The chief medical officer at United Memorial Medical Center in Houston speaking with a Covid-19 patient on July 10. An HHS official says nearly twice as many hospitals are reporting data about the pandemic under its system.
Photo: callaghan o'hare/ReutersPublic release of hospital data about the coronavirus pandemic has slowed to a crawl, one month after the federal government ordered states to report it directly to the Department of Health and Human Services and bypass the Centers for Disease Control and Prevention.
Key indicators, such as estimates of the portion of inpatient beds occupied by Covid-19 patients, are lagging by a week or more, making it harder for citizens and local officials to get a handle on how the pandemic is progressing and for agencies to allocate supplies of antiviral drugs and personal protective equipment, public-health experts say.
The decision to switch data reporting in the middle of a public-health crisis was reckless, researchers and former public-health officials say.
“The transition has been a disaster,” as hospitals typically take time to adjust to new data systems, said Jeffrey Engel, senior adviser to the Council of State and Territorial Epidemiologists, an association that represents state public-health officials. “What HHS said was that the CDC was not nimble enough and couldn’t handle new data elements, and that’s simply not true.”
HHS officials say the new system is more complete because more hospitals are reporting a more thorough set of statistics. But because the system is so new, it is taking time to ensure the quality of the data and control for variations in numbers such as the quantity of cases reported each day. The quality-control process has led to some delays in reporting hospital capacity estimates, HHS says.
Under the CDC, between 2,900 and 3,000 hospitals were reporting coronavirus-related data each day, while now, nearly twice as many hospitals are reporting, a senior HHS official said. But HHS needs more time to analyze the data to establish confidence in the results, this person said.
“We’ve been at it for a month now, so we’re starting to see the data stabilize and shake out. It’s why the data has only been updated on a weekly basis,” the official said. “In being more transparent, it creates some level of confusion [in the short term].”
The data hospitals report to the federal government is important in part because it helps determine how officials allocate supplies of remdesivir, an antiviral drug manufactured by Gilead Sciences Inc. that has been distributed by the U.S. since it was authorized for emergency use in May.
The government also uses the hospital data to allocate supplies such as N95 face masks and protective body suits distributed through the Federal Emergency Management Agency.
Key indicators, such as estimates of the portion of inpatient beds occupied by Covid-19 patients, are lagging by a week or more.
Photo: callaghan o'hare/ReutersBut more importantly, the data is the most publicly available information used by businesses, local elected officials, hospitals and contractors to gauge how stressed the U.S. hospital system is, said Thomas Frieden, who was director of the CDC from 2009 to 2017.
HHS switched the data reporting system too abruptly, he said, “and the result has been chaotic.”
“There’s been inconsistent reporting, there have been serious lags in the reporting. The last time I reviewed it, some data was 11 days old, and now it’s three days old,” Dr. Frieden said. “They pulled it away from CDC because it was updated three times a week, and now they update it once a week. Give me a break.”
HHS’s estimated patient impact and hospital-capacity statistics, for example, weren’t updated between Aug. 3 and Aug. 10, according to a review of HHS data by The Wall Street Journal. That data set includes indicators such as inpatient and intensive-care beds occupied by Covid-19 patients, which researchers say are key to understanding the pandemic.
“We’re not doing a good job of tracking either the virus or our response to it, and because of that we’re flying blind,” Dr. Frieden said. “That’s the big picture.”
Twenty-two state attorneys general, led by Maura Healy of Massachusetts, sent a letter in late July to HHS Secretary Alex Azar, demanding that the agency reverse the decision and return to the old data collection system.
“This sudden disruption...harms the nation’s ability to track and respond to the pandemic, hampers state and local public health authorities’ efforts to address the crisis in their communities, risks compromising the health data of millions of Americans, and undermines public confidence in any reports about COVID-19 coming from the federal government,” the letter said.
In early July, the White House coronavirus task force asked the CDC to add dozens of new elements to its National Health Safety Network system, which has been in place for about 15 years. The White House gave the CDC a deadline of two to three days, the HHS official said, but the CDC said it needed two to three weeks to implement changes.
HHS, on orders from the White House task force, on July 10 instructed hospitals to switch from the CDC’s system to a new one operated by a private contractor called TeleTracking Technologies Inc., the HHS official said.
The CDC didn't immediately respond to a request for comment.
In mid-July, Congressional Democrats requested documents related to the switch from HHS to conduct an investigation into potential political interference in how coronavirus data is collected. In a letter to Mr. Azar, Select Subcommittee on Coronavirus Chairman James Clyburn, a representative from South Carolina, wrote that “delays or problems in transitioning to the new system could have serious consequences on infection control and patient care at hospitals.”
Jennifer Nuzzo, senior scholar at the Johns Hopkins Center for Health Security, said her team has tracked inconsistencies between HHS’s reporting and state-level hospital occupancy data.
“This switch happened at a very vulnerable moment, and there is a data consistency and quality problem,” Ms. Nuzzo said.
Some states, however, say the transition to the new data system has been smooth.
“Like any new system that requires a change in process, there is a period of adjustment,” said a spokesman for the state health department in Arkansas, where hospitals have reported one of the country’s highest levels of inpatient bed occupancy by Covid-19 patients. “But we’re confident that we can work through any issues that may arise.”
The switch “has not impeded ability to address the pandemic,” Dean Sidelinger, a public-health official in Oregon, said Friday. In Rhode Island, a health-department official said the change hasn’t been disruptive, and it is “just a matter of rerouting it to a different entity at the federal level.”
Write to Robbie Whelan at robbie.whelan@wsj.com
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