Don't expect the federal coronavirus response to get better

The Trump administration abruptly required hospitals to stop reporting COVID data to CDC and use a new reporting system set up by a contractor. Two weeks in, the promised improvements in the data have yet to materialize.

  NPR

You're as shocked as I am, no doubt.

Michael Caputo, HHS assistant secretary for public affairs, framed the switch at the time in a statement to NPR as a technology upgrade from "the CDC's old data gathering operation," which "just cannot keep up with this pandemic."

"The new faster and complete data system is what our nation needs to defeat the coronavirus," Caputo wrote.

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Instead, the public data hub created under the new system is updated erratically and is rife with inconsistencies and errors, data analysts say.

A feature, not a bug.

The data now available to the public appears to be neither faster nor more complete.

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The established system was disrupted by a memo dated July 10, issued to hospitals by HHS. In the memo, HHS took the unusual step of instructing hospitals to stop reporting the capacity data to CDC, and to instead use a reporting platform developed recently by the private contractor, TeleTracking. As NPR has reported, the details of how the contract was awarded to TeleTracking are unclear.

Surprise, surprise.

Lawmakers plan to grill members of the White House Coronavirus Task Force about the reporting change, and what's being done to ensure the data remains public and reliable, in a Friday morning hearing of the House Select Subcommittee on the Coronavirus. Several House subcommittees have already launched an investigation into to the data change.

The delays and problems with data on the availability of beds, ventilators and safety equipment could have profound consequences as infections and deaths soar throughout most of the country, public health experts say.

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For instance, knowing which hospitals have the capacity to take on new patients is critical.

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When HHS took over the collection and reporting of this hospital capacity data, it promised to update "multiple times each day." Later, the agency walked that back to say it would be updated daily.

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On Thursday, an HHS spokesperson told NPR via e-mail, "We will be updating the site to make it clear that the estimates are only updated weekly."

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CDC posted estimates derived from the data to show an approximation of the actual availability of ICU beds, accounting for the lags and gaps in reporting. These estimates — promised on the HHS website — have not been updated in over a week.

By contrast, the CDC estimates was updated three times a week. And while the data sent to CDC was vetted for accuracy before being posted publicly, the data sent to the new platform appears to be posted as it is received and contains multiple anomalies, analysts note.

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Still, hospitals are required to report this data daily to TeleTracking, either directly or via their state health department. Failure to do so could affect the state's access to remdesivir, one of the few drugs that's shown promise in treating severe COVID-19 cases, according to the HHS guidance to hospitals and the American Hospital Association.

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Hospitals got only a few days notice of the change and scrambled to adapt.

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The only information about hospital capacity that appears to be updated regularly on the HHS Protect site is the percentage of hospitals that have submitted data in the past seven days.

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Public health groups objected to the change as unnecessary and burdensome for hospitals in the midst of a pandemic. Open government organizations demanded that HHS rescind its guidance and return control of the data to CDC. On Tuesday, 22 state attorneys general added to the chorus of those demanding that HHS reverse course.

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[A] higher level of compliance is not the whole picture, according to a CDC official familiar with the former reporting system. The tallies do not include certain categories of hospitals, including rehabilitation or veterans' hospitals, which have suffered COVID-19 outbreaks. These rehabilitation and veterans' hospitals had previously been included in the data reported by CDC.

You see where they're going with this.

The organizers of the tracking website COVID Exit Strategy initially found the data provided by HHS Protect to be unusable. "It had some states like Rhode Island having an inpatient bed utilization of above 100%," says site co-founder Ryan Panchadsaram, "And Rhode Island is a state where hospitalizations are quite low for COVID."

Another feature: completely useless data.

The site stopped pulling hospital capacity data from HHS Protect for several days but resumed the reporting on July 30, using a dataset from HealthData.gov with a "user beware" warning that reads in part: "For the time being, we recommend cross-checking these numbers with the ones reported on a state's official website to get an accurate picture."

The article includes specific data anomalies in various states. Continue reading by clicking here.

...but hey, do what you want...you will anyway.

The real hoax is minimizing the count

In at least a dozen states, health departments have inflated testing numbers or deflated death tallies by changing criteria for who counts as a coronavirus victim and what counts as a coronavirus test, according to reporting from POLITICO, other news outlets and the states' own admissions. Some states have shifted the metrics for a “safe” reopening; Arizona sought to clamp down on bad news at one point by simply shuttering its pandemic modeling. About a third of the states aren’t even reporting hospital admission data — a big red flag for the resurgence of the virus.

