Bacon's Rebellion

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Hospital Association Publishes More Granular COVID-19 Data

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James A. Bacon
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by James A. Bacon

The Virginia Hospital and Healthcare Association today unveiled its own COVID-19 dashboard — and it puts the Virginia Department of Health information portal to shame. The VHHA dashboard contains key metrics lacking in the state’s statistical summary, and its data on the number of hospitalizations conflicts with those provided by the state.

While the VDH reported this morning that Virginia has seen 497 hospitalizations, the VHHA says the number of confirmed positives in hospitals is 538. Including the number of hospitalized patients whose tests are pending, the number is 1,194.

The VHHA dashboard also provides the number of COVID-19 patients in intensive care, an indicator of the number of acutely ill patients. The combined  number of COVID-19 patients (both confirmed and tests pending) in the ICU is 387. The combined number for patients on ventilators, a metric for the most acute level of care for virus victims, is 285.

The new dashboard also provides other critical public health data:

Total ventilators on-hand in hospitals: 2,566
Total ventilators in use: 666
Percentage of ventilators in use: 26%
Bed availability: 5,519
Number of Virginia hospitals experiencing difficulty in obtaining or replenishing personal protective equipment in the next 72 hours: 11
Number of Virginia hospitals experiencing difficult in obtaining or replenishing other medical supplies in the next 72 hours: 1

“Reliable data is a cornerstone of any predictive modeling work being done by those who are working to forecast the spread of COVID-19, anticipate its peak, and identify health care providers’ needs as they battle this virus,” said VHHA Vice President of Data Analytics David Vaamonde. “The data gathered to populate this dashboard is a key component of that effort.”

When asked why the VHHA numbers differ from the state’s, Julian Walker told Bacon’s Rebellion said only that the VHHA gets its data directly from Virginia’s hospitals and that its methodology differs from that of the Virginia Department of Health. I have requested information from VDH and will update this post when I get a response. Update: I have posted the VDH’s explanation in the comments, which you can find here.

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25 responses to “Hospital Association Publishes More Granular COVID-19 Data”

  1. Steve Haner Avatar
    Steve Haner

    I’m sure they waited to create this report until the government experts directed it, per Larry’s world view.

    1. LarrytheG Avatar
      LarrytheG

      One wonders why the state is not getting complete information or if this group actually represents all hospitals in Virginia, all providers in Virginia that might see people with the coronavirus?

      I had asked from the beginning where VDH was getting it’s data – who was reporting. One might think that the State would require reporting from all providers in the state as a matter of process.

      Isn’t this the group that Sherlock says is the “enemy” of the free market?

      😉

      1. CrazyJD Avatar
        CrazyJD

        >>I had asked from the beginning where VDH was getting it’s data –

        Who did you ask, Larry?

        1. LarrytheG Avatar
          LarrytheG

          the folks who were reporting VDH data here… and noting inconsistencies… seemed like the next place to go was to find out
          where the data itself was coming from… no?

  2. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    The answer is obvious. Like most government databases, the VDH does not have its own folks out there collecting data; it is dependent on the reports it gets from health care providers, including hospitals. I am not surprised that some hospitals have not submitted data to VDH, but are now supplying that data to their own association.

    1. Steve Haner Avatar
      Steve Haner

      I remember hearing over a week ago in a Northam presser that VDH was not getting data from the hospitals’ own testing. But it is doing its own testing, 200 results a day (pathetic) and that it its own data. At this point, credibility is strained, and don’t think that makes me happy. It doesn’t.

    2. CrazyJD Avatar
      CrazyJD

      >> I am not surprised that some hospitals have not submitted data to VDH

      Are you saying that they don’t trust the government? Or that you are not surprised that they don’t trust the government?

      1. Dick Hall-Sizemore Avatar
        Dick Hall-Sizemore

        I am saying that many organizations (local government and private entities) don’t make it a priority to report data to state agencies. There are many reasons for this: they are short of personnel, they don’t think it is important, they just don’t want to be bothered with it, etc.) When their own organization asks for this data, it emphasizes how publishing that data is to the benefit of those local entities.

        1. TooManyTaxes Avatar
          TooManyTaxes

          The last thing any busy entity thinks about is making a report while the alligators are biting. Unless reporting is a rule, expect all the attention to be on the alligators.

  3. sherlockj Avatar
    sherlockj

    VHHA has published more granular information than the Virginia Department of Health (VDH). No shock there. I have been writing for years about the disfunctionality of the VDH. Unfortunately, the VHHA represents “integrated health care delivery systems and their long-term care facilities and services, ambulatory care sites, home health services, insurance subsidiaries, and other health system-related entities”. It does not represent nor does either VDH or VHHA have data from the independent physicians, not only about testing but also PPE. That is a critical issue today.
    Neither the VDH, nor the VHHA, nor the state lab have addressed point-of-care testing with Abbott’s new COVID-19 test. The test will run on the company’s ID NOW™ platform, providing rapid results in a wide range of healthcare settings such as physicians’ offices, urgent care clinics and hospital emergency departments. The Abbott ID NOW platform is small, lightweight (6.6 pounds) and portable (the size of a small toaster), is already the most widely available molecular point-of-care testing platform in the U.S. today with some 18,000 testing platforms nationwide. Abbot since a week ago has been shipping 50,000 COVID-19 test a day that will run on that platform. These tests will produce a positive reading in about 3 minutes and a confirmed negative reading in less that 15 minutes. We have no information whatever whether these tests are being shipped to Virginia and if so where, and whether they are getting to owners of the platforms.
    Since VDH publicly admits it gets all of its information from VHHA, it will only get hospital information.
    I have asked RTD reporters to query the Governor about this in his news conference today.

    1. CrazyJD Avatar
      CrazyJD

      >>I have asked RTD reporters to query the Governor about this in his news conference today?

      Were you expecting a knowledgeable answer?

      1. sherlockj Avatar
        sherlockj

        No, but I expect the question to generate comment in the Governor’s press conference on Wednesday. That is how Virginia government gets informed and motivated in this crisis.

  4. LarrytheG Avatar
    LarrytheG

    One of the problems – issues – is that we got a lot of folks representing data – and not all of them are really understanding where the data is actually coming from – which is important… i.e. is there a uniform/standard reporting system or is it willy-nilly, wild-wild west?

  5. LarrytheG Avatar
    LarrytheG

    Reporting of the following diseases is required by state law (Sections 32.1-36 and 32.1-37 of the Code of Virginia and 12 VAC 5-90-80 of the Board of Health Regulations for Disease Reporting and Control –http://www.vdh.virginia.gov/surveillance-and-investigation/division-of-surveillance-and-investigation/commonwealth-of-virginiastate-board-of-h ealth/). Report all conditions when suspected or confirmed to your local health department (LDH). Reports may be submitted by computer-generated printout, Epi-1 form, CDC or VDH surveillance form, or upon agreement with VDH, by means of secure electronic submission

    REPORT IMMEDIATELY
    Coronavirus infection, severe (e.g., SARS-CoV, MERS-CoV)

    http://www.vdh.virginia.gov/content/uploads/sites/13/2018/11/Reportable_Disease_List.pdf

  6. sherlockj Avatar
    sherlockj

    Larry, I’ll submit a column later this afternoon to answer your question.

  7. Peter Galuszka Avatar
    Peter Galuszka

    Sherlockj,
    Just curious. What are your qualifications as a health expert? What did you do in the Navy? Thanks!

    1. TooManyTaxes Avatar
      TooManyTaxes

      Who does he think he is – a CNN talking head?

  8. James A. Bacon Avatar
    James A. Bacon

    A Virginia Department of Health spokesperson offered the following explanation of why VDH data differs from hospital association data:

    • The Virginia Department of Health and the Virginia Hospital & Healthcare Association each collect data to help inform the planning and response to the COVID-19 pandemic with a shared goal of providing timely information to the public.
    • VDH bases its hospitalization numbers on case investigations conducted by health department officials. VDH’s process also includes a filter to identify Virginians who are hospitalized, which is reflected in its public reporting.
    • VDH’s data capture Virginia residents with COVID-19 who were hospitalized at the time of the public health investigation. It under-represents the total number because it does not capture patients who are hospitalized later in their course of illness.
    • VHHA’s data is based on figures supplied by hospitals and health systems across the Commonwealth.
    • Because VDH and VHHA are distinctive organizations, there are differences in the data sets each use.
    • VDH and the VHHA continue to work in partnership with each other, and other agencies and stakeholders, as part of the broad-based collaborative effort to slow the spread of COVID-19 and safeguard public health.

    Update: The VDH spokesperson added this is a subsequent communication: VHHA’s data is based on figures supplied by hospitals and health systems across the Commonwealth and does not filter out non-Virginia residents or include confirmed cases in other care settings.

    1. CrazyJD Avatar
      CrazyJD

      For Larry: This would be my point. Take a look at the first sentence of Jim’s post just above.
      “A Virginia Department of Health spokesperson offered the following explanation of why VDH data differs from Hospital Association data”

      I could be mistaken, but I think that means that Jim actually called or emailed the VDH spokesperson, like…like… like a reporter. Ergo, more or less first hand information (with the caveat that the spokesperson may have misinterpreted the information he/she received from others in the agency, may not have understood it, did not realize that he/she had gotten conflicting information from within the agency, never knew who was qualified within the agency to give out information, etc. ). It apparently was not Jim’s speculation of what their position was, should have been, might be, or never will be.

      1. LarrytheG Avatar
        LarrytheG

        Crazy – oh he did – this time after how many prior posts not done?

        See, when some folks see differences between the two – they suspect something is done wrong or etc…. but if you read the response, what
        do you know? Not a whole lot more other than , yeah, they’re different between we do data differenet… right?

        big whoop!

  9. Acbar Avatar
    Acbar

    If VDH is dysfunctional (“I have been writing for years about the disfunctionality of the VDH”), it’s hardly surprising that it is not enforcing its own regulations. But even if it had, would this regulation have supplied a sufficient data base for the reporting we now clamor for?

    Some questions: To whom exactly does this rule apply — hospitals only, or hospitals and public health clinics also, or those plus private clinics and private solo practices too, or all of these plus nursing home staff and OSHA doctors and death certificates from the coroner, etc.? Is there any interpretative guidance to give meaning to a vague general requirement like “report all conditions when suspected or confirmed”; what would prevent overlapping “suspected” and “confirmed” cases? Would the resulting data that are supposed to be supplied to VDH be sufficiently consistent and comprehensive to be compiled and useful, especially during a fast-moving pandemic-tracking exercise such as we are now engaged in?
    When medical staff cannot test a patient because it’s unavailable, or because it will take over a week to get the results, is the doctor’s best diagnosis required, or sufficient, or is reporting limited only to “definitive-test-positive” cases (even when that plainly under-reports what doctors are seeing in the field)? With all these reports flooding in on all the many different permitted forms and reporting options, does the staff exist to screen them for overlapping or obviously erroneous data and compile all that stuff into a report on current status — and on what timeframe could all this be done?

    The problem with broad-brush, ill-defined and open-ended “tell us everything” requirements like the one Larry found is that (in my experience) such agency rules were never intended to yield accurate reports on anything. Rather, this has all the hallmarks of a requirement imposed to create a “gotcha” situation for anyone arguably subject to the rule. What better position could a bureaucrat be in than to have the ability to withhold agency approvals and administrative favors, essentially arbitrarily, to any applicant who didn’t report every situation arguably covered by its vague rule? Such a reporting requirement is motivated by bureaucratic desire — not for accurate public health statistics but for leverage, and for the agency’s own C.Y.A. purposes.

    1. sherlockj Avatar
      sherlockj

      I submitted a column that addresses your questions. I think it will be up soon.

    2. LarrytheG Avatar
      LarrytheG

      Just from a pure functionality point of view – you’d want/need a centralized reporting capability. To NOT have that will pretty much assure chaos.

      It’s in the state code that infectious disease should be reported to VDH. If you’re NOT going to do this and/or gonna split hairs over what exactly to report – it ends up the same problem – a failure to collect and summarize data such that it can be used to inform decisions. Failing that you get decisions made without good information.

      Many of us “know” VDH through things like drainfield permits and restaurant inspections… neither ever came across as “dysfunctional” to me.

  10. Nancy_Naive Avatar
    Nancy_Naive

    What can it hurt? What do ya got to lose?
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760572/

    1. Atlas Rand Avatar
      Atlas Rand

      Are people treated with these drugs planning on taking them for another 10 years post-coronavirus?

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