WASHINGTON — The Trump administration is asking governors to consider sending the National Guard to hospitals to help improve data collection about novel-coronavirus patients, supplies and capacity, according to a letter, internal emails and officials familiar with the plans.
The move is part of a new data reporting protocol for hospitals that eliminates the Centers for Disease Control and Prevention as a recipient of that information — a decision that is sparking controversy about whether that data is reliable.
In a letter to the nation’s governors that says the National Guard could help improve hospitals’ data flow, Health and Human Services Secretary Alex Azar and Deborah Birx, the White House’s Coronavirus Task Force response coordinator, say they ordered the changes because some hospitals have failed to report the information daily or completely. That portrayal, and the involvement of the National Guard, have infuriated hospital industry leaders, who say any data collection problems lie primarily with HHS and repeatedly shifting federal instructions.
The new protocol, to begin Wednesday, leaves health care institutions to report information daily about covid-19, the disease caused by the novel virus, to a federal contractor or to their state, which would coordinate the federal reporting.
Public health experts say bypassing the CDC could harm the quality of data and the federal response to the coronavirus pandemic.
Under the reporting system that is ending, about 3,000 hospitals — or the health systems that own them — send detailed information about covid-19 patients and other metrics to the CDC’s long-standing hospital network, the National Healthcare Safety Network. CDC staff members analyze the data and provide tailored reports to every state twice a week and multiple federal agencies every day, according to a federal health official who spoke on the condition of anonymity to discuss policy deliberations. This data is used by local health officials and policymakers to identify coronavirus trends in hospitals in their communities, the official said.
Some experts said the move could further marginalize the CDC, the government’s premier public health agency, at a time when the pandemic is worsening in most of the country, with records falling day by day of new infections.
“I worry greatly about cutting CDC out of these reporting efforts,” said Jennifer Nuzzo, an epidemiologist with the Johns Hopkins Bloomberg School of Public Health’s Center for Health Security. “I see little benefit from separating reporting of hospitalizations from reporting of cases, which CDC currently coordinates.”
The letter from Azar and Birx to the governors, which was sent out late Monday night or early Tuesday, backs away from earlier drafts that had directed state leaders to deploy the National Guard to help hospitals with daily data submissions. It now includes the National Guard among states’ options for improving the data flow.
The idea of bringing in the Guard was first broached at a late June meeting with hospital industry leaders by Birx, according to two industry officials who attended and spoke on the condition of anonymity.
According to one administration official, the draft of the letter that had directed governors to deploy the National Guard was revised over the weekend. The final version tells governors that the data submitted by hospitals and health officials “is not always complete or timely enough to be effective. ... We ask that you demand this of all of your hospitals, especially those that have failed to report daily or complete. Please insist that every hospital leader assign this reporting responsibility as a mission-critical assignment. If need be, you could consider prioritizing National Guard duties, in coordination with state health officers and emergency managers, to serve reporting needs for hospitals in the red zones.”