Health care experts have anxiously watched the recent surge in COVID-19 cases threatening to overwhelm hospitals in places like Florida and Texas.
Missouri has also reached record high daily counts of new cases, but the Missouri Hospital Association won’t release its latest data report until July 1, eleven days since the last day for which data is available.
Delays and slow reporting of this hospital data, which include numbers of available beds and supplies of personal protective equipment, as well as virus trends for various parts of the state, are problematic because they make it harder for the public and policymakers to respond to the virus.
“You have to remember that most of social distancing was premised on the on the point of trying to preserve hospital capacity,” says Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security. “In order to preserve hospital capacity, you have to have a very granular knowledge of that hospital capacity at any given hour of the day.”
In mid-June, the hospital association changed the way it reports data, going from daily statewide reports to weekly regional reports with more comprehensive information.
However, the switch to new reporting also means information is provided on a less frequent basis, which hospital association spokesperson Dave Dillon acknowledged.
“Each pivot on reporting takes time to implement, but we are actively engaged with partners to figure out how to best deliver the data stakeholders need as quickly as possible,” Dillon wrote in an email.
Individual hospitals’ reporting of data to the association has been delayed and incomplete, resulting in daily reports that have been at times inconsistent and misleading.
County and local health departments generally provide limited data about hospitalizations. Jackson County's health department, for example, provides total numbers of patients hospitalized but does not show trends.
The daily hospitalization rates reported by the Missouri Department of Health and Senior Services, meanwhile, have shown confusing trends.
Recent updates show that on Wednesday, June 24, for example, the number of hospitalization jumped from 527 to 680, a sharp increase after weeks of relatively stable hospital activity.
But the next day, the reported number of patients hospitalized dropped to 412, the lowest number since mid-April. Such a decline would suggest that nearly 40% of hospitalized COVID-19 patients were released on the same day.
Such inconsistencies can result from changes in reporting methods, according to Johns Hopkins researcher Adalja, but they can undermine the public’s trust in health agencies.
“In this environment, where there is a lot of misinformation and conspiracy theories, it’s really important that people can trust the data, and that when there are data changes like that, that they are explained and not seem to be a way of undercounting or over-counting cases or deaths,” Adalja said.
Dillon said that he didn’t have complete information to explain the case numbers, but he said an overall upward trend is clear.
“The trend lines are moving in the wrong direction, and we want our transparency efforts to reflect hospitals’ ability to address what’s happening in the state,” Dillon said.
Missouri’s Show Me Strong Recovery plan has focused heavily on protecting hospital capacity, and Governor Mike Parson has frequently cited hospitalization numbers as evidence of the relatively low impact of COVID-19 in Missouri.
Recent hospitalization data has also suggested that the impact of the coronavirus may be increasingly shifting toward younger people, who are being infected at higher rates.
The increase in cases has not been accompanied by a corresponding increase in hospitalizations or deaths in many parts of the country, which may be due to either fewer severe cases among younger people, or it may simply reflect the fact that severe or fatal illness may take longer to develop.
Dillon suggested that further changes in the hospital reporting would continue to take place.
“We’ll need to look at our systems and capacity to produce to understand how quickly any change could be implemented,” Dillon said. “Nonetheless, we are having those conversations.”
