The Trump administration confirmed on Wednesday that it ordered hospitals to send data on coronavirus patients directly to the Department of Health and Human Services, rather than the Centers for Disease Control and Prevention.
The change raised questions about the integrity of the process. Some former health officials fear the measure may lead to less transparent data, although they acknowledged in interviews that the CDC’s data collection system is outdated and does not meet the demands of the Covid-19 pandemic.
“The old CDC data collection operation once worked well in monitoring hospital information across the country, but today it is an inadequate system,” HHS spokesman Michael Caputo said in a statement to CNBC. “The President’s Coronavirus Task Force has been asking for improvements for months, but they simply cannot keep up with this pandemic.”
The New York Times first reported on the updated guidance from the Trump administration on reporting data for hospitals and laboratories. The new guide, which was silently updated on July 10, was posted on the HHS website. The agency, which oversees the CDC, the Food and Drug Administration and other U.S. health agencies, will now collect daily Covid-19 reports directly. That includes the number of hospitalized patients, available beds, and medical equipment such as ventilators, as well as information used to organize the response to the pandemic in the United States.
CDC Director Dr. Robert Redfield said Wednesday in a conference call with reporters that states were told to stop sending hospital information to the National Health Safety Network site, the CDC system for collect data, starting Wednesday. He added that the decision was made in conjunction with the CDC.
“In order to meet the needs for flexibility in data collection, CDC has agreed to remove the National Health Safety Network from the collection process to expedite reporting,” he said. “This has no effect on CDC’s ability to use data and continue to produce daily data, the MMWRs, and the guidance we publish.”
Caputo said the change in policy will allow the US to collect more comprehensive data and do it more quickly. He added that CDC will continue to “participate in this simplified, government-wide response,” but will no longer control the data reporting element.
“Today, the CDC still provides data from only 85 percent of hospitals; the president’s COVID response requires 100 percent to report,” said Caputo. “Today, the CDC still has at least a one-week delay to report hospital data; the United States requires it in real time.”
José Arrieta, HHS chief information officer, said in the conference call Wednesday that despite the change in reporting systems, the government will continue to occasionally release data to the public through the CDC. Arrieta said the HHS data was initially for analysis and policy decisions rather than for the general public, but said some of the data is publicly disclosed through the CDC.
He added that HHS is working to make more of its data publicly available.
“We have focused on collecting data to be able to effectively analyze and allocate resources,” he said, adding that some data is disclosed through the CDC. “There is a possibility that we can do it on a larger scale … That is the final vision.”
Dr. Janis Orlowski, who is part of the working group of White House health adviser Dr. Deborah Birx, to improve the national data reporting system, said the group was formed because the administration was Concerned that some hospitals misinformed or failed to report critical Covid. -19 information to CDC.
Orlowski, director of healthcare for the Association of American Medical Colleges, said most hospitals were doing their best to report updated information, but many were inundated with redundant requests from separate agencies.
“Why [hospitals] They reported to the agencies and used different portals for the data to be sent, and in addition to the portals, they could report to the state, as you can imagine, this became a data problem on how to coordinate all of this, “he said.” So that our work showed, can we simplify the reporting process. “
Orlowski said Birx and other administration officials gave their word to the working group, which includes CDC staff, that the change would not hinder the quality or transparency of the data. However, he said he does not know whether outside researchers, such as the universities that are tracking the outbreak, will have the same access to the data as before.
“We were verbally told that transparency would be maintained,” he said. “And so those of us in the working group didn’t see this as a cut from the CDC.”
Former Food and Drug Administration Commissioner Dr. Scott Gottlieb said “the data will still be shared with the CDC.” He said Wednesday that there has been frustration over the CDC data report, but that the administration could have been better working to fix those problems within the CDC, rather than trying to “recreate the wheel.”
“I think they would have been better served probably by investing in what CDC and CDC systems are doing because CDC is a better repository of information,” he said on CNBC’s “Squawk Box”. “They have the scientific expertise to select this data in a way that no other agency does.”
Dr. Bill Winkenwerder, who served as undersecretary of defense for health affairs under President George W. Bush from 2001 to 2007, said the decision is a function of an outdated data reporting system that was little invested during a year. He said he does not believe it is fair to characterize the decision as necessarily political.
“The key point is that HHS and the White House need this data quickly to coordinate a large number of decisions that are not made at the CDC level,” Winkenwerder told CNBC. “The one week delay that was described is a long time. Every day counts, so I can understand why they need and want that information.”
HHS needs accurate data quickly in order to make potentially life-saving decisions, such as allocating the nation’s limited supply of remdesivir, the only drug that has been granted emergency use authorization in the US to treat Covid. -19. He added that it is crucial that this data is shared transparently with other agencies and with the public, but he is pleased that the reporting system is being revised.
“Hopefully once this Covid pandemic is at least more under control or once we get a vaccine, we need to invest more in updating our data aggregation systems,” said Winkenwerder. “Anything they can do to correct the data in the meantime is excellent. In the long term, it needs to be improved overall.”
President Donald Trump and his administration have come under fire during the pandemic of critics who say the White House is undermining the country’s public health professionals. Last week, Trump criticized the CDC’s guidelines on reopening schools as too harsh and expensive, and Vice President Mike Pence said the agency will issue additional recommendations.
“As the president said today, we just don’t want the orientation to be too harsh,” Pence told reporters last week. “That is why the CDC will issue more guidance in the future, because we know that each school system has unique capabilities and different facilities.”
On Tuesday, four former CDC directors wrote in an opinion piece published in The Washington Post that the United States faces “two opponents” in their efforts to reopen the country: Covid-19 and politicians and others trying to undermine the CDC. .
“It is not unusual for CDC guidelines to be modified or modified during an approval process that goes through various agencies and the White House. But it is extraordinary that the guidelines are undermined after their release,” wrote former CDC directors. : Tom Frieden, who served under former President Barack Obama; Jeffrey Koplan, who served under former Presidents Bill Clinton and George W. Bush; David Satcher, who served under Clinton; and Richard Besser, who served under Obama.
“Until last week, and through Monday, the administration continued to cast public doubt on the recommendations and the agency’s role in informing and guiding the nation’s pandemic response,” they said.
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