According to Politico, the Trump administration's contracts with drug companies to produce a COVID-19 vaccine have transparency problems, with drug executives shielded from disclosing conflicts of interest.
"The arrangement, which is covered through a $611,500 contract for 'Operation Warp Speed,' raises more questions about the transparency of the pandemic response and the roles of outside contractors, including top coronavirus vaccine adviser Moncef Slaoui, who are helping steer the government's $10 billion development program," reported Dan Diamond. "It's also paying for several other consultants whose roles have not been previously reported, including Carlo de Notaristefani, a pharmaceutical industry veteran who the Department of Health and Human Services said is overseeing all of the program's manufacturing. As consultants, instead of political appointees, Slaoui and de Notaristefani can sidestep the ethics disclosures required of federal workers."
Slaoui's conflicts were first reported in May by The New York Times. He has declined to divest from his holdings, despite the controversy, and the Trump administration will not force him to do so.
According to the report, "The contract also covers William Erhardt and Rachel Harrigan, who are both former Pfizer executives. HHS declined to specify their tasks when asked about their roles; Harrigan is listed as a clinical adviser in the HHS directory."
“For a drug company executive with clear conflicts of interest who is already skirting government ethics rules to be given 'free' housing by a private contractor who was awarded a vague $600,000 government contract smacks of the kind of corruption that is unacceptable in any government program,” said Eli Zupnick, who is affiliated with progressive activist group Patients Over Pharma. “Examples like these are exactly why [Operation Warp Speed] needs to be brought out of the shadows.”
In a blunt-talking column for the Daily Beast, longtime political observer Mike Barnicle mocked Donald Trump for thinking he's a "wartime president," saying the president has done nothing but run from his responsibilities as the country is wracked by the coronavirus pandemic and millions have lost their jobs in an economy that is collapsing.
According to the MSNBC contributor, Trump is a "pretender in chief" who has never been up to the job, and now the country is waking up to the devastation he has brought about.
"Trump’s dreams of wearing that title—commander-in-chief—are both ludicrous and dangerous. Every hour of every day he is a walking, talking, tweeting threat to the national and global security of the United States," he wrote before listing off the following numbers to make his case: "Americans infected by the virus: 4,635,886. Americans dead from the virus: 155,330. Americans filing unemployment claims: 36 million. Americans collecting benefits: 25 million. Unemployment rate: 11.1 percent."
Writing, "That’s just a partial picture of the casualties the pretender-in-chief has left on the battlefield while he sulks in a parody of self-pity. The only thing he has in common with his idols like Patton and MacArthur is that both of those men were also aptly described by critics as 'media whores,'" Barnicle wrote and added that he is unaware of any time during the coronavirus pandemic where the president had offered any sincere expression of sympathy to the families of the COVID-19 victims while also noting the president's complete disregard for those who have lost their jobs and are facing possible eviction.
"He behaves as if millions of Americans, jobless with dwindling hope for a future they now measure by a clock instead of a calendar, are invisible to him. And they are because Trump is a stranger to loss, who’s never had any emotional connection to an element of life that connects all of us to its reality and inevitability," he accused before calling Trump a 'badly-damaged" individual.
The columnist then made his final case against the president.
"A fraud. A race-baiter. A loudmouth. A self-absorbed and self-deluded mini-demagogue who uses the tools of division and deception to puff himself up in front of the mirror," Barnicle wrote of the president. "And, perhaps more than anything, a coward who is afraid of eye-to-eye confrontation, a fraud who rants and pouts and pretends to be a leader as the noise of the rotor-blades of Marine One drown out his words while the lifeline of unemployment checks vanish as he golfs."
Lockdown measures in the UK were set to be further eased this weekend, but on Friday Britain "put the brakes on" those plans and imposed new rules on millions of households in northern England, following concerns over a spike in coronavirus infections.
The reopening of high-risk activities such as casinos, bowling alleys and skating rinks, which was meant to begin on Saturday, will be delayed until at least August 15, as will the reintroduction of indoor performances and pilot schemes of larger crowds at sporting events, Prime Minister Boris Johnson announced.
"I have said our plan to reopen society and the economy is conditional... that we would not hesitate to put the brakes on if required. Our assessment is that we should now squeeze that brake pedal," he told a Downing Street briefing.
Johnson, who earlier this week warned of a "second wave" of cases in Europe, added that Britain "cannot be complacent" about increasing infection numbers.
Increase in new infections
His announcement came hours after the government increased regional lockdown measures – under which people from different households are banned from meeting indoors – for some four million people across Greater Manchester and parts of Lancashire and Yorkshire.
