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Excerpt: "Withholding this information from the public and the research community is a missed opportunity to help prevent outbreaks and even save lives, say public health and data experts."

The ICU at Tampa General Hospital in Tampa, Florida, was 99% full this week, according to an internal report produced by the federal government. It's among numerous hospitals the report highlighted with ICUs filled to over 90% capacity. (photo: Michael S. Williamson/Getty)
The ICU at Tampa General Hospital in Tampa, Florida, was 99% full this week, according to an internal report produced by the federal government. It's among numerous hospitals the report highlighted with ICUs filled to over 90% capacity. (photo: Michael S. Williamson/Getty)


Internal Documents Reveal COVID-19 Hospitalization Data the Government Keeps Hidden

By Pien Huang and Selena Simmons-Duffin, NPR

30 October 20

 

s coronavirus cases rise swiftly around the country, surpassing both the spring and summer surges, health officials brace for a coming wave of hospitalizations and deaths. Knowing which hospitals in which communities are reaching capacity could be key to an effective response to the growing crisis. That information is gathered by the federal government — but not shared openly with the public.

NPR has obtained documents that give a snapshot of data the U.S. Department of Health and Human Services collects and analyzes daily. The documents — reports sent to agency staffers — highlight trends in hospitalizations and pinpoint cities nearing full hospital capacity and facilities under stress. They paint a granular picture of the strain on hospitals across the country that could help local citizens decide when to take extra precautions against COVID-19.

Withholding this information from the public and the research community is a missed opportunity to help prevent outbreaks and even save lives, say public health and data experts who reviewed the documents for NPR.

"At this point, I think it's reckless. It's endangering people," says Ryan Panchadsaram, co-founder of the website COVID Exit Strategy and a former data official in the Obama administration. "We're now in the third wave, and I think our only way out is really open, transparent and actionable information."

The documents show that detailed information hospitals report to HHS every day is reviewed and analyzed — but circulation seems to be limited to a few dozen government staffers from HHS and its agencies, including the Centers for Disease Control and Prevention and National Institutes of Health, according to distribution lists reviewed by NPR. Only one member of the White House Coronavirus Task Force, Adm. Brett Giroir, appears to receive the documents directly.

"Our goal is to be as transparent as possible, while still protecting privacy," an HHS spokesperson wrote in an email to NPR. "HHS and the White House Coronavirus Task Force utilize hospital capacity data to gain greater insights into how COVID-19 is spreading and impacting the population, and to better inform response efforts like staff deployments and supply shipments."

What data is being collected and shared internally?

The daily reports show county, city and hospital-level details, as well as national analyses that HHS does not post online.

For instance, the most recent report obtained by NPR, dated Oct 27, lists cities where hospitals are filling up, including the metro areas of Atlanta, Minneapolis and Baltimore, where in-patient hospital beds are over 80% full. It also lists specific hospitals reaching max capacity, including facilities in Tampa, Birmingham and New York that are at over 95% ICU capacity and at risk of running out of intensive care beds.

In reviewing the analysis obtained by NPR, Panchadsaram says the local and hospital-level data HHS is collecting would be very useful to researchers and health leaders. "That stuff isn't easy to find at a national level," he says. "There's no one place [publicly] you can go to get all that data."

Hospitalization data is invaluable in looking ahead to see where and when outbreaks are getting worse, says Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington. "Right now, as we head into the fall and winter surge," Murray says, "we're trying to put more emphasis on predicting where systems will be overwhelmed."

But what's missing for this kind of planning, he says, is "exactly the information" that appears in the internal report.

NPR has reviewed several of these reports generated in the past month. They present trends in hospital use, including increases in ventilator usage, along with a growing number of inpatient and ICU beds being occupied by COVID-19 patients. The Oct. 27 report showed that all three measures have increased by 14%-16% in the past month.

About 24% of U.S. hospitals are using more than 80% of their ICU capacity, based on reporting from nearly 5,000 "priority facilities," and more hospitals have joined their ranks in recent weeks.

Researchers say observing these trend lines can help the nation know how to prepare for surge and be ready to intervene before systems become overwhelmed.

Daily hospitalization numbers in particular are key measures for tracking pandemic hotspots, Murray says, because they reflect the number of severe COVID-19 cases in a community.

"The best possible measure of where we are in the pandemic, and the one we would want to anchor modeling to, is daily hospitalizations," he says, which give an early warning of deaths that will likely follow.

Panchadsaram's data-tracking site COVID Exit Strategy pulls state-level hospital capacity estimates from HHS when they're updated, which generally happens once a week. In reviewing the reports obtained by NPR, Panchadsaram says it's clear that vital data is flowing into HHS daily. "But sharing with the public seems to be an afterthought," he says.

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