On Monday, The New York Times reported that many public health officials around the country are overwhelmed — because they have had to rely on fax machines to distribute and collect data on the coronavirus pandemic, all coming in real-time from over half a million tests performed every day.
"As hard as the United States works to control coronavirus, it keeps running into problems caused by its fragmented health system, a jumble of old and new technology, and data standards that don’t meet epidemiologists’ needs," reported Sarah Kliff and Margot Sanger-Katz. "Health departments track the virus’s spread with a distinctly American patchwork: a reporting system in which some test results arrive via smooth data feeds but others come by phone, email, physical mail or fax, a technology retained because it complies with digital privacy standards for health information. These reports often come in duplicate, go to the wrong health department, or are missing crucial information such as a patient’s phone number or address."
One health department facing this problem is in Harris County, Texas — the largest county in a state where coronavirus cases are exploding and state officials are scrambling to roll back the reopening effort. Harris County has recorded over 40,000 cases so far.
"Public health officials in Houston are struggling to keep up with one of the nation’s largest coronavirus outbreaks. They are desperate to trace cases and quarantine patients before they spread the virus to others. But first, they must negotiate with the office fax machine," said the report. "The machine at the Harris County Public Health department recently became overwhelmed when one laboratory sent a large batch of test results, spraying hundreds of pages all over the floor."
Executive Director Dr. Umair Shah, who is even receiving some of the records at his personal fax, said Harris County just can't keep up. “From an operational standpoint, it makes things incredibly difficult,” he said. “The data is moving slower than the disease.”
"Large, national laboratories typically have software that allows them to communicate electronically with a wide range of hospitals and public health systems. But smaller labs, drawn to coronavirus testing by high payment rates, often don’t invest in expensive software packages when they can simply send data by fax instead," said the report. "Public health departments, whose budgets have been cut back over the past decade, were unable to finance the digital upgrades themselves."
For months, the principal challenge to the U.S. coronavirus response has been a lack of coronavirus testing — which was allegedly compounded by President Donald Trump ordering fewer tests to be conducted. But now that testing has been ramped up, the problem has instead become how to manage all the data, inform all the patients, and keep everything coordinated — and around the country, that is proving to be a gargantuan task.
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