Keeping you in the dark

As coronavirus cases rise swiftly around the country, surpassing both the spring and summer surges, health officials brace for a coming wave of hospitalizations and deaths. Knowing which hospitals in which communities are reaching capacity could be key to an effective response to the growing crisis. That information is gathered by the federal government — but not shared openly with the public.

NPR has obtained documents that give a snapshot of data the U.S. Department of Health and Human Services collects and analyzes daily. The documents — reports sent to agency staffers — highlight trends in hospitalizations and pinpoint cities nearing full hospital capacity and facilities under stress.

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Withholding this information from the public and the research community is a missed opportunity to help prevent outbreaks and even save lives, say public health and data experts who reviewed the documents for NPR.

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For instance, the most recent report obtained by NPR, dated Oct 27, lists cities where hospitals are filling up, including the metro areas of Atlanta, Minneapolis and Baltimore, where in-patient hospital beds are over 80% full. It also lists specific hospitals reaching max capacity, including facilities in Tampa, Birmingham and New York that are at over 95% ICU capacity and at risk of running out of intensive care beds.

In reviewing the analysis obtained by NPR, Panchadsaram says the local and hospital-level data HHS is collecting would be very useful to researchers and health leaders. "That stuff isn't easy to find at a national level," he says. "There's no one place [publicly] you can go to get all that data."

Hospitalization data is invaluable in looking ahead to see where and when outbreaks are getting worse, says Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington. "Right now, as we head into the fall and winter surge," Murray says, "we're trying to put more emphasis on predicting where systems will be overwhelmed."

  NPR

Without a larger view into national or regional data, some states — like Tennessee, which has eight bordering states — are missing out on valuable regional data, says Melissa McPheeters, who directs the Center for Improving the Public's Health through Informatics at Vanderbilt University.

"Hospitals in Tennessee serve patients who are from Arkansas and Mississippi and Kentucky and Georgia and vice versa, and so we're a little bit blind to what's going on there," she says. "When we see hospitals that are particularly near those state borders having increases, one of the things we can't tell is: Is that because hospitals in an adjacent state are full? What's going on there? And that could be a really important piece of the picture."

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This kind of visibility into data could help policymakers decide how best to curb the spread of the virus.

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It could influence behavior among the public, says Lee. "The neighborhood data, the county data and metro-area data can be really helpful for people to say, 'Whoa, they're not kidding, this is right here,'" she says. "It can help public health prevention folks get their messages across and get people to change their behavior."

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HHS told NPR that since it took over collecting hospital capacity data, it has "consistently displayed state-level hospitalization data to help inform the public about COVID-19 prevalence in their communities."

But public health experts say the state level data isn't detailed enough — and since the government is putting the effort into generating more granular daily analyses, it should share them.

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Panchadsaram's data-tracking site COVID Exit Strategy pulls state-level hospital capacity estimates from HHS when they're updated, which generally happens once a week. In reviewing the reports obtained by NPR, Panchadsaram says it's clear that vital data is flowing into HHS daily. "But sharing with the public seems to be an afterthought," he says.

It's not an afterthought. It's a Trump administration ploy. 

How many lives have been lost and will be lost in an effort to keep Trump in the White House?