Health Care

Public health groups denounce new Trump move sidelining CDC

A new Trump administration policy that bypasses the Centers for Disease Control and Prevention (CDC) for control of key coronavirus information is provoking outrage among public health experts.

Under the policy, quietly announced late last week, hospitals are now required to report directly to the Department of Health and Human Services (HHS) on the number of COVID-19 patients each facility is treating, available beds and ventilators, and other data.

The CDC had been collecting that information from the start of the pandemic on its National Healthcare Safety Network (NHSN), which the agency describes as the country’s most widely used health care-associated infection tracking system.

The administration argues the new approach will streamline the compilation of patient data and improve tracking efforts, but experts fear it will harm the quality of the information. They also worry the move is part of a concerted effort to sideline the CDC at a time when President Trump is seeking to deflect blame for his administration’s response to the pandemic.

“Placing medical data collection outside of the leadership of public health experts could severely weaken the quality and availability of data, add an additional burden to already overwhelmed hospitals and add a new challenge to the U.S. pandemic response,” Thomas File Jr., president of the Infectious Diseases Society of America, said in a statement.

Administration officials said the change is an attempt to modernize the reporting system, because the CDC database was too decentralized and out of date.

“The CDC’s old data-gathering operation once worked well monitoring hospital information across the country, but it’s an inadequate system today,” Michael Caputo, HHS assistant secretary for public affairs, said in a statement.

CDC Director Robert Redfield told reporters on a conference call Wednesday that his agency asked for the change.

“No one is taking access or data away from CDC,” Redfield said.

Redfield said the change will allow the NHSN to better focus on “other critical areas” of COVID-19, such as nursing homes.

“All elements of our public health system are being stretched right now, and streamlining the hospital reporting allows the NHSN to concentrate its COVID-19 activities on this high priority area of protecting the vulnerable in our nursing homes,” Redfield said.

Jose Arrieta, HHS’s chief information officer, said the goal is to better “allocate resources in real time, so that you can actually start to combat a pandemic like COVID-19.”

Janis Orlowski, the chief health care officer of the Association of American Medical Colleges, said the Trump administration has pledged to retain data transparency and give hospitals and public health agencies access to the data.

“As long as the data is made public and the administration continues to interact with health experts and stakeholders to improve our response to the pandemic, we support the new process,” Orlowski said in a statement.

But the new database, called HHS Protects, is not public, raising concerns that the data could be manipulated for political purposes.

Howard Koh, former HHS assistant secretary for health in the Obama administration, said there is an argument to be made for upgrading public health data infrastructure.

“Public health surveillance infrastructure in particular has just not gotten the funding and the attention it needs and deserves. So that’s a legitimate issue,” Koh said.

But he questioned why the administration would need to completely overhaul the existing system instead of simply making improvements to it.

“Having such centralized information could be a way to identify places of highest needs as soon as possible and address them quickly through a national strategy,” Koh said. “But there hasn’t been any national strategy.”

The new HHS database is run by a private contractor called TeleTracking, which was awarded a $10 million contract in April.

Sen. Patty Murray (Wash.), the top Democrat on the Senate Health Committee, has raised questions about the firm and the process by which it secured the contract. In June, she asked the CDC for information about the “noncompetitive, multimillion-dollar contract” awarded for a “duplicative health data system.”

On Wednesday, Murray said the timing of the new decision is also suspect.

“It’s entirely unclear why the Trump Administration has asked states and hospitals to upend their reporting systems in the middle of a pandemic—in 48 hours nonetheless—without a single explanation as to why this new system is better or necessary,” Murray said in a statement.

Any move the Trump administration makes regarding the CDC is under a microscope.

The administration has effectively silenced the agency during much of the pandemic; four former CDC directors recently accused the White House of politicizing science and undermining health experts.

Trump and key White House officials this week broadened their attacks by seeking to publicly discredit Anthony Fauci, the nation’s top infectious diseases expert and a member of the White House coronavirus task force.

Congressional Democrats warn that shifting more power to HHS is a dangerous move.

Rep. Rosa DeLauro (D-Conn.), who chairs the House Appropriations subcommittee that oversees HHS funding, said the agency “has been operating as a dangerous, political apparatus and cannot be trusted to share accurate hospital information with Congress and the American public.”

DeLauro added that the CDC, not HHS, “was created as a nonpartisan entity to tackle public health crises like the one we’re facing today and track data related to these crises.”

Trump officials say they are looking into concerns about public health data.

Arrieta said HHS is considering giving members of Congress access to the data and is “exploring the best way to make this information available to the public.”

Tags Anthony Fauci CDC Coronavirus COVID-19 Donald Trump HHS hospitals Pandemic Patty Murray Public health Rosa DeLauro

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