By Robin Foster and E.J. Mundell
WEDNESDAY, July 15, 2020 (HealthDay News) As 64,000 new U.S. coronavirus cases were reported Tuesday and states struggled to control the spread of the virus, the Trump Administration stripped the country's leading public health agency of the ability to collect hospitalization data on COVID-19.
Instead of patient information going to the U.S. Centers for Disease Control and Prevention, it will now be sent to a central database in Washington, The New York Times reported. The unprecedented move has alarmed health experts who fear the data will be politicized or withheld from the public, the newspaper said.
From now on, the U.S. Department of Health and Human Services (HHS) will collect daily reports about cases, available beds and available ventilators, the Times reported.
But the HHS database is not open to the public, which could affect the work of researchers, modelers and health officials who rely on CDC data to make projections and crucial policy decisions, the Times reported.
"Historically, CDC has been the place where public health data has been sent, and this raises questions about not just access for researchers but access for reporters, access for the public to try to better understand what is happening with the outbreak," Jen Kates, the director of global health and HIV policy with the nonpartisan Kaiser Family Foundation, told the Times.
HHS spokesman Michael Caputo insisted the change was made to streamline the flow of information.
"Today, the CDC still has at least a week lag in reporting hospital data," Caputo told the Times. "America requires it in real time. The new, faster and complete data system is what our nation needs to defeat the coronavirus, and the CDC, an operating division of HHS, will certainly participate in this streamlined all-of-government response. They will simply no longer control it."
In addition to changing where hospitalization data will be sent, the Trump Administration has also asked governors to consider using the National Guard in hospitals to help improve data collection on patients, supplies and capacity, the Washington Post reported.
In a letter to the nation's governors that says the National Guard could help improve hospitals' data flow, HHS Secretary Alex Azar and coronavirus task force response coordinator Dr. Deborah Birx said some hospitals have failed to report information daily or completely. But hospital industry leaders say any data collection problems lie primarily with the HHS and constantly shifting federal instructions, the newspaper said.
"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 in Baltimore, told the Post. "I see little benefit from separating reporting of hospitalizations from reporting of cases, which CDC currently coordinates."
States roll back reopening plans as cases surge
Meanwhile, states continued to try to rein in surging case counts. California and Oregon rolled back their reopenings on Monday, two of several states across the country that are seeing spikes in cases.
More than 900 U.S. coronavirus deaths were reported on Tuesday, including single-day records in Alabama, Florida and Utah, the Times reported. In Florida, which reported 132 new COVID-19 cases on Tuesday, a group of mayors from Miami-Dade County warned that time is running out to avoid another painful lockdown.
"There is a significant amount of pressure for us to shut down," Mayor Francis Suarez of Miami told Gov. Ron DeSantis at an event in the city on Tuesday. "We have between one week and four weeks to get this thing under control, or we will have to take some aggressive measures."
DeSantis, who has said in the past that future lockdowns are not an option, wore a mask as he acknowledged how difficult the pandemic has been for Floridians, adding that "people are apprehensive," the Times reported.
With more than 2,000 patients hospitalized and hundreds in ICUs in Miami, that city "is now the epicenter of the pandemic," one infectious disease expert said Monday.
"What we were seeing in Wuhan -- six months ago, five months ago -- now we are there," Lilian Abbo, with the Jackson Health System said during a news conference Monday, CNN reported. The Chinese city of Wuhan, the original epicenter of the coronavirus crisis, went into a 76-day lockdown in late January after a deadly outbreak infected and killed thousands.
And there were signs of new trouble in regions outside current hotspots: Twenty states and Puerto Rico reported a record-high average of new infections over the past week, the Post reported. In the Midwest, cases have been trending upward in every state except Nebraska and South Dakota.
Adding to the problem, long delays in testing are hampering efforts to contain future spread of the coronavirus, the Post reported. Many testing sites are struggling to provide results in five to seven days. Others are taking even longer, the newspaper reported, as outbreaks across the Sun Belt have strained labs beyond capacity.
Hospitals filling up
The case spikes are resulting in another grim fact: Hospitals across the South and West are being flooded with COVID-19 patients and are having to cancel elective surgeries and discharge patients early as they try to keep beds open, the Times reported.
In Miami-Dade County, Fla., six hospitals have reached capacity as virus cases spike. In response, Miami Mayor Carlos Gimenez rolled back reopening plans by imposing a curfew and closing restaurants for indoor dining, the Times reported.
"We've definitely had a sharp increase in the number of people going to the hospital, the number of people in the ICU, and the number of people on ventilators," he told the Times. "We still have capacity, but it does cause me a lot of concern."
To try to address the shortage of beds in Texas, Gov. Greg Abbott has ordered an increase in hospital bed capacity in nearly 100 counties, extending a ban on elective procedures to new corners of the state, the Times reported.
Even though regular wards are being converted into intensive care units and long-term care facilities are being opened for patients too sick to go home, doctors say they are barely managing, the newspaper said.
"When hospitals and health care assistants talk about surge capacity, they're often talking about a single event," John Sinnott, chairman of internal medicine at the University of South Florida and chief epidemiologist at Tampa General Hospital, told the Times. "But what we're having now is the equivalent of a bus accident a day, every day, and it just keeps adding."
While hospital beds are easily converted for ICU use, the more difficult challenge is having enough advanced practice nurses who are qualified to care for such patients and equipment such as ventilators, hospital experts told the Times.
Hospitals can "pivot enough space," Jay Wolfson, a professor of public health at the University of South Florida, explained. "The trick is going to be staffing. If you get people burned out, they get sick, then you lose critical care personnel."
Beds aren't the only thing hospitals are running out of now: Some states have ordered refrigerated trucks, to increase morgue space, the Times reported. In Texas, officials said the trucks were being readied because hospital morgues were filling up. In Arizona, two hospital systems in Maricopa County, which includes Phoenix, also plan to use refrigerated trucks. The mayor of Phoenix said Tuesday that the county morgue is close to capacity.
Medical supplies are also running short: Roopa Ganga, an infectious disease specialist at two hospitals near Tampa, told the Times that they lacked sufficient supplies of the COVID-19 medication remdesivir, forcing her to choose which patients need it the most. Patients were also being discharged "aggressively," sometimes returning in worse shape a few days later.
"About five people came back in one week last week," she said. "That is making me feel like, you know, you got to slow down."
By Wednesday, the U.S. coronavirus case count passed 3.4 million as the death toll passed 136,000, according to a Times tally.
According to the same tally, the top five states in coronavirus cases as of Wednesday were: New York with nearly 408,000; California with over 346,000; Florida with over 291,000; Texas with over 284,000 and New Jersey with over 177,800.
Nations grapple with pandemic
Elsewhere in the world, the situation remains challenging.
Even as the pandemic is easing in Europe and some parts of Asia, it is worsening in India. That country now has the third-highest number of COVID-19 cases, with over 936,000 infections, a Johns Hopkins tally showed.
Brazil has also become a hotspot in the coronavirus pandemic, with over 1.9 million confirmed infections by Wednesday, according to the Hopkins tally. It has the second-highest number of cases, behind only the United States.
Cases are also spiking wildly in Russia: As of Wednesday, that country reported the world's fourth-highest number of COVID-19 cases, at nearly 739,000, the Hopkins tally showed.
Worldwide, the number of reported infections passed 13.3 million on Wednesday, with more than 578,000 deaths, according to the Hopkins tally.