Health Secretary Matt Hancock said the restrictions were being brought in because people were "meeting and not abiding (by) social distancing".
"We take this action with a heavy heart, but we can see increasing rates of Covid across Europe and are determined to do whatever is necessary to keep people safe," Hancock said on Twitter.
Government data Friday showed there was "some evidence that the incidence of new infections has increased in recent weeks" in England.
Chief Medical Officer Chris Whitty said: "I don't think it is helpful" to talk yet of a second wave sweeping across Europe, but admitted the actions taken so far to ease restrictions were "at the edge" of what could be done safely.
"The idea that we can open up everything and keep the virus under control is clearly wrong and what we're seeing is that we're at the outer edge of what we can do," he said.
The opposition Labour party warned that the delayed reopening of parts of the economy could have dire consequences for workers and called on the government to help those affected.
"With millions of workers still furloughed, including those in casinos, night clubs, ice rinks and bowling alleys, the government's one-size-fits-all plan risks accelerating the jobs crisis," said MP and former party leader Ed Miliband.
The local lockdown measures came into effect at midnight (23:00 GMT Thursday), just hours after being announced.
Andy Burnham, the mayor of Manchester, backed the measures due to the increase in infections.
"The picture in Greater Manchester has changed over the last seven days," he told the BBC.
"We have a rise in nine out of the 10 boroughs, the reality on the ground is changing."
Scots should avoid Manchester
The new measures were also criticized by Labour for being announced late at night.
Labour leader Keir Starmer said on Twitter: "Announcing measures affecting potentially millions of people late at night on Twitter is a new low for the government's communications during this crisis."
The measures also came into force just as celebrations of the Muslim festival Eid al-Adha began. Areas affected by the latest lockdown have significant Muslim populations.
Scottish First Minister Nicola Sturgeon meanwhile warned her citizens against travelling to the affected areas.
"To... minimize risks of onward transmission here, @scotgov is STRONGLY advising against non-essential travel between Scotland and these parts of the north of England," she wrote on Twitter.
It is not the first local lockdown – England has lifted most of its restrictions nationally but imposed store closures around the central city of Leicester at the end of June.
Britain's official virus death toll stands at 45,999 but is believed to be as high as 65,000 if excess deaths are used as a guide.
A global pandemic ravaging America is no time to forget the first rule of American health care: There is no set price. One out-of-network medical provider in Texas seeks permission from patients to charge fees as high as six figures to their insurance.
As she waited for the results of her rapid COVID-19 test, Rachel de Cordova sat in her car and read through a stack of documents given to her by SignatureCare Emergency Center.
Without de Cordova leaving her car, the staff at the freestanding emergency room near her home in Houston had checked her blood pressure, pulse and temperature during the July 21 appointment. She had been suffering sinus stuffiness and a headache, so she handed them her insurance card to pay for the $175 rapid-response drive-thru test. Then they stuck a swab deep into her nasal cavity to obtain a specimen.
De Cordova is an attorney who specializes in civil litigation defense and maritime law. She cringes when she’s asked to sign away her rights and scrutinizes the fine print. The documents she had been given included disclosures required by recent laws in Texas that try to rein in the billing practices of stand-alone emergency centers like SignatureCare. One said that while the facility would submit its bill to insurance plans, it doesn’t have contractual relationships with them, meaning the care would be considered out-of-network. Patients are responsible for any charges not covered by their plan, it said, as well as any copayment, deductible or coinsurance.
The more she read, the more annoyed de Cordova became. SignatureCare charges a “facility fee” for treatment, the document said, ranging “between five hundred dollars and one hundred thousand dollars.” Another charge, the “observation fee,” could range from $1,000 to $100,000.
De Cordova didn’t think her fees for the test could rise into the six figures. But SignatureCare was giving itself leeway to charge almost any amount to her insurance plan — and she could be on the hook. She knew she couldn’t sign the document. But that created a problem: She still needed to get her test results.
Even in a public health emergency, what could be considered the first rule of American health care is still in effect: There is no set price. Medical providers often inflate their charges and then give discounts to insurance plans that sign contracts with them. Out-of-network insurers and their members are often left to pay the full tab or whatever discount they can negotiate after the fact.
A portion of the document given to Rachel de Cordova at SignatureCare highlighted by ProPublica describes fees for the “facility” and “observation” that could reach $100,000 each.Photo credit: Obtained by ProPublica
The CARES Act, passed by Congress in March, includes a provision that says insurers must pay for an out-of-network COVID-19 test at the price the testing facility lists on its website. But it sets no maximum for the cost of the tests. Insurance representatives told ProPublica that the charge for a COVID-19 test in Texas can range from less than $100 to thousands of dollars. Health plans are generally waiving out-of-pocket costs for all related COVID-19 treatment, insurance representatives said. Some costs may be passed on to the patient, depending on their coverage and the circumstances.
As she waited, de Cordova realized she didn’t want to play insurance roulette. She changed her mind and decided she’d pay the $175 out-of-pocket for her test. But when the SignatureCare nurse came to collect the paperwork, de Cordova said the nurse told her, “You can’t do that. It’s insurance fraud for you to pay for our services once we know you have insurance.”
Dr. Hashibul Hannan, an emergency room physician, lab director and manager at SignatureCare, told ProPublica his facility is an emergency room that offers testing, not a typical testing site. He said de Cordova should have been allowed to pay the $175 cash price. The staff members were concerned about being accused of fraud because they had already entered her insurance information into the record, he said. So they didn’t want it to appear she was being double-billed. Hannan also said he regrets that she was upset by the disclosure forms that are now required under state law.
Unable to pay cash and unwilling to take a chance on the unknown cost, de Cordova decided to leave without getting the results of her COVID-19 test.
“I would have signed anything”
Later that day, de Cordova couldn’t get past what happened. She wondered what happened to patients who didn’t read the fine print before signing the packet.
Then she realized she and her husband, Hayan Charara, could investigate it themselves. In June, the couple’s 8-year-old son had attended a baseball tryout. They thought the kids would be socially distanced and that precautions would be taken. But then the coaches had crowded the players in a dugout, with no masks or social distancing, and a couple days later the boy said he wasn’t feeling well.
So just to be safe, on June 12, Charara took their son to the same SignatureCare, the Heights location, for a COVID-19 test. The line was so long they had to wait for hours, go home, come back and wait for hours again in their car in the 100-degree heat. Charara, a poet who teaches at the University of Houston, said he didn’t take a close look at the financial disclosure paperwork. De Cordova wasn’t with them. It had been 10 hours of waiting by the time the boy was tested, so “I would have signed anything,” he said. (The child tested negative.)
Charara, de Cordova and their children are covered by the Employees Retirement System of Texas, a taxpayer-funded benefit plan that covers about half a million people. They hadn’t received any notices about the charges for their son. So they contacted the SignatureCare billing department and asked for an itemized statement. The test charge was indeed $175. But the total balance, including the physician and facility fees associated with an emergency room visit, came to $2,479.
The facility fee was $1,784 and the physician fee $486.
The couple were dumbfounded. Their son’s vital signs had been checked but there had been no physical examination, they said. The interactions took less than five minutes total, and the child stayed in the car. “You’re getting a drive-thru test, and they’re pretending like they’re giving you emergency services,” de Cordova said.
The statement for de Cordova’s son’s evaluation and $175 COVID-19 test came to $2,479 after fees added by SignatureCare. Photo credit: Obtained by ProPublica
The SignatureCare charges shocked experts who study health care costs. Charging $2,479 for a drive-thru COVID-19 test is a “nauseating” example of profiteering during a pandemic, said Niall Brennan, president and CEO of the Health Care Cost Institute, a nonprofit organization that studies health care prices. “It’s one of the most egregious examples of giving the fox the keys to the henhouse I’ve ever seen and yet another example of the absurdity of U.S. health care pricing.
“Imagine a vendor in any other walk of life being allowed to bill a third party for whatever amount they wanted,” Brennan said.
Insurance companies in Texas typically pay between $100 and $300 for drive-thru COVID-19 tests, said Jamie Dudensing, CEO of the Texas Association of Health Plans. But the association’s members have seen hundreds of out-of-network COVID-19 test charges come in far higher, some in the thousands of dollars.
“There’s no excuse for that, especially in a public health crisis,” said Chris Callahan, spokesperson for Blue Cross and Blue Shield of Texas, which likewise has seen high charges for COVID-19 tests from out-of-network providers.
The reimbursement rates negotiated between insurance companies and in-network providers are much lower, but they still vary, according to data provided by the nonprofit FAIR Health, which tracks spending by private insurers. For the same test billed by SignatureCare, an in-network insurer pays a median price of $23 in Utah and $75 in Wisconsin, according to FAIR Health estimates.
Texas is notorious for its high-priced out-of-network emergency bills and free-standing emergency departments. Some of the facilities appear to be using COVID-19 testing to draw in patients so their insurance plans can be charged for additional services, said Blake Hutson, associate state director for AARP Texas, the advocacy organization for older Americans. “It’s not a surprise they would be racking up the charges and adding on everything they can and billing the health plan,” he said.
