated surveillance databases have gone dark. Of 82 databases that were updated at least monthly at the start of 2025, 38 have stopped no new data, no explanation, no timeline for resumption. Eighty-seven percent of the paused databases are vaccination-related.
Physicians have relied on that data for 40 years. Every morning before walking into the ICU, my colleagues and I checked flu activity levels, RSV hospitalizations, drug-resistant organism patterns. This wasnt academic curiosity it was how we kept patients alive. When influenza surged, we had antivirals ready. When adult RSV spiked, we warned colleagues in pediatrics. When resistant pathogens emerged, we adjusted our antibiotic choices before culture results returned.
That surveillance data was the nervous system of American medicine constantly sensing, constantly warning us what was coming. Now its falling silent, and the CDC isnt even telling us why. (Some of these databases are updated seasonally and may have been affected by the government shutdown at the time the researchers checked.)
Ive seen what happens when public health infrastructure goes quiet. In 1981, when young men started dying of strange infections, there was no surveillance system to connect the dots. It took months months of preventable deaths before anyone recognized we were facing a new epidemic. Those of us in public health and clinical medicine built surveillance systems precisely so that would never happen again. Those systems worked: They caught H1N1 in 2009, tracked Ebolas spread, and gave us week-by-week Covid-19 data that shaped hospital surge planning nationwide.
Now the federal government is dismantling them with nary a congressional vote or public debate.
https://www.statnews.com/2026/02/13/cdc-surveillance-dismantled-rebuild-early-warning-systems/
The editorial points out that states such as California, Washington, etc. are trying to fill the void that will be left by this dismantling, but that will lack the cohesion required on a national scale, with each state creating their own databases.