Beginning today (July 15), President Donald Trump’s administration is ordering hospitals to report their COVID-19 patient information directly to a new database managed by the Department of Health and Human Services, effectively cutting the Centers for Disease Control and Prevention out of the flow of data. In order to force a timely compliance, a letter sent by the administration to state governors this week recommended deploying of the National Guard to collect the data themselves.
While federal officials say the new guidelines will make data reporting more streamlined and centralized, opponents claim that the move sidelines the nation’s main public health agency even as cases continue to rise. In addition, the Centers for Disease Control and Prevention (CDC) currently makes much of its data freely available, a boon for the many groups using this information to populate their disease models and direct their work. Health and Human Services (HHS) has yet to share details on which data will be made available.
“Historically, CDC 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,” Jen Kates, the director of global health and HIV policy with the Kaiser Family Foundation, tells The New York Times
Under the current system set to be scrapped, around 25,000 medical centers report their information each day to the CDC’s National Healthcare Safety Network, the Times reports. CDC analysts use the information to write up detailed reports for states twice a week and for certain federal agencies on a daily basis. The information helps officials track trends in each state and identify where additional resources should be allocated.
Instead, individual hospitals will now report their information to either their state (pending a written release from HHS) or to the federally contracted health data firm TeleTracking, which will in turn coordinate the federal reporting. In a letter from HHS Secretary Alex Azar and Deborah Birx, the response coordinator for the federal government’s Coronavirus Task Force, sent to state governors this week and obtained by The Washington Post, the pair say they ordered the changes because many hospitals were failing to report their data quickly enough.
“Today, the CDC still has at least a week lag in reporting hospital data,” Michael Caputo, an HHS spokesman, tells the Times. “America requires it in real time. The new, faster and complete data system is what our nation needs to defeat the coronavirus, and the CDC, an operating division of H.H.S., will certainly participate in this streamlined all-of-government response. They will simply no longer control it.”
Some medical professionals argue that the lag stems from the fact that federal regulations have shifted several times during the pandemic. Carrie Williams, a spokeswoman for the Texas Hospital Association, tells the Times, “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.”
The choice to deploy the National Guard to ensure compliance by hospitals appears to many hospital industry leaders to be an unnecessarily aggressive measure, the Post reports. “Given our track record of being cooperative to evolving data requests, it’s perplexing that the possibility of using the National Guard has been suggested,” says Rick Pollack, the president of the American Hospital Association.
Internal emails exchanged between Daniel Abel, a member of the HHS team overseeing the federal response to the pandemic, and HHS general counsel Robert Charrow hint at indecision over this policy at the federal level. While earlier drafts of the letter sent to governors this week had at first asked states to deploy the Guard, the final version suggested it as an option.
“As a practical matter, I cannot imagine how the National Guard would be able to collect data at the hospital itself nor the number of Guards who would be exposed to COVID-19 in the process,” Charrow wrote in one email shared with the Post. “I believe that using National Guard troops to gather these data would be counter-productive.”
A group of hospitals has since protested in a letter to Birx. In the letter, hospital officials claim that the industry has been complying with the data requests and that most hospitals have been submitting the required information.