New GAO Report Reveals “Lack of Clarity” Behind Trump Administration’s Abrupt Decision to Divert Coronavirus Data from CDC

August 5, 2021

Washington, D.C. (August 5, 2021) — Today, Rep. James E. Clyburn, Chairman of the Select Subcommittee on the Coronavirus Crisis, issued the following statement in response to a new report from the Government Accountability Office (GAO) on the Department of Health and Human Services' (HHS) abrupt decision last year to sideline the Centers for Disease Control and Prevention (CDC) and launch a new portal—HHS Protect—to capture hospital coronavirus data:

"I am troubled by GAO's findings that the Trump Administration's abrupt and frequent changes to hospital data reporting requirements and failure to engage with stakeholders placed additional burdens on hospitals trying to save lives as the virus spread. These ill-conceived actions harmed the nation's ability to respond to the pandemic, including efforts to allocate desperately needed resources. The Select Subcommittee will continue our investigations into the missteps that occurred under the prior Administration to determine what we must do to ensure they never happen again."

As the pandemic unfolded, the Trump Administration instructed hospitals to divert critical information about patients and the spread of the coronavirus from CDC's National Healthcare Safety Network (NHSN) to HHS Protect and TeleTracking Technologies, Inc. (TeleTracking), a private contractor without any epidemiological expertise. Though the NHSN had served as a national public health data resource for more than a decade, HHS implemented the new system in April 2020 to compile key hospital data, such as the availability of ventilators, inpatient and intensive care beds, personal protective equipment, and therapies to treat the virus.

Today's GAO report includes the following findings:

HHS Diverted Hospital Data Collection from CDC to Private Company After CDC Requested Time to Make Changes to NHSN to Comply with Legal Requirements.

GAO's report found that "the White House Coronavirus Task Force directed CDC to add new data fields to NHSN within four days, but CDC officials told the task force it would need more time than that to make the requested change" to comply with certain legal requirements. On July 15, 2020, HHS removed NHSN as a method for hospitals to report their capacity data "in part because its hospital capacity data were incomplete."

This finding is consistent with prior testimony from former CDC Director Robert Redfield that former HHS Secretary Alex Azar made the decision to redirect hospitalization data away from CDC. During a July 31, 2020, hearing before the Select Subcommittee, Dr. Redfield acknowledged that CDC was not consulted about the abrupt decision to divert hospital capacity data from NHSN to TeleTracking and that he learned about the change only after then-Secretary Azar had already made the decision.

The Trump Administration's "Frequent and Significant Changes" to the Collection of Hospital Data Created "Multiple Challenges" and Added Burdensome Reporting Requirements on Hospitals During the Pandemic.

GAO's report found that "HHS made frequent and significant changes to requirements for the collection of hospital capacity data" during the pandemic, including changing "the methods through which hospital capacity data could be submitted" and increasing "the number of required and optional reporting elements over time." According to GAO, "Reporting entities said they experienced multiple challenges implementing the changes including a lack of clarity on the requirements and logistical challenges such as having to adapt their systems to provide the data." Complying with these reporting requirements imposed a time burden on hospitals in excess of 1.5 hours per day.

Some Public Health Stakeholders Question the Quality and Usefulness of HHS Protect Data.

According to GAO, "some stakeholders raised concerns about HHS Protect data quality," including "several stakeholders [who] noted that they had higher confidence in [NHSN's] data quality than they do for HHS Protect data." The report stated: "Representatives from the public health stakeholder organizations we spoke with told us that they have not used the hospital capacity data in HHS Protect and instead rely on state and local data sources which they said were more useful for their purposes." For example, representatives from one epidemiological association told GAO that "their members did not find HHS Protect data useful for their purposes, noting that they require more granular data for case investigation than is available from HHS Protect."

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