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The lack of accurate and consistent Covid-19 data, coupled with the fact that the White House no longer has regular briefings where officials reinforce the need for ongoing social distancing, makes [the task of public health officials trying to help Americans make safe decisions] even harder.

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The problems are widespread and have infiltrated federal health agencies as well. The Centers for Disease Control and Prevention blended diagnostic and antibody tests, boosting the nation's overall testing numbers.

The Department of Health and Human Services took out of context data on the danger of “deaths of despair” from overdoses and suicides amid an economic debacle, according to the authors of the report in question. On Tuesday, an ethics center at Harvard rebuked the White House for misleadingly citing numbers from one of its studies to buttress the administration's national testing report.

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The District of Columbia this week became the latest jurisdiction to endure scrutiny, with the city using a “community spread” metric — excluding nursing homes, correctional facilities and others — as a justification for reopening the area.

Iowa Gov. Kim Reynolds told reporters that the state will share information about outbreaks at meatpacking plants only upon request. And Georgia has only just begun to differentiate between the two types of coronavirus tests it's been adding into its testing totals for weeks.

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The country, [Irwin Redlener, a public health expert at Columbia University] said, is confronting an “unheard of level of chaos in the data, the protocols, the information.”

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In Georgia, where Gov. Brian Kemp has been among the strongest proponents of reopening, the inclusion of antibody tests inflated the state’s overall testing count by nearly 78,000 — a disclosure that came a few weeks after officials posted a chart of new confirmed cases in Georgia with the dates jumbled out of order, showing a downward trajectory.

Like several other states, Georgia's health department began listing separate totals for its antibody and diagnostic test counts only after reporters discovered it had been quietly combining the two.

Georgia's count of hospitalized coronavirus patients also includes only those who were already in the hospital when their diagnosis was reported to the state, a limitation that the state has openly admitted likely creates “an underestimation of actual hospitalizations.”

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Florida has weathered a string of controversies over its evidence to support GOP Gov. Ron DeSantis’ boasts that the state is faring better than most, including an attempt to block access to information on nursing home deaths and the firing of a health department official who now alleges she was pushed out for refusing to manipulate the state’s data.

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New Jersey revised down its nursing home coronavirus death count by about 1,400 after concluding it would only count those with a lab-confirmed diagnosis of the disease, a move a GOP state legislator called a “whitewash.”

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At least a half-dozen states have admitted to inflating their testing figures by mixing two different types of tests into its totals, a practice widely derided as scientifically unsound.

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Nearly half the U.S., meanwhile, has registered rising caseloads as states press ahead with reopening the economy. While some of that reflects increased testing, an accompanying uptick in hospitalizations is worrying experts.

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HHS Secretary Alex Azar warned during a recent Cabinet meeting that the U.S. could see 65,000 additional “deaths of despair” if the country does not get back on track to normalcy soon.

In reality, the study he cited explicitly warned against lifting lockdowns before health data showed it was safe to do so.

“Some might use this report to argue that this is why our economy needs to open up fast. But that’s NOT what we are saying,” wrote the authors of the report, which was published by the American Academy of Family Physicians and Well Being Trust. “Even as of today parts of the country are opening, data suggest that this is premature due to a lack of consistent testing, which allows public health authorities to trace, treat and isolate to prevent further spread.”

Harvard University’s Safra Center for Ethics similarly publicly chastised the administration. HHS used one of the center’s testing models to suggest the U.S. was already testing enough people to contain the virus — when the center was arguing that testing is woefully inadequate to ensure a safe reemergence from “stay at home.”

“The Department’s Report does not provide an accurate summary of the modeling supporting our recommendations,” said the center’s director, adding that HHS had cited a “nonprimary” model in the study’s appendix and then adjusted the assumptions underpinning it.

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[T]he Centers for Disease Control and Prevention has established few firm standards for how states should monitor Covid-19 and made little overt effort to coordinate its messaging with state and local health departments.

That’s created a patchwork system where key health information is collected and communicated with little uniformity, and amid rising concern over whether Americans are receiving reliable reports about the pandemic fight.

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It’s an environment that threatens to erode public trust, experts warn. “You want people to trust what authorities are telling them,” said Jennifer Kates of the Kaiser Family Foundation, and that trust is going to be difficult to earn.

  Politico

Too late.

UPDATE: