“Not knowing what the likelihood of getting transmission in the hospital really impacts an individual’s ability to quote unquote ‘make a personal decision’ on their risk levels,” said Mia Ives-Rublee, a disability rights advocate who has a lung condition that makes her more susceptible to Covid.
Over the four weeks ending June 19, U.S. hospitals reported an average of 1,457 patients per week had caught Covid during their stay, according to a POLITICO analysis of data from the Department of Health and Human Services. That follows a record month in January when more than 3,000 patients each week were infected while in the hospital.
Though the higher numbers have subsided, the risk remains real for a subset of the population with compromised immune systems who must weigh getting check-ups and treatments for potentially serious issues “versus maybe getting Covid and ending up on the ventilator,” Ives-Rublee said.
In a March meeting with the CDC, Ives-Rublee and other patient advocates requested more transparency on hospitals’ transmission, but the conversations went nowhere, she said.
“We are frustrated with the lack of progress that we’ve seen in terms of addressing concerns for folks who are extremely at risk for Covid,” Ives-Rublee said.
Other advocates told POLITICO they intend to keep pressing the administration ahead of what the Centers for Disease Control and Prevention predicts could be another fall surge in Covid cases.
“A majority of voters want HHS to level with us – tell us how much coronavirus is spreading in the particular hospital we go to,” said Matthew Cortland, an immunocompromised disability rights activist who ran a recent poll on the issue for Data for Progress, a left-leaning think tank. “But that transparency is inconvenient for the powerful hospital lobby.”
The American Hospital Association wants facilities’ infection numbers to stay private. “Reporting aggregate data is the most appropriate approach given the very low occurrence of hospital onset COVID-19,” Nancy Foster, an executive with the AHA, said in a statement.
Throughout the pandemic, many hospitals chose not to implement measures that could have dramatically decreased transmission, according to workers, health executives and patients around the country.
Many facilities no longer require masks for visitors or staff, despite CDC recommendations. Even where masks are required, workers and visitors usually don surgical masks, among the least protective ones available, instead of N95s. Hospitals follow CDC guidelines, which allow Covid-positive staff to return while infectious. Industry executives insist their protocols are adequate and that some Covid transmission is inevitable; the AHA says hospitals’ measures are generally safe.
U.S. health officials have debated the merits of identifying hospitals’ infections since the Trump administration began collecting the information in 2020, according to three current and former officials who were granted anonymity to speak candidly about internal deliberations.
The figures only include patients who test positive after a minimum hospital stay of 14 days to ensure a patient didn’t contract the virus before admission. The government’s tallies are likely less than the total because hospitals don’t report people who test positive after being discharged.
Trump-era officials decided to keep hospitals’ names private, fearing that outing them might discourage people from seeking health care, according to two former health officials, one of whom worked in the Trump and Biden administrations. Also, a Trump HHS spokesperson confirmed the thinking.
But more than two years into the pandemic, with the availability of vaccines and treatments, Biden officials no longer worry that most patients are avoiding care, according to one of the people involved in more recent discussions. Some U.S. health officials want the same kind of transparency that exists for other hospital-acquired infections, they say. For years, the U.S. government has collected patient infection rates for various pathogens and published scores for each hospital on a website for patients.
Yet the CDC and Office of the Assistant Secretary Preparedness and Response, the two agencies that could make the data public, have declined to release it. POLITICO filed freedom of information requests in April but federal officials have not yet provided the records.
A HHS spokesperson said in a statement the agency wouldn’t release the names for “privacy concerns” but declined to specify what the privacy concerns were.
One concern held by some federal health officials is that the disclosure could embarrass hospitals and lead them to stop reporting their information, according to one U.S. health official who has discussed the matter with the CDC and CMS. But, that concern isn’t universally held.
Some CDC officials have argued internally that the information — as hospitals currently provide it — is not a good measure of risk, according to two CDC officials who have reviewed the data, who were granted anonymity to speak about internal debates. That’s because facilities report snapshots each day of the number of patients who currently have hospital-acquired Covid, meaning some patients are counted again in the following days as they remain in the facility.
The CDC didn’t respond to comment requests.
Allan James Vestal contributed to this report.