The new instructions were recently posted on the Department of Health and Human Services website. According to the document from now on the Department of Health and Human Services will be collecting the daily reports and information about the patients that each hospital is treating, the number of available beds and ventilators, as well as other information that is vital to tracking the virus.
Officials say that this change will serve to streamline the data gathering process and assist the White House COVID-19 Task Force in allocating supplies such as PPE and medications such as Remdesivir which has been shown to be effective at combating this virus. However, this database is currently not open to the public, which could affect researchers, modelers and others who rely on this data to make projections.
“Historically, C.D.C. has been the place where public health data has been sent, and this raises questions about not just access for researchers but access for reporters, access for the public to try to better understand what is happening with the outbreak,” said Jen Kates, the director of global health and H.I.V. policy with the nonpartisan Kaiser Family Foundation.
Michael R. Caputo who is a spokesperson for the Health and Human Services called the current CDC system inadequate, and said that the two systems would be linked, with the CDC continuing to make the data public.
“Today, the C.D.C. still has at least a week lag in reporting hospital data,” Mr. Caputo said. “America requires it in real time. The new, faster and complete data system is what our nation needs to defeat the coronavirus, and the C.D.C., an operating division of H.H.S., will certainly participate in this streamlined all-of-government response. They will simply no longer control it.”
This change grew from a tense conference call that occurred several weeks ago between hospital executives and Dr. Deborah L. Brix who is the White House COVID-19 Response Coordinator. Dr. Birx is adamant that the hospitals are not adequately reporting their data, as such she has convened a working group of government and hospital officials who devised the new plan, according to Dr. Janis Orlowski who is the chief health care officer of the Association of American Medical Colleges who also participated in the group meeting.
According to Dr. Orlowski while she understands some of the concerns that this change has brought about the administration has pledged in a “verbal discussion” to make the data public or at least give the hospitals access to it.
“We are comfortable with that as long as they continue to work with us, as long as they continue to make the information public, and as long as we’re able to continue to advise them and look at the data,” she said, calling the switch “a sincere effort to streamline and improve data collection.’’
Under the new guidance moving forward hospitals should report their detailed information on a daily basis directly to the new centralized system which is managed by TeleTracking to get away from the inadequate old system. But if hospitals were already reporting this information to their states they can continue to do so if they receive a written release saying that their state would be handling their reporting to avoid duplicative reporting.
Both the TeleTracking and CDC network rely on push data, which means that hospital staffing must manually enter their data, rather than tapping into an electronic system to obtain the information.
“The whole thing needs to be scrapped and started anew,” said Dr. Dan Hanfling, an expert in medical and disaster preparedness and a vice president at In-Q-Tel, a nonprofit strategic investment firm focused on national security. “It is laughable that this administration can’t find the wherewithal to bring 21st-century technologies in data management to the fight.”
Although DR. Hanfling agrees that this information needs to be centralized, he disagrees on how it should happen and is calling for a new national data coordination center that would be used for “forecasting, identifying, detecting, tracking and reporting on emerging diseases.” Even hospitals agree that the previous CDC reporting requirements were rather cumbersome which was partly due to them changing frequently.
“It has been an administrative hassle and confusing to constantly be shifting gears on reporting while hospitals are on the front lines during a pandemic,” Carrie Williams, a spokeswoman for the Texas Hospital Association, wrote in an email.
Dr. Bala N. Hota who is the chief analytics officer at Rush University Medical Center Chicago says that this hospital had 4 full time employees who were reporting the data to 4 different agencies from the over 100 different measures, some of which determined how much money the hospital would receive under different federal programs. Dr. Hota supports streamlining the processes and involvement of state/local agencies in reporting, but he is concerned that this far into the outbreak America still has not established a system to collect the kind of information that is needed to seamlessly move patients from full locations to ones with available beds.
The CDC has been getting criticized for its data collection, especially since the agency acknowledged that it had been combining tests that detect active infections with those that detect antibodies from coronavirus which does not distinguish between active infection or recovery from the virus in recent months in their attempts to track the spread of this virus. This is the system that has muddied the true picture of this virus and raised the percentage of infected as well as the number of Americans tested.
“Reporting both serology and viral tests under the same category is not appropriate, as these two types of tests are very different and tell us different things,” said Jennifer Nuzzo, who is an epidemiologist at the Johns Hopkins Center for Health Security, expressing concerns that adding the two types of tests together could leave the impression that more testing of active cases had been conducted than was actually the case.
The CDC is not the only one to be facing complaints about their data reporting, all over the nation similar are appearing, such as in Florida where a former data manager for the Health Department accused one of her superiors of directing her to manipulate the data used in the state’s plan of opening. Ms Shalala said that the mayor of Miami-Dade County “was so concerned about the state data that he has the hospitals reporting their data directly to him as well.”
In Arizona a partnership with a university modelling team was ended whose projections showed a rising caseload that did not line up which prompted the push back from the executive director of the Arizona Public Health Association Will Humble, who is also a former director of the Arizona Health Services Department.
“Trust and accountability and transparency — all three go together,” Mr. Humble said. Of the federal government’s new system, he said: “They’d better keep it transparent, or else people are going to think that it was an ulterior motive.”
Several states have acknowledged that they are also combining both types of testing, at least one, Virginia, has reported reversing this practice after it was made public. But this is just one of the criticisms over how testing results are being reported in a series of controversies related to testing for this virus, all of which have resulted in this change announced by the current administration. Here’s to hoping that this is a change for the better.
