How Data Asymmetry Drives COVID Policy

Confirmed COVID-19 cases, just one of many COVID data points tracked by the Virginia Department of Health. Good news: The virus is receding!

by James A. Bacon

There’s a common saying in the business world: You manage what you measure. In Virginia, as in the rest of the United States, we have a super-abundance of data about COVID-19. Just visit the VDH website for a taste.

As we have frequently observed on this blog — and we’re hardly alone in doing so — the lockdowns imposed in an effort to contain the virus have negative effects, the most visible of which is increasing peoples’ sense of social isolation. The effects are measured in a variety of ways, from counting drug overdoses to suicides, but the data is not updated daily. Indeed, the numbers are typically released quarterly or annually after lengthy reporting delays, if they are compiled at all. For all practical purposes, that data is invisible and, therefore, plays almost no role in formulating policy.

Patrick Wilson with the Richmond Times-Dispatch (yes, I have to give the RTD credit for still doing some good reporting) tells the story of Michael McDermott, who supplies information about drug overdoses in the website FAVOR (Faces and Voices of Recovery in Virginia). He updates a chart showing the monthly EMS response data for overdoses in Virginia, using data collected by the Virginia Department of Health.

As Wilson summarizes, “the trends showed overdoses going up between 2017 and 2020 — evidence, McDermott says, that what the state’s doing to combat substance use isn’t working.”

Source: www.favorva.org

Here’s the kicker: McDermott said he hasn’t been able to get the same data this year.

He said he spent months going back and forth on the phone and email with the Office of Emergency Medical Services, where the associate director eventually told him they’d get him the 2021 data by Sept. 30. When that date passed, McDermott was so frustrated that he filed a petition in court in Goochland County, where he lives, asking a judge to order the agency to turn over the data under the Virginia Freedom of Information Act.

At a hearing Monday in Goochland General District Court, a judge found that the agency didn’t need to turn it over because an ongoing data migration was hindering the agency’s ability to provide it.

McDermott was disappointed.

“This data can save lives, your honor,” McDermott told Judge Claiborne H. Stokes Jr. “…This data is important to point out ways we can do a better job in the community against this epidemic of addiction.”

The state insists that it will make the data available, but perhaps not until the first of the year.

Clearly, VDH does have overdose data, but it’s not clear who, if anyone, looks at it, or whether the data percolates up through the system to the policy shop in Governor Ralph Northam’s office. Presumably, someone in the state also keeps track of suicides, another grim marker of social isolation. But suicide trend data is rarely if ever reported.

A complete COVID-19 data dashboard would contain more information than just COVID-19 confirmed cases, hospitalizations, deaths, and vaccinations. It would include data showing the fallout from epidemic-containment measures so the public could evaluate costs, benefits and tradeoffs of Virginia public health policy.

I chatted with a young woman yesterday who works as a nurse at a psychiatric hospital in the Richmond area. Admissions are through the roof. Psychiatric hospitals are running at full capacity. Obviously, mental health issues preceded the COVID-19 epidemic, but there was no question in her mind that the social isolation stemming from the epidemic was an aggravating factor. Other than Michael McDermott, no one seems to be tracking the increase in drug overdoses. As far as I can tell, no one is tracking and reporting suicides. If no one is paying attention to those numbers, they can’t be factored into COVID-related policy.

That’s just wrong.


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26 responses to “How Data Asymmetry Drives COVID Policy”

  1. LarrytheG Avatar

    So the question is – did COVID cause this or did the wrong GOVT reaction cause it?

    JAB and like-minded seem bound and determined that this did not need to happen and it was really caused by wrong Govt policies in reaction to it and so JAB “needs” data to prove his point…..

    If this was a Virginia-only problem or a national or even worldwide problem?

    Did government around the world screw up in their lockdown policies in response to COVID or did COVID itself cause it?

    1. A certain amount of “lockdown” and social isolation would have occurred without government action as people voluntarily took precautions to protect themselves. Look to Sweden as an example. Government mandates and emergency orders intensified the magnitude of the lockdown considerably. It’s not a binary either/or situation as LarrytheG would like to portray it.