In some cases, insurers do pay the exorbitant out-of-network charges, Hutson said, but they typically get reduced. In 2019, Texas lawmakers voted to ban billing patients in state-regulated insurance plans for charges not covered by their policy, Hutson said, which is known as “balance” or “surprise” billing. But consumers may still be responsible for any deductibles and other cost-sharing under their health plan. And the costs covered by the health plan get passed back to the consumers over time in the form of higher premiums, he said. “It’s all problematic for the cost of care,” Hutson said.
Hannan defended SignatureCare’s high out-of-network charges by blaming insurance companies for refusing to give what he considers to be fair in-network rates. The charges are a starting point for negotiating a fair deal from out-of-network insurance plans, he said. He described SignatureCare, which has 18 locations, as “small players. When it comes to negotiating with insurance companies, we have no luck.”
Was the statement accurate?
The medical record portrays the visit as an emergency and contains details that are not consistent with how Charara and de Cordova describe their son’s condition. The chief complaint in the record is “body fluid exposure,” and elsewhere it says “confirmed COVID exposure.”
But that’s not accurate, according to the parents. No one had coughed or sneezed on their son, and they knew of no one from the tryout who had tested positive for COVID-19, they said. The child’s temperature is registered in the record as 102.8, which is high. But Charara said that could have been caused by sitting in the Texas heat, waiting for the test.
Shelley Safian, a Florida health care coding expert who has written four books on medical billing, examined the bill and medical records of Charara and de Cordova’s son at ProPublica’s request. She said the medical records don’t justify the charges. SignatureCare billed the case as if the exam were an emergency that required an “expanded problem focused history” and “medical decision making of moderate complexity,” she said.
In order to qualify for reimbursement of an exam at that level, the encounter would need to include examining the affected organ system, Safian said. But the medical records do not document any check of the respiratory system, which would be indicated for suspected COVID-19.
Much of the medical record appeared to be cut and pasted from other electronic records, Safian said. “This is boilerplate B.S.,” she said, “and I don’t mean ‘bachelor of science.’”
Hannan, the SignatureCare doctor and manager, stands by the charges associated with the child’s COVID-19 test. The facility has to treat every case like a possible emergency, and that requires an examination, he said. He pointed out that the charges are in line with what other out-of-network providers would charge in the area, according to FAIR Health, though they are far higher than in-network prices.
A doctor’s examination may not be as hands-on during COVID-19, but, similar to a telemedicine visit, a lot can be examined visually, Hannan said. Hannan said the company he uses for coding said COVID-19 requires a higher level of care and vigilance because it’s an infectious disease.
In light of the questions raised by ProPublica and Safian, Hannan said he asked his billing company to audit the charges. Sharon Nicka, president and CEO of Nicka and Associates, the billing company used by SignatureCare, took issue with Safian’s assessment and said the billing codes used were justified by the medical record. She said the charges are high for a drive-thru test, but those are set by SignatureCare.
ProPublica identified several apparent errors and contradictions in the medical record and billing documentation. For example, the notes in the medical record alternatively refer to the boy as “symptomatic” and “asymptomatic.” The record also says the physical exam showed a skin wound that “was not red, swollen or tender,” but the child had no wound of any kind, the family said. And the billing documentation shows a charge for an antibody test when the medical record showed that the patient actually received a diagnostic test, which is something different.
In response to ProPublica’s questions, a SignatureCare medical director reviewed the record. The error about the “wound” may have been caused by a software template adding something that was not in the physician chart, the reviewer wrote. The facility now uses a different template. The charge for the antibody test is likely a billing error, as the physician had ordered the correct test, the reviewer wrote. “We will continue to update and improve our (electronic medical records),” the reviewer said.
Hannan stressed that SignatureCare is upfront with patients about the possible fees associated with its treatment, including the disclosure paperwork and explanations on its website. It’s an emergency room, he said, so patients should expect emergency room fees. Patients who do not have a medical emergency should not come, he said, though the ER allows patients to book appointments a day in advance for a COVID-19 test.
Dudensing, the chief executive of the Texas Association of Health Plans, said she’s heard Hannan’s contention before and it’s true that freestanding emergency rooms have a license that allows them to charge more. But she still believes that they handle many nonemergency cases and are forcing facility fees of thousands of dollars on them. “They’re hiding under the guise of emergency rooms when they’re really dressed-up urgent care,” she said.
