Bad U.S. Outbreak Data Tracking Could Kill Your Client

U.S. COVID-19 pandemic data tracking was a mess, and it continues to be a mess.

Dr. Deborah Birx, the former White House coronavirus response coordinator, gave that assessment last week at a hearing before the House Select Subcommittee on the Coronavirus Crisis.

“You cannot contain a virus that cannot be seen, and it wasn’t being seen because we weren’t testing,” Birx said at the hearing. “It’s clear what made America vulnerable was the lack of data streams on just common diseases.”

“Today,” Birx added, “we are still not using data in real-time strategically and equitably to save Americans — in time to really change the outcomes and impact of COVID-19.”

What It Means

Your clients may pay extra for life insurance — and may be more likely to become disabled, or die — partly because the United States has trouble scraping together complete, detailed data on the COVID-19 pandemic, as well as on other infectious disease outbreaks.

Dr. Deborah Birx

Birx is a medical doctor who started out as a U.S. Army colonel and then worked for the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. State Department.

She oversaw CDC efforts to help countries in Africa get the HIV epidemic there under control.

When the pandemic hit, she was the official who put dire warnings about looming COVID-19 surges in the weekly White House situation reports, as enormous spikes in the number of deaths were about to occur.

The Hearing

The House subcommittee streamed the hearing live and posted a recording on YouTube.

In Africa, Birx testified, public health programs watched for outbreaks by using lab tests to test patients with high fevers for conditions such as influenza, HIV, tuberculosis and malaria.

If the United States had a similar kind of approach to lab testing for patients with fevers, “we would have had the lab capacity at every single hospital, no matter if they were community hospitals or large-throughput hospitals, to diagnose flu,” Birx said.

When COVID-19 arrived, “we would have seen there was a circulating virus that did not match any of those laboratory diagnoses, and we would have seen it coming,” she added.

Instead, Birx said, U.S. public health agencies sequenced the genomes of only about 0.001% of the flu samples from patients with flu, and they performed that sequencing only in public health laboratories.

The lack of genome sequencing meant that the CDC had no ability to track symptom-free cases of COVID-19 or monitor the spread of the virus that causes the disease, Birx said.

Even for patients with the flu, diagnosing them and treating them based solely on symptoms is unacceptable in the 21st century, Birx added.

“Sequencing is critical,” she said. “It allows you to see transmission trends.”

Birx’ Written Testimony

Birx also provided written testimony.

In the written testimony, she went into more detail about what she sees as severe U.S. public health data reporting problems.

The COVID-19 pandemic has killed more than 1 million Americans since early 2020.

Birx said that she believes that more than about 30% of the deaths were avoidable and that poor data contributed to many of the avoidable deaths.

In addition to the lack of genome sequencing, another serious weakness in U.S. disease tracking efforts has been dependence on “suboptimal” systems built and maintained by the CDC, Birx said.

The CDC has relied on hospital emergency rooms and central hospital offices to send in data, and “reporting was voluntary and sporadic,” Birx said. “Specific regions in the United States were either overrepresented or underrepresented, with inadequate visibility into all U.S. counties.”

She said that, when she asked the CDC to get her COVID-19 case data from all U.S. hospitals and all U.S. hospital intensive care units, it refused to collect the data.

The CDC also refused to collect information about hospitals’ supplies of face masks, gloves and other personal protective equipment, Birx said.

Long COVID

Many doctors call the long-term effects of COVID-19 “long COVID.”

Some doctors have speculated that many or all cases of long COVID are actually the effects of mental illness, or the effects of patients suffering from staying in bed and inside too long.

Other doctors say long COVID appears to be the result of measurable changes in the body.

Birx said in the written testimony that having better pandemic tracking data would help researchers do a better job of analyzing long COVID.

“We should know today whether vaccination and boosters protect against long COVID across age groups, protect against the inflammatory syndromes, protect against the late cardiovascular findings, the increased incidence of diabetes and the late brain findings,” she said.

But researchers still do not have the necessary data to answer questions about the effects of vaccinations and boosters on long COVID, and the country still lacks the data it needs to reduce the acute COVID-19 death rate in counties that continue to have high death rates, Birx warned.

Dr. Deborah Birx. (Photo: Tia Dufour/White House)