Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.
Hospitals Strong-Armed into Using New Data Reporting System
The Trump administration bullied hospitals into reporting their COVID-19 data to the Department of Health and Human Services (HHS) — rather than to the CDC as they previously did — by tying their CARES Act funding to doing so, the New York Times reports.
The Times uncovered an email from HHS Secretary Alex Azar’s office in April effectively ordering hospitals to report their data to TeleTracking Technologies, a Pittsburgh company with a $10.2 million, five-month government contract, in order to receive CARES Act funds. “Please be aware that submitting this data will inform the decision-making on targeted Relief Fund payments and is a prerequisite to payment,” the email stated.
In July, HHS finally ordered hospitals directly to report daily coronavirus data to TeleTracking, raising alarms among public health experts as the CDC had previously been managing such reporting via its National Healthcare Safety Network.
Critics charged that money and politics were behind the new reporting system. The nonpartisan COVID Tracking Project has called federal hospital data “unreliable,” while the Association of American Medical Colleges’ chief medical officer said data and maps published on HHS’ project data hub are “just not as sophisticated as the CDC.”
“The fear of having their data leaked or misused or used for a purpose that they weren’t aware of or agreed to — I think that’s the biggest rub,” Patina Zarcone, MPH, director of informatics for the Association of Public Health Laboratories, told the Times.
Public Health Cuts Left Florida Vulnerable to Pandemic
Years of gutting public health funding left Florida vastly unprepared for the pandemic, according to a report by Kaiser Health News and the Associated Press.
While the state’s population increased by 2.4 million from 2010-2019, staffing at local health departments has decreased from 12,422 full-time equivalent workers to 9,125. After spending peaked in the late 1990s, the departments spent 41% less per resident in 2019 than 2010 ($34 vs $57), adjusting for inflation. By comparison, departments nationally cut spending by an average of 18% over that span.
The public health department in Duval County, for example, has been “dismantled to the extent that it could not really manage an outbreak,” Jeff Goldhagen, MD, a former county health director, told the news outlets. “Dismantling the system was a complete disregard for the health and well-being of the citizens of Florida.”
“The reality, unfortunately, is people are going to die because of the irresponsibility of the decisions being made by the people crafting the budgets,” said Ron Bialek, MPP, president of the Public Health Foundation. “Public health can’t help us get out of this situation without our elected officials giving us the resources.”
The least staffed public health offices in the state per capita reside in the counties with the most people, including the counties where Miami, Tampa, Jacksonville, and Orlando are located.
Insiders and analysts blamed the Great Recession and a succession of republican governors who de-emphasized public health spending in favor of hiring private companies. A 2011 public health workforce survey showed budget cuts and lack of money were the most-cited challenges; the state then suffered some of the nation’s highest rates of heart disease and diabetes over the following years.
Rick Scott, the state’s governor from 2011-2019, is unapologetic about the cuts, saying they were “making government more efficient” without endangering public health.
“Current events demonstrate how bad a decision” the cuts were, said Marissa Levine, MD, a professor of public health and family medicine at the University of South Florida. “It’s really come back to haunt us.”
Pfizer COVID Vaccine Leader Has Solid Track Record
The woman leading Pfizer’s COVID-19 vaccine development is an experienced scientist who led the development of the world’s two best-selling vaccines at two different companies, STAT reports.
Kathrin Jansen, PhD, leads Pfizer’s vaccine development program and is supervising a 650-person team across Pfizer and its COVID vaccine partner, BioNTech, which is based in Germany.
A native of Germany, Jansen pushed Merck to cultivate Gardasil, which was approved in 2006.
At Wyeth, which became a Pfizer subsidiary in 2009, she helped develop the Prevnar 13 pneumococcal vaccine, approved for children in 2010 and older adults in 2012. It has thus far generated $5.8 billion in sales this year, making it the best-selling vaccine worldwide and Pfizer’s best-selling product.
Jansen and those who have worked with her promised she is being diligent now. “She will not sacrifice quality for speed. In other words, it’s got to be right,” said William Gruber, a longtime Pfizer vaccine executive.
The race to develop a COVID vaccine reminds her of the arduous process to develop Gardasil in the early 2000’s. “There were many people who thought this couldn’t work, and of course, they were wrong,” she said.
Said Paul Offit, MD, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, of Jansen: “She’s exactly who you want in that position.”