The Trump administration has ordered hospitals to send data on coronavirus patients to the Department of Health and Human Services in Washington rather than to the US Centers for Disease Control and Prevention in Atlanta.
“It’s another example of CDC being sidelined. Not only should the data be coming to CDC, but CDC should be talking to the public through the media every day,” Besser told CNN chief medical correspondent Dr. Sanjay Gupta in an interview.
CNN also spoke with Dr. Amira Roess, a professor of Global Health and Epidemiology at George Mason University and former CDC Epidemic Intelligence Service officer, about how the system works and what the change might mean for the US coronavirus response.
The conversation, conducted over the phone and lightly edited for flow, is below.
CNN: The hospital data on coronavirus patients is now going to be rerouted to the Trump administration instead of first being sent to the CDC. What is your reaction to that move?
AR: Right away, my first concern is what this means for the system that has been established over the last several years, if not decades. By shifting suddenly, you’re really disrupting the process that took a very long time to establish. And you’re also setting a precedent that can be very harmful down the road.
CNN: Can you expand on that a little?
AR: Basically, I think every time you make changes to these systems that are so difficult to establish to begin with, and that do take time to put together — every time you make changes to this you could be really damaging the integrity of the data and the system as a whole.
I don’t think many people fully understand how complex it is to move data from clinics or hospitals into a usable format that a large entity like the CDC can then curate, check for quality and make it usable for tracking, for surveillance and for understanding what’s happening in the country in terms of health.
So you could be doing some substantial damage to the system that we’ve had in place and that’s taken a while to build up. Any high-income country or any — what we call sometimes any developed country — depends on having timely surveillance and usable data to help the country really promote health and have the best possible health care system and public health system. So when you start to dismantle things or to move things around like this, you’re actually creating a lot of chaos and potentially setting up your future system for failure.
CNN: It sounds like this would be a difficult process in a normal times, never mind in the middle of a pandemic.
AR: Absolutely. It is a complex process. Because every hospital has a point person or a department that curates the data and then forwards it on. And then the receiver at the CDC, they have systems in place to receive the data, to check its quality, to communicate back to the hospital if there are data that are either missing or if there are data that don’t make any sense, to get clarification and to really get the data in the best quality shape that it can be in. And that’s not an easy task.
We have these systems in place for a number of different health conditions and pathogens. And when you start picking and choosing which pathogen or which health condition is going to be reported to CDC vs. HHS, you’re really creating more of a burden on the hospital system and on the departments or the individuals who are trying to figure out which reports go to whom.
CNN: There’s obviously concerns with transparency here. Can you explain why transparency is so important when you’re dealing with hospital data, particularly right now?
AR: If you use the established system, we do know that there are checks, and there’s quality control where we’re verifying the data and we’re making sure that it’s clean. So we understand that when we are looking at our usual system for tracking hospital data. That’s really important. When you start to establish a new system, a new movement of data, right away, there’s going to be some growing pains.
