Use of the U.S. National Poison Data System (NPDS) to Detect and Describe Potentially Harmful, Non-Traditional Behaviors Taken by Individuals to Prevent, Treat, or Cure COVID-19

Introduction: On January 19, 2020, Washington State reported the first confirmed case of COVID-19. Two years later, the Centers for Disease Control and Prevention (CDC) reported over 90 million cases across every U.S. state and territory causing more than 1 million deaths, with numbers continuing to grow. As part of the overall pandemic response, CDC, in coordination with America’s Poison Centers, conducted enhanced surveillance of National Poison Data System (NPDS) data to detect potentially harmful, non-traditional behaviors taken to prevent, treat, or cure COVID-19 to provide situational awareness and ensure CDC continues to develop effective, evidence-based health communication messages and materials. Method: Data from the fifty-five U.S. poison centers (PCs) are uploaded in near real-time to NPDS. CDC monitored several categories including cleaners and disinfectants, medications/vitamins, and behaviors such as suicide and drug use. We characterized exposures by daily call volume, age group, management site, route of exposure, and medical outcome compared to previous years. We also conducted follow-up detailed review for certain anomalies, spikes, or extreme adverse events. Results: We reported PC data to several task forces within the CDC Emergency Operations Center. The daily number of exposures increased sharply beginning in March 2020 for exposures to cleaners and disinfectants. For example, bleach exposure calls saw a 62.1% increase compared to 2019. Several medications saw spikes in calls in coordination with media coverage of certain treatments (e.g., hydroxychloroquine) throughout the pandemic. Conclusion: This data helped ensure a coordinated public health response to COVID-19 and maximized the unique role of PCs in addressing public and medical provider concerns and questions. Results led to several actions including notifications to state health departments, targeted messaging, and tailored response efforts. PCs are a valuable resource for providing guidance and advice about exposures to hazardous substances and can help reduce the burden on the healthcare system.