In any defensive battle, nothing is more precious than accurate, up-to-the-minute intelligence on your enemy’s advance. Without it, determining the best deployment of forces to repel the invader is impossible.
As April dawned in the war against COVID-19, the U.S. was still scrambling to create adequate information systems to track and trace exposure to the novel coronavirus. Hopefully, the new tests being rushed into production by Abbott Labs and other manufacturers will address this shortcoming over the next few weeks.
One can only hope the same will be true for our inadequate supply of ventilators, N95 masks and other personal protective equipment for front-line healthcare workers. Hospital supply chain firms, manufacturers large and small, governors, mayors and individual citizens are doing their best to provide needed supplies for the regions hit first and hardest by the pandemic.
But even as production of these items increases, the temptation to hoard is overwhelming, and rightfully so. With 50 governors and every hospital scrambling to ensure their own readiness, what official in their right mind will independently decide to send their stockpiled supplies to meet another state or city’s desperate need?
What we need now is a centralized command-and-control system for allocating critical healthcare supplies. The president finally invoked the Defense Production Act to force General Motors to produce ventilators. But it will be weeks, if not months, before this and other crash programs begin to deliver machines.
In the meantime, the most logical approach for rapid deployment is commandeering ventilators, masks and PPE from where they’re not yet needed and sending them to places where they are. Gov. Andrew Cuomo of New York, the current epicenter of the pandemic, promised “we’ll return the favor” when he made that plea late last month.
The Trump administration needs to take the lead by publicly embracing this strategy and using its emergency powers to pursue it.
It has only recently begun collecting the information needed to make it happen. On March 29, Vice President Mike Pence, who heads the White House pandemic task force, sent a letter to every hospital asking them to report daily on their in-house testing numbers and results. Private labs already report.
He also asked them to report daily on COVID-19 patient caseload and mortality; the capacity and use of hospital beds, intensive-care unit beds and ventilators; and how many patients are awaiting ventilators in their emergency departments.
This is vital information for accurately tracking and tracing the pandemic’s spread and identifying both current and emerging hot spots and equipment needs. Right now, the most widely cited data on COVID-19’s spread comes from the University of Washington, which relies on state and local government reports, published hospital capacity numbers and “utilization data from select locations.”
Private, voluntary efforts are not good enough for pinpointing deliveries during a shortage. Real-time data from every front-line provider is key, and only the federal government can demand it.
Sad to report, the vice president made reporting this information to the Centers for Disease Control and Prevention voluntary. The federal government continues to pursue the wrongheaded approach that is, as Pence put it, “locally executed, state managed and federally supported.”
I couldn’t help but note that Pence also asked hospitals to convey their daily reports on spreadsheets or a downloadable form they could fill out. Has the nation’s need for an internet-based, national health information exchange that every hospital and physician practice must plug into ever been more apparent? Add that to the infrastructure agenda now being developed in Washington.
The U.S. invested $30 billion over the last decade to help healthcare facilities deploy electronic health record systems. We need a crash program to put that investment to work in setting up an emergency logistical system for the war against COVID-19.