The Atlantic

America’s Most Reliable Pandemic Data Are Now at Risk

The Biden administration has to make a choice: Should it undo a vital system that Trump’s health department created?
Source: Katie Martin / The Atlantic

When a hospital is in trouble, the signs are unmistakable. The number of COVID-19 admissions rises quickly. The number of patients who remain hospitalized grows steadily—and the bar to be admitted gets higher. The percentage of patients in intensive-care units increases. Supplies run low. As an ICU nears capacity, sick people get less care than they would have. More people suffer, and more people die. Right now, in Alabama, Arizona, and California—Los Angeles, especially—this is exactly what’s happening. We know this because of the data system that’s now in place.

But until recently, we did not have this national picture. Who had the most COVID-19 patients? Which hospitals’ ICUs were overrun? Who had staffing shortages? No one could say. Even assuming that the federal government could have executed a competent pandemic response, it couldn’t know where help was needed.

The government needed a national hospital-data system. So multiple teams scrambled to build one. In a short time, control over this hospitalization data became one of the most hotly contested elements of the American response, as fears of Trump-administration meddling cast doubt on the Department of Health and Human Services. Now the Biden administration is poised to take over as the country faces the worst surge yet, and hospitalization data may be the most important information it will have in the fight to save lives. The administration must decide where those data will live.

Since July, these data have been routed through the Department of Health and Human Services, but some officials inside the CDC are trying to regain control. It might seem obvious that the CDC, the traditional repository of infectious-disease information, should win this intragovernmental battle, but the reality is much more complicated. The current, HHS-run system works—unlike so much else in the response—and with these data flowing in, the federal government can dispatch help to hospitals that need it. If the new administration changed that system, it would be setting aside the best available data about the pandemic, and gambling that it could build a better system when it cannot afford to lose.


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