      1. LarrytheG Avatar

        Nope and I’m not the one to portray it that way at all. The typical narrative here in BR is that govt overreacted and instituted policies that caused harm – all states and with some exceptions most countries.

        As I’ve said – when you hear from Conservatives and BR, do they blame COVID for the problems or government – even if in shades…?

        Seldom if ever, have I seen BR say that it’s the COVID – it almost always goes to govt – even though COVID has affected the world , apparently govt – around the world – overreacted and made things worse.

        I’m not going to be surprised to see JAB blame the supply chain problem – on Govt! Already has blamed Biden for not fixing it – this from a guy who says he does not want the govt interfering with “free markets”!

        just some objective and honest commentary – in a blog that purports to be about public policy issues that has steadily degenerated into a ‘blame govt” blog!

        1. DJRippert Avatar

          Jim asks how intelligent policy can be formulated with only a portion of the relevant data available for review by policy makers. Setting lockdown levels without understanding the mental health impacts of the lockdowns is half-assed. However, that is what apparently was done.

          1. LarrytheG Avatar

            worldwide? how would you EVER KNOW this ahead of time?

            And even if you could – would you have competing priorities that weighted – for instance – total deaths to increased mental health issues – that COVID itself imposed and Govt really had little choice but to make judgements and choices?

            The basic premise here seems to be that govt did it wrong and did not have to – that the fault was govt not the COVID.

            In what kind of world – when much if not most of the world ended up with similar impacts?

            So then the premise becomes that govt in general, worldwide, screwed up.

            it’s just bonkers.

          2. DJRippert Avatar

            The 50 states and DC had very different approaches to COVID lockdowns. Those lockdowns started in March, 2020 – 20 months ago! The idea that mental health impacts of the lockdowns, if recorded in a timely manner, couldn’t have factored into the level of lockdown is nonsense.

            Our state is inept, especially with regard to modern information management and even general management.

          3. LarrytheG Avatar

            MOST STATES had some restrictions including schools – that’s the facts.

            Our state is not that different than a LOT of other states in what it did. It’s no more inept than a majority of US states and for that matter – other countries on COVID policies.

            On information management – if you want to show me how Virginia compares to states like Kansas or Georgia or West Virginia on information systems, I’d listen. If you want to show a credible ranking of states on IT systems – I’d listen to that. But if you want to call Virginia a failure and not much else then no dice…just another critics without any real substance.

  2. The Roanoke Times reported on the mental health crisis in July along with a statement from the Virginia agency responsible for patient care:
    https://roanoke.com/opinion/columnists/cruser-the-crisis-in-virginia-mental-health/article_dd535b1e-bff8-11eb-bc0b-2be666f7d3a0.html
    And
    https://www.vachiefs.org/blog_home.asp?Display=166&fbclid=IwAR0yGgB6Yf3OpOd8DAUUJrUamccckvXbrr7_J0H_FzQi9_fde7JQS9xWSsM

    No answers but the problem continues unresolved.

    1. LarrytheG Avatar

      Thanks for the links. I was under the impression that this was a problem long before COVID – even back when Creigh Deeds son had problems.

      https://www.usnews.com/news/blogs/washington-whispers/2014/03/31/creigh-deeds-tells-sons-mental-health-horror-story

      similar with OPIODs :

      ‘… Published: 5:16 PM EST November 19, 2019
      Updated: 12:52 PM EST November 26, 2019

      NEWPORT NEWS, Va. — New information revealed as part of multiple national lawsuits against drug manufacturers and distributors shows how the number of prescriptions of opioids like Oxycodone boomed between 2006 and 2012 in all Hampton Roads cities.’

      IOW – we already had these problems and COVID is not the root cause – but perhaps an aggravating factor – but why even mention it if the argument basically is that it was Govt’s wrong response to COVID that caused problems? If that is even true, how did bad govt policy responses to COVID cause upticks in mental health and opioid and related?

