Subverted, concealed and failed to collect vital statistics about COVID-19
Good data about where the coronavirus is spreading, whom it’s affecting, and the capacity of health systems is essential for government officials to make better decisions on, for example, lockdown orders and where to send supplies. Epidemiologists and infectious disease experts can use the information to understand COVID-19 better and, more importantly, to contain it.
But over the past year, experts have watched with bewilderment at how the Trump administration has collected, distributed and used public health data. “We’re still flying blind,” said Ryan Panchadsaram, co-founder of the the United States Digital Response, an all-volunteer effort to collect and publish COVID-19 data that the federal government hasn’t.
An early controversy erupted in May, when White House economist Kevin Hassett produced a set of charts on COVID-19 spread that appeared to predict a rapid decline in cases and deaths. In them, the country appeared to be nearly virus-free by summer. Hassett distributed the charts internally—much to the delight of President Donald Trump, according to The Washington Post. When Hassett published the charts on an official White House Twitter feed, experts reacted in horror and said reopening prematurely was likely to cause a new surge in cases, which is precisely what happened.
One month later, the administration abruptly decided to make a major change in how hospitals report their inpatient COVID-19 data. No longer would they submit information to the Centers for Disease Control and Prevention. Instead, hospitals would file data directly (or indirectly through state governments) to the Department of Health and Human Services.
Administration officials said the change would allow them to collect more complete and standardized data. A chorus of angry public health officials, scientists and hospital representatives warned in a public letter that the transition was likely to lead to less information, not more, precisely when the information was needed most.
Sure enough, data on the HHS website was incomplete and lagging for several weeks, in part because the change came with almost no advance warning.
“Usually you’ve got months and months, sometimes years, to prepare for big changes like this,” said Chip Kahn, president of the Federation of American Hospitals. “Here, you had days.”
Larger hospitals and those that were already using the HHS portal were mostly able to adapt. Smaller hospitals frequently struggled because they hadn’t been using the new system and because they didn’t have the dedicated IT staff of larger hospital networks. “The majority of our hospitals in Nebraska are rural, and the staff at these hospitals are often responsible for many roles, which can stretch resources very thin,” said Margaret Woeppel, vice president for quality and data at the Nebraska Hospital Association. “The nurse who is taking care of patients may also be responsible for quality reporting and infection control.”
Panchadsaram, who served as deputy chief technology officer during the Obama administration, said the quality of the data is slowly improving. But he identified another problem: The Trump administration isn’t sharing it with the public.
Every week, the White House coronavirus task force puts together a detailed status report on the outbreak and the response for all 50 states. It includes everything from test positivity rates to a breakdown of which communities have rising caseloads, along with policy recommendations. The task force gives each governor a copy of their state’s report, but otherwise doesn’t make them public. (The few copies that have surfaced have been obtained by reporters and the Center for Public Integrity, which is posting the reports it obtains on its webpage.)
The White House has not responded to questions about why the reports remain private, leaving critics to wonder whether administration officials are reluctant to publish information that might contradict the optimistic outlook of, say, the president or some Reublican governors. “They have a really good analytics team creating these beautiful reports, those reports have really important recommendations on them, and they're not making them public,” Panchadsaram said. “Maybe that is because the reports clearly contradict what governors are saying, that it’s under control when it’s not.”