Diana Kongevick, director of group benefits for the Employees Retirement System of Texas, said the health plan had only recently received the bill for the 8-year-old’s test. It hadn’t been processed, so she could not speak to it directly. But, in general, the health plan will pay 100% of the cost of the test, in this case $175, she said. The claim would be processed using out-of-network provisions, she said. So for the other charges, the patient may be responsible for paying in the range of $600, she estimated, for the out-of-network copay and deductibles. “This is a nonemergent patient self-referral to an out-of-network provider,” Kongevick said.
“Testing should be free”
Even if the Employees Retirement System of Texas determines that Charara and de Cordova should pay $600 for their son’s test, SignatureCare will not be sending the family a bill, Hannan said. He said insured patients are not being sent bills for COVID-19 treatment beyond what their insurance companies cover.
De Cordova never did get her test results, and she didn’t seek a test elsewhere. She felt better later and now believes she had just been suffering from allergies. But what if it had turned out to be COVID-19, she wondered. Might she have gone on to infect others, she’s asked herself.
From a public health perspective, the haggling about out-of-network charges and payments puts patients in the middle, and it might discourage them from getting tested for COVID-19 during the pandemic, said Stuart Craig, an economist at the University of Pennsylvania who studies health care costs. “It’s another part of the fragmentation of the health care system that makes patients’ lives miserable,” Craig said.
It’s especially frustrating, he said, because COVID-19 testing is so essential to making it safely through the pandemic. Craig said he believes there should be a nationally mandated price and government subsidies to make sure medical providers and manufacturers are motivated financially to provide tests. “Testing should be free,” Craig said. “In fact, we should probably be paying patients to get tested.”
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Disclosure: The University of Houston, the Texas Association of Health Plans, Blue Cross and Blue Shield of Texas, and AARP Texas have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.
MSNBC anchor Lawrence O'Donnell on Friday presented what he described as a "Friday night thought exercise" on the 2020 presidential election.
"If Ivanka Trump had married Sean Penn, would Donald Trump be on his way to a re-election victory tonight?" O'Donnell asked.
"Okay, stay with me here, this will only take a minute," he continued. "And Sean, if you are watching, don't worry -- you are going to be okay with where this ends up."
He then laid out his case for why Ivanka should've married the actor, who has been married to Madonna and Robin Wright.
"We have a coronavirus testing crisis in this country tonight because Ivanka Trump married Jared Kushner, who history will surely judge to be the second-worst human being working in the Trump White House, second only to Donald Trump and, yes, worse than Stephen Miller because Jared Kushner's wedding ring gives him more power than Steven Miller."
"Jared Kushner should be one of the millions of private citizens with no medical training who has no idea what to do who is just watching the coronavirus battle from the civilian sidelines. Sean Penn is a private citizen with no medical training who has done more than any other private citizen with no medical training to get people tested for coronavirus in this country," he explained.
"Sean Penn started with one pilot program close to home for him in California, and his organization, CORE, is now running 44 testing sites throughout the country, including mobile units within the Navajo Nation," he continued. "But because Ivanka Trump married Jared Kushner, there is no national testing program and because of that Donald Trump is far behind Joe Biden in the polls."
Former photography pioneer Kodak received a huge infusion of cash from President Donald Trump this week.
But it is what happened one day before that is raising eyebrows.
"At the beginning of this week, the Eastman Kodak Company handed its chief executive 1.75 million stock options," The New York Timesreported Friday.
"It was the type of compensation decision that generally wouldn’t attract much notice, except for one thing: The day after the stock options were granted, the White House announced that the company would receive a $765 million federal loan to produce ingredients to make pharmaceuticals in the United States," the newspaper reported. "The news of the deal caused Kodak’s shares to soar more than 1,000 percent. Within 48 hours of the options grants, their value had ballooned, at least on paper, to about $50 million."
This is not the first time something like this has happened during the Trump administration.
"The options grant to Kodak’s executive chairman and chief executive officer, Jim Continenza, is the latest example of executives and board members at companies receiving such federal support to benefit from extraordinarily good timing. A number of those companies are involved in the hunt for vaccines and treatments for Covid-19," The Times reported. "Insiders at Vaxart, for example, received stock options shortly before the California biotech company announced in June that its potential coronavirus vaccine was being tested in a program organized by a federal agency, causing its shares to instantly double."
Anthony Fauci, the United States' top infectious disease official, raised concerns Friday regarding the safety of COVID-19 vaccines under development by China and Russia.
Several Chinese companies are at the forefront of the global vaccine race, while Russia has said it hopes to be the first in the world to produce a vaccine for the public, with a target date of September.
But the medicines will likely face heightened scrutiny given that the regulatory systems in both countries are far more opaque than they are in the West.
Fauci, who was asked during a Congressional hearing whether the US could make use of Chinese or Russian vaccines if they arrived first, indicated that was unlikely.
