Public health data systems in the United States are out of date, underfunded, and can’t communicate with each other. Those issues left states unable to keep track of COVID-19 spread, and during surges, many local health departments stopped contact tracing, according to a new investigation from Politico.
The deep-dive look at the gaps in public health surveillance shows breakdowns at nearly every step in the process. Labs that ran COVID-19 tests didn’t report data directly to health departments through electronic systems, instead using faxes or emails. Health departments used different systems to track different types of outbreaks and relied on programs that required laborious, manual entry. They couldn’t get information about cases through the system in time to intervene in outbreaks.
The challenges were exacerbated during COVID-19 case surges, Politico’s investigation showed:
In Alabama, during surges, data systems crashed from an influx of cases hitting the system. In Vermont, more than 1,300 of Covid-19 lab results in December 2020 were received through fax, email or snail mail — not through the state’s electronic reporting system. In Washington state, labs were up to 10 days late reporting Covid-19 results during peak periods. In Wyoming, the state health department had to “deduplicate” thousands of records in its electronic system each month to ensure positive results were counted just once.
The delays at the state level meant the Centers for Disease Control and Prevention was sent inconsistent or delayed data. The federal agency had to build a program to scrape the states’ data sites for information, because they weren’t getting it from officials.
The shoddy surveillance systems were one reason the US wasn’t able to control the spread of COVID-19. “Because we did not have the kind of centralized intelligence to identify, test for and execute rapid containment, the U.S. missed our opportunity to contain the virus,” Charity Dean, California’s former assistant director of the Department of Public Health, told Politico.
Investment from the CARES Act could help modernize systems, but officials say it’s not enough. The problems that plagued health departments last year are still a problem today, officials are exhausted, and the delta surge is making things even harder to manage — much less fix.
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