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TECHNOLOGY Saturday 16 May 2020
Faxes and email: Old technology slows COVID-19 response

By FRANK BAJAK feed it into the $25 million
AP Technology Writer Palantir system. On April
On April 1, a researcher 10, Health and Human Ser-
at the Centers for Disease vices Secretary Alex Azar
Control and Prevention added more reporting re-
emailed Nevada public quirements for 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 factors such as diabetes,
disease data and share it CDC or other health ex- cases, largely because it heart and respiratory dis-
with federal authorities. perts. "We are woefully be- would have to be manually ease — for 6% of reported
This data dysfunction is hind," the CDC's No. 2 offi- extracted from electronic cases.
hamstringing the nation's cial, Anne Schuchat, wrote records, then sent by fax Missing from daily indica-
coronavirus response by, in a September report on or email, said Johns Hop- tors that CDC makes public
among other things, slow- public health data technol- kins epidemiologist Jennifer is data such as nationwide
ing the tracing of people ogy. She likened the state Nuzzo. hospitalizations over the
potentially exposed to of U.S. public health tech- It's not unusual for public previous 24 hours and num-
the virus. In response, the nology to "puttering along health workers to have to bers of tests ordered and
Trump administration set up the data superhighway in track patients down on so- completed — information
a parallel reporting system our Model T Ford." cial media, use the phone vital to guiding the federal
run by the Silicon Valley HOLES IN THE DATA book or scavenge through response, said Dr. Ashish
data-wrangling firm Palan- This information technol- other public-health data- Jha, director of the Harvard
tir. Duplicating many data ogy gap might seem puz- bases that may have that Global Health Institute.
requests, it has placed new zling given that most hospi- information, said Rachelle "The CDC during this entire
burdens on front-line work- tals and other health care Boulton, the Utah health pandemic has been two
ers at hospitals, labs and providers have long since department official respon- steps behind the disease,"
other health care centers ditched paper files for elec- sible for epidemiological Jha said.
who already report case tronic health records. Inside reporting. Even when hos- REINVENTING THE WHEEL
and testing data to public the industry, they're eas- pitals and labs report that Instead of accelerating ex-
health agencies. ily shared, often automati- information electronically, isting efforts to modernize
There's little evidence so cally. it's often incomplete. U.S. disease reporting, the
far that the Palantir system But data collection for in- Deficiencies in CDC collec- White House asked Palantir,
has measurably improved fectious-disease reports is tion have been especially whose founder Peter Thiel is
federal or state response to another story, particularly glaring. a major backer of President
COVID-19. in comparison to other in- In 75% of COVID-19 cases Donald Trump, to hastily
Emails exchanged be- dustrialized nations. Coun- compiled in April, data on build out a data collection
tween the CDC and Ne- tries like Germany, Britain the race and ethnicity of platform called HHS Pro-
vada officials in March and and South Korea — and victims was missing. A re- tect. It has not gone well.
early April, obtained by The U.S. states such as New York port on children affected On March 29, Vice Presi-
Associated Press in a pub- and Colorado — are able by the virus only had symp- dent Mike Pence, who
lic records request, illustrate to populate online dash- tom data for 9%of labora- chairs the task force, sent a
the scope of the problem. boards far richer in real- tory-confirmed cases for letter asking 4,700 hospitals
It sometimes takes multiple time data and analysis. In which age was known. A to collect daily numbers
days to track down such Germany, a map populat- study on virus-stricken U.S. on virus test results, patient
basic information as pa- ed with public data gath- health care workers could loads and hospital bed and
tient addresses and phone ered by an emergency- not tally the number affect- intensive care-unit capac-
numbers. One disease de- care doctors' association ed because the applicable ity. That information, the
tective consults Google to even shows hospital bed boxes were only checked letter said, should be com-
fill a gap. Data vital to case availability. on 16% of received case piled into spreadsheets
investigations such as pa- In the U.S., many hospitals forms. In another study, the and emailed to the Federal
tient travel and medical and doctors are often fail- CDC only had data on pre- Emergency Management
histories is missing. ing to report detailed clini- existing conditions — risk Agency, which would