"I do hope that the Chinese and the Russians are actually testing the vaccine before they are administering the vaccine to anyone," he said.
He added: "Claims of having a vaccine ready to distribute before you do testing, I think, is problematic, at best.
"We are going very quickly. I do not believe that there will be vaccines, so far ahead of us, that we will have to depend on other countries to get us vaccines."
Last month, Chinese media announced a coronavirus vaccine developed by CanSino Biologics was being used to immunize the Chinese military -- making it the first approved for people, albeit in a limited population.
Many scientists however raised ethical concerns because the vaccine has not yet begun its final stages of testing.
- 'Sputnik moment'? -
Two other Chinese companies Sinovac and Sinopharm, have launched final phase three trials in Brazil and the United Arab Emirates, respectively.
China, where the virus originated, has largely brought its outbreak under control and has therefore had to turn to other countries to test its vaccines.
The trials in Brazil and the UAE will be watched particularly closely, given China's history of vaccine and other health scandals.
In 2018, more than 200,000 children were administered a defective vaccine for diphtheria, tetanus and whooping cough (DPT) that caused paralysis in a few cases.
Russia, which was once a global vaccine leader during Soviet times, aims to bring two to market by September and October, respectively.
The first is being developed by the Moscow-based Gamaleya institute and the defense ministry, and the second by the Vektor state laboratory near the Siberian city of Novosibirsk.
Russia has released no scientific data proving the vaccines' safety or efficacy.
Nevertheless, Kirill Dmitriev, the head of Russia's sovereign wealth fund which is financing the Gamaleya trials, told CNN: "It's a Sputnik moment."
Sputnik was the world's first satellite launched by Russia in 1957.
Three Western coronavirus vaccines are in final phase three trials.
One is produced by US biotech firm Moderna and the National Institutes for Health; one by the University of Oxford and Britain's AstraZeneca; and the last by Germany's BioNTech with US pharmaceutical Pfizer.
China and Russia both stand accused of attempting to steal Western coronavirus research -- charges they deny.
President Donald Trump was personally involved in sending a mailer to 130 million households, according to administration emails obtained by The New York Times.
"In accusing the administration of politicizing the Postal Service, the president’s critics point to a recent decision to send a mailer detailing guidelines to protect against the coronavirus. The mailer, which featured Mr. Trump’s name in a campaignlike style, was sent in March to 130 million American households at a reported cost of $28 million," the newspaper reported.
One email was sent from John M. Barger, a governor of the postal system, to the postmaster general.
“I know that POTUS personally approved this postcard and is aware of the USPS effort in service to the nation — pushing information out to every household, urban and rural,” Barger wrote.
The newspaper interviewed S. David Fineman, who served on the board during the Bill Clinton and George W. Bush administrations.
“I’ve never seen anything quite like this,” Fineman said. “No one would have thought that we would have sought the input of the administration.”
In mid-July, the Trump administration instructed hospitals to change the way they reported data on their coronavirus patients, promising the new approach would provide better, more up-to-the-minute information about the virus’s toll and allow resources and supplies to be quickly dispatched across the country.
Instead, the move has created widespread confusion, leaving some states in the dark about their hospitals’ remaining bed and intensive care capacity and, at least temporarily, removing this information from public view. As a result, it has been unclear how many people are in hospitals being treated for COVID-19 at a time when the number of infected patients nationally has been soaring.
Hospitalizations for COVID-19 have been seen as a key metric of both the coronavirus’s toll and the health care system’s ability to deal with it.
Since early in the pandemic, hospitals had been reporting data on COVID-19 patients to the U.S. Centers for Disease Control and Prevention through its National Healthcare Safety Network, which traditionally tracks hospital-acquired infections.
In a memo dated July 10, the U.S. Department of Health and Human Services told hospitals to abruptly change course — to stop reporting their data to the CDC and instead to submit it to HHS through a new portal run by a company called TeleTracking. The change took effect within days. Vice President Mike Pence said the administration would continue releasing the data publicly, as the CDC had done.
Almost immediately, the CDC pulled its historical data offline, only to repost it under pressure a couple days later. Meanwhile the website for the administration’s new portal promised to update numbers on a daily basis, but, as of Friday morning, the site hadn’t been updated since July 23. (HHS is posting some data daily on a different federal website but not representative estimates for each state.)
“The most pernicious portion of it is that at the state level and at the regional level we lost our situational awareness,” said Dave Dillon, spokesman for the Missouri Hospital Association. “At the end of this, we may have a fantastic data product out of HHS. I will not beat them up for trying to do something positive about the data, but the rollout of this has been absolutely a catastrophe.”
