Until this week, hospitals across the nation sent their data each day to the National Healthcare Safety Network. There had been some complaints about this network—mostly that it was unforgiving when it came to the data format and didn’t provide flexibility for capturing additional information. But that information fed dashboards at the CDC, which provided information not just on the number of confirmed cases and deaths, but on the rates of hospitalization and number of available beds. On Thursday morning, that site temporarily vanished. Then it returned, featuring data from … last week.
The change in where and how hospitals report data, backed up by Donald Trump threatening to sending the National Guard in to make them “do it right,” means that the CDC is now bypassed. Instead, the data is now going into a new system from HHS. And what’s coming out is significantly less information. Just a couple of days into the new program, experts at both the state and national level are finding that the change is doing exactly what many feared—making it more difficult to track the threat of COVID-19.
As the Idaho Statesman reports, the switchover had an immediate effect on the ability of state officials to see what was going on in their own states, with the spokesperson for the Idaho Department of Health reporting “significant challenges” in their ability to monitor the number of hospitalizations. With the way information is now being routed, it’s not being congregated at the state level, or available on the public website of the CDC. It’s all going into HHS, directly from individual hospitals, and what comes out the other side is only what the White House chooses to make available.
Information provided to the National Healthcare Safety Network was displayed as soon as it was updated, in real time. This led to some errors being displayed to the public, as mistakes, or badly formatted submissions, could generate errors that were instantly visible. But the alternative system, which is managed by private healthcare firm TeleTracking, is already resulting in delays and a lack of information that state officials called stunning and disappointing.
Idaho is far from the only state complaining about this abrupt and unexpected change to the system in the middle of a public health crisis. Unlike the CDC data, the HHS database that is now taking in the information is not visible to the public. That means not just unavailable to the casual observer, but also to anyone who wants to research, provide projections of trends, or double-check information coming from leadership at the state or federal level. It also means that thousands of city and county health officials have lost their direct access to their own local data.
As CNBC reports, sites like Covid Exit Strategy, which had been providing the public (and publications) with regularly updated information on the effectiveness of state-level actions, had found the data that’s required suddenly unavailable. This wasn’t a subtle change, or a loss of minor features. It’s sudden and complete inaccess to the core information needed to show what tactics are working and how healthcare systems are to being overwhelmed. The official position on the new system is that it’s supposed to allow the White House better visibility to the information, but the cost appears to be that everyone else has been shut out, including workers directly addressing the fast-moving crisis. When concerns are expressed about the data not being visible to “the public,” just assume that term means everyone outside the White House, including officials who need the information most.
It’s not as if states can simply send their data to the HHS system and to the National Healthcare Safety Network at the CDC. As of Wednesday, access to the CDC site has been cut off. There is a single data hotel for COVID-19 information—all the data is going in. Very little is coming out.
HHS spokesman Michael Caputo issued a statement on Thursday saying that the CDC had been directed to “make the data available again.” At the time of publication, the CDC site was running again, but was showing only information last updated on Monday, meaning that any agencies or researchers depending on the information were already well out of date. The HHS statement also indicates that at some point, the new system will offer more opportunities for data display and analysis, but that ability doesn’t seem to be ready, and there’s no date given for when it will be ready.
As The New York Times reported on Tuesday just before access to the CDC site was removed, health experts feared that COVID-19 data will be easily politicized, or withheld from the public, in a system where everything is invisible until the White House makes it visible.
Those fears appear to be well grounded. And Trump hasn’t even sent in the National Guard. Yet.