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TECHNOLOGY Friday 15 May 2020
Faxes and email: Old technology slows COVID-19 response

By FRANK BAJAK million Palantir system. On
AP Technology Writer April 10, Health and Hu-
On April 1, a researcher man Services Secretary
at the Centers for Disease Alex Azar added more re-
Control and Prevention porting requirements for
emailed Nevada public hospitals.
health counterparts for lab Those mandates sparked a
reports on two travelers backlash among stressed
who had tested positive for hospitals already report-
the coronavirus. She asked ing data to state and local
Nevada to send those re- health departments. Pro-
cords via a secure network ducing additional cumber-
or a "password protected some spreadsheets for the
encrypted file" to protect federal government "is just
the travelers' privacy. not sustainable," said Janet
The Nevada response: Can Hamilton, executive direc-
we just fax them over? tor of the Council of State
You'd hardly know the U.S. and Territorial Epidemiolo-
invented the internet by gists. q
the way its public health
workers are collecting vi-
tal pandemic data. While
health-care industry re-
cord-keeping is now mostly In this Feb. 13, 2020, file photo, Jay Butler, deputy director for infectious diseases at the Centers for
electronic, cash-strapped Disease Control and Prevention (CDC), speaks to the media in regards to the novel coronavirus,
while standing in front of a map marked with areas having reported cases, inside the Emergency
state and local health de- Operations Center in Atlanta.
partments still rely heavily Associated Press
on faxes, email and spread-
sheets to gather infectious None of this is news to the cal data on coronavirus heart and respiratory dis-
disease data and share it CDC or other health ex- cases, largely because it ease — for 6% of reported
with federal authorities. perts. "We are woefully be- would have to be manually cases. Missing from daily
This data dysfunction is hind," the CDC's No. 2 offi- extracted from electronic indicators that CDC makes
hamstringing the nation's cial, Anne Schuchat, wrote records, then sent by fax public is data such as na-
coronavirus response by, in a September report on or email, said Johns Hop- tionwide hospitalizations
among other things, slow- public health data technol- kins epidemiologist Jenni- over the previous 24 hours
ing the tracing of people ogy. She likened the state fer Nuzzo. It's not unusual and numbers of tests or-
potentially exposed to of U.S. public health tech- for public health workers dered and completed —
the virus. In response, the nology to "puttering along to have to track patients information vital to guiding
Trump administration set up the data superhighway in down on social media, use the federal response, said
a parallel reporting system our Model T Ford." the phone book or scav- Dr. Ashish Jha, director of
run by the Silicon Valley HOLES IN THE DATA enge through other pub- the Harvard Global Health
data-wrangling firm Palan- This information technol- lic-health databases that Institute.
tir. Duplicating many data ogy gap might seem puz- may have that information, "The CDC during this entire
requests, it has placed new zling given that most hospi- said Rachelle Boulton, the pandemic has been two
burdens on front-line work- tals and other health care Utah health department steps behind the disease,"
ers at hospitals, labs and providers have long since official responsible for epi- Jha said.
other health care centers ditched paper files for elec- demiological reporting. REINVENTING THE WHEEL
who already report case tronic health records. Inside Even when hospitals and Instead of accelerating ex-
and testing data to public the industry, they're eas- labs report that information isting efforts to modernize
health agencies. ily shared, often automati- electronically, it's often in- U.S. disease reporting, the
There's little evidence so cally. complete. Deficiencies in White House asked Palantir,
far that the Palantir system But data collection for in- CDC collection have been whose founder Peter Thiel is
has measurably improved fectious-disease reports is especially glaring. a major backer of President
federal or state response to another story, particularly In 75% of COVID-19 cases Donald Trump, to hastily
COVID-19. in comparison to other in- compiled in April, data on build out a data collection
Emails exchanged be- dustrialized nations. Coun- the race and ethnicity of platform called HHS Pro-
tween the CDC and Ne- tries like Germany, Britain victims was missing. A re- tect. It has not gone well.
vada officials in March and and South Korea — and port on children affected On March 29, Vice Presi-
early April, obtained by The U.S. states such as New York by the virus only had symp- dent Mike Pence, who
Associated Press in a pub- and Colorado — are able tom data for 9%of labora- chairs the task force, sent a
lic records request, illustrate to populate online dash- tory-confirmed cases for letter asking 4,700 hospitals
the scope of the problem. boards far richer in real- which age was known. A to collect daily numbers
It sometimes takes multiple time data and analysis. In study on virus-stricken U.S. on virus test results, patient
days to track down such Germany, a map populat- health care workers could loads and hospital bed
basic information as pa- ed with public data gath- not tally the number affect- and intensive care-unit
tient addresses and phone ered by an emergency- ed because the applicable capacity. That informa-
numbers. One disease de- care doctors' association boxes were only checked tion, the letter said, should
tective consults Google to even shows hospital bed on 16% of received case be compiled into spread-
fill a gap. Data vital to case availability. forms. In another study, the sheets and emailed to the
investigations such as pa- In the U.S., many hospitals CDC only had data on pre- Federal Emergency Man-
tient travel and medical and doctors are often fail- existing conditions — risk agement Agency, which
histories is missing. ing to report detailed clini- factors such as diabetes, would feed it into the $25