The Missouri Hospital Association had taken the daily data submitted by its hospitals to the CDC and created a state dashboard. The transition knocked that offline. The dashboard came back online this week, but Dillon said in a follow-up email, “the data is only as good as our ability to know that everyone is reporting the same data, in the correct way, for tracking and comparison purposes at the state level.”
Other states, including Idaho and South Carolina, also experienced temporary information blackouts. And The COVID Tracking Project, which has been following the pandemic’s toll across the country based on state data, noted issues with its figures. “These problems mean that our hospitalization data — a crucial metric of the COVID-19 pandemic — is, for now, unreliable, and likely an undercount. We do not think that either the state-level hospitalization data or the new federal data is reliable in isolation,” according to a blog post Tuesday on the group’s website.
Making matters more complicated, the administration has changed the information that it is requiring hospitals to report, adding many elements, such as the age range of admitted COVID-19 patients, and removing others. As of this week, for instance, HHS told hospitals to stop reporting the total number of deaths they’ve had since Jan. 1, the total number of COVID-19 deaths and the total number of COVID-19 admissions. (Hospitals still report daily figures, just not historical ones.)
“Massachusetts hospitals are continuing to navigate the dramatic increase of daily data requirements,” the Massachusetts Health and Hospital Association said in a newsletter on Monday. “MHA and other state health officials continue to raise concerns about the administrative burden and questionable usefulness of some of the data.”
“Hospitals across the country were given little time to adjust to the unnecessary and seismic changes put forth by the U.S. Department of Health and Human Services, which fundamentally shift both the volume of data and the platforms through which data is submitted,” the association’s CEO, Steve Walsh, said in the newsletter.
A number of state websites also noted problems with hospital data. For days, the Texas Department of State Health Services included a note on its dashboard that it was “reporting incomplete hospitalization numbers … due to a transition in reporting to comply with new federal requirements.” That came just as the state was experiencing a peak in COVID-19 hospitalizations.
A spokesperson for HHS acknowledged some bumps in the transition but said in an email: “We are pleased with the progress we have made during this transition and the actionable data it is providing. We have had some states and hospital associations report difficulty with the new collection system. When HHS identifies errors in the data submissions, we work directly with the state or hospital association to quickly resolve them.
“Our objective with this new approach is to collaborate with the states and the healthcare system. The goal of full transparency is to acknowledge when we find discrepancies in the data and correct them.”
Last week, HHS noted, 93% of its prioritized list of hospitals, excluding psychiatric, rehabilitation and religious nonmedical facilities, reported data at least once during the week. (The guidance to hospitals asks them to report every day.)
Asked about the lack of timely data on its public website, HHS said it will update the site to “make it clear that the estimates are only updated weekly.” HHS is now posting a date file each day on healthdata.gov with aggregate information on hospitalizations by state.
But unlike the prior releases from CDC, which provided estimates on hospital capacity based on the responses, this file only gives totals for the hospitals that reported data. It’s unclear which hospitals did not report, how large they are, or whether the reported data is representative.
It’s also unclear if it’s accurate. New York state, for instance, reported that fewer than 600 people were currently hospitalized with COVID-19, as of Friday. Federal data released the same day pegged the number of suspected and confirmed COVID-19 hospitalizations at around 1,800.
Louisiana says more than 1,500 people are currently hospitalized with COVID-19. The federal data puts the figure at fewer than 700.
Nationally, The COVID Tracking Project reports that more than 56,000 people were hospitalized around the country with the virus, as of Thursday.
The data released by HHS on Friday puts the figure at more than 70,000.
NPR reported this week that it had found irregularities in the process used by the Trump administration to award the contract to manage the hospital data. Among other things, HHS directly contacted TeleTracking about the contract and the agency used a process that is more often used for innovative scientific research, NPR reported.
An HHS spokesperson told NPR that the contract process it used is a “common mechanism ... for areas of research interest,” and said that the system used by the CDC was “fraught with challenges.”
Ryan Panchadsaram, co-founder of the tracking website CovidExitStrategy.org, has been critical of the problems created by the hospital data changeover.
“Without real-time accurate monitoring, you can’t make quick and fast and accurate decisions in a crisis,” he said in an interview. “This is just so important. This indicator that’s gone shows how the health system in a state is doing.”
Dillon of the Missouri Hospital Association said the administration could have handled this differently. For big technology projects, he noted, there is often a well-publicized transition with information sessions, an educational program and, perhaps, running the old system and the new one in parallel.
This “was extremely abrupt,” he said. “That is not akin to anything you would expect from HHS about how you would implement a program.”
State Rep. Tony Tinderholt was hospitalized last week after testing positive for the novel coronavirus, the lawmaker confirmed Friday to The Texas Tribune, marking the first known case involving a member of the Texas Legislature.
"I truly thought last Friday was gonna be my last," Tinderholt, an Arlington Republican, said in a text message to the Tribune. Tinderholt said his wife and two of his children also tested positive for the virus, though their symptoms were less severe.
Tinderholt said he is recovering after receiving medical treatment from a North Texas doctor. He and his family wore masks every time they went out in public because they felt it was the right thing to do, he said.
"I would like for people to try to mitigate risk by wearing masks," he said. "But wear them because you think it's right. I'm sure it works to some degree — it just didn't for me."
Medical experts and doctors have recommended wearing masks to reduce the spread of the virus, with recent research suggesting that wearing one could lessen the severity of symptoms or stop someone from catching it entirely.Research has also shown that face coverings such as masks are most effective at reducing spread when a higher number of people in a community participate in wearing them.
Tinderholt is a member of the hardline conservative House Freedom Caucus, which has frequently criticized Gov. Greg Abbott's response to the pandemic — shutting down businesses and requiring masks in public — as government overreach.
In an April 24 letter to the governor, the caucus urged Abbott to "fully reopen" the state economy, arguing that the longer he waited to reopen, the longer it would take to recover.
"Too many jobs have been lost; too many sit at home as their livelihoods wither away, uncertain if they'll be able to pay their mortgage or buy groceries next week," read the letter, which included recommendations on how to reopen safely. "We must rebuild this economy by allowing those who built it in the first place to reopen."
While Tinderholt acknowledged the virus is a "serious illness," he reiterated Fridayhis position that Abbott shutting down parts of the economy is wrong.
"Closing the entire economy and halting business as well as illegally taking people's freedoms are absolutely the wrong things to do to Texas, Texans and our nation," Tinderholt said.
Tinderholt said his recovery was largely thanks to state Sen. Bob Hall, R-Edgewood, who referred him to Dr. Brian Procter of McKinney Family Medicine. Procter, Tinderholt said, told him that out of the few hundred patients he has seen so far for the coronavirus, the lawmaker was among "the worst five he had handled." Tinderholt said he was considered at risk for the virus due to his titanium aortic heart valve.
Tinderholt's first day of symptoms, he said, consisted of mild joint pain that soon turned into severe pain accompanied by bad headaches and a loss of taste and smell. Now, in recovery, he said he has nausea and a cough with slight breathing difficulties. He said he does not know how he caught it.
MSNBC anchor Nicolle Wallace on Friday reported on the "panicky behavior" exhibited by President Donald Trump as coronavirus fatalities continue to surge while the economy is in shambles.
Wallace noted a report by New York Times chief White House correspondent Peter Baker on Trump's complaints about the legitimacy of the election.
"It is the kind of language resonant of conspiracy theorists, cranks and defeated candidates, not an incumbent living in the White House. Never before has a sitting president of the United States sought to undermine public faith in the election system the way Mr. Trump has," Baker wrote. "He has refused to commit to respecting the results and, even after his election-delay trial balloon was panned by Republican allies, he raised the specter on Thursday evening of months of lawsuits challenging the outcome."
David Jolly, served as a Republican congressman representing Florida, explained what we are seeing.
"There's a saying in politics that fish always flop around before they die -- you see candidates engage in erratic behavior when they know they're going to lose," he explained.
In the wake of a threatening online rant from anti-LGBT pastor Greg Locke, Dunkin' Donuts has announced that it will now require customers to wear masks in all its stores.
In the video, Locke said he had threatened to knock a Dunkin’ Donuts employee’s teeth down his throat. The video has been viewed nearly 6 million times on Facebook. Locke said the employee, who he called “Nazi Skippy,” asked him to wear a mask the next time he’s in the store. When Locke pushed open the door with his foot on the way out, the employee allegedly falsely accused him of trying to break the door's glass.
“I said, ‘If you call me a liar one more time, I’m going to take these work boots and I’m going to kick your teeth down your throat,'” Locke said in his rant, which according to Towerload is a confession to a possible crime.
"Locke, a staunch anti-masker and full-fledged COVID-19 denier, said in another video this week that he will go to jail before halting services at Global Vision Bible Church in Mount Juliet, Tennessee, due to the coronavirus pandemic, which he calls a hoax," Towerload reports. "In his video about the Dunkin’ Donuts incident, he said he’s also willing to go to jail over mask requirements."
“This is the United States of America! Y’all hear me? Trump 2020!” Locke said.
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