      The argument sorta sounds like the govt gets the blame no matter what… even if COVID actually directly caused it.

      1. The Creigh Deeds law established requirements for government to fulfill. Government was and is still unable to comply with the law. Is it more demand, fewer beds or a combination? Likely both but the people in crisis are not getting help because of a helpless government.

        1. LarrytheG Avatar

          I don’t disagree but isn’t the problem the GA funding ? or is it something else?

          For decades Virginia has done a crap job for mental health – even after taking the Medicaid money which pays for this.

          Is it just money , the lack of it or what?

          Not sure I’ve ever seen an analysis of the issue in BR and actually would like to – more so than the standard COVID blame game.

        2. Dick Hall-Sizemore Avatar
          Dick Hall-Sizemore

          The mental health crisis in Virginia is a long-standing one. It has roots that long pre-date COVID. In fact, I posted about this issue in 2019, before anyone had heard the term COVID. https://www.baconsrebellion.com/speaking-of-mental-health-virginia-has-a-crisis/

          The issue is complex, but it can be boiled as follows: There is a fundamental disagreement among policymakers over the proper role of institutional care and treatment vs. community care and treatment. Those who advocate community care are not clear about what community care would look like and no one seems willing to put up the money to finance the community care facilities and programs that are needed.

          1. LarrytheG Avatar

            and yet… critics point to government’s response to COVID as the problem.

            One could argue that COVID made it worse but to argue that govt’s response to COVID is the core reason is just not fair nor objective.

  3. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    Jim, this is a good story in the RTD and it raises an important issue. However, I think you are stretching to make it applicable to COVID.

    You mention several types of data that would be useful in documenting the impact of COVID and guiding policy makers. One of the main problems is that the data is not in one place or collected by the same agency. Getting agencies to coordinate their data reporting is a major task, as I know from experience. Also, just throwing a lot of data up on a dashboard may cause more problems than it solves. To be useful, most data needs to be analyzed. For example, overdose data. As the story relates, overdoses have been rising in recent years. To be useful in the context of evaluating the effects of COVID policies, that data would need to analyzed in an attempt to isolate the the effects of COVID policies from other factors related to overdoses. That sort of analysis is complex.

    You are anxious to get all this data out there so we can get a better idea of the adverse effects of lockdowns, social distancing, school closings, etc. I understand that. However, there is another piece of data that would shed a great deal of light on the the effects of these policies. The problem is that it is not possible to obtain this data. That would be the number of hospitalizations and deaths that we would have had if those COVID policies had not been effect.

    This next observation is off the topic of COVID, but it does relate to the article. It is clear to me that the agency is just giving McDermott the runaround. The data migration excuse may be a valid one, but it could be an IT smokescreen. Anyway, it should not take that long.

    This article raises the larger issue of how hard it is to get information from state agencies. VDH just does not want to give McDermott the data; it even went to court to keep from doing so. It seems to me that agencies in this administration are more reluctant to share information. That is not true in all cases. I have two FOIAs pending now. For one, the agency contact said, “Sure, that data is readily available. I would be happy to send it to you.” For the other request, I have gotten push back on a document that I know exists. We will see how that works out.

    Finally, Patrick Wilson is filling a role that has been void for a long time. A primary focus of a newspaper in a state capital should be the state government and workings and shenanigans of state agencies. The RTD has neglected that responsibility for quite some time. I am happy that we finally have a good reporter to take on that role. I hope that the RTD would provide him with some companions to help him out. It is a big beat.

    1. DJRippert Avatar

      “Getting agencies to coordinate their data reporting is a major task, as I know from experience.”

      In the free market a lack of data coordination among corporate departments would result in a lack of revenue growth and profitability. Hence, there is vast interest and efforts in master data management, data warehouses, data lakes, etc with companies like Databricks, Snowflake and Palantir minting money in the effort.

      What is the motivation for state agencies to streamline, consolidate and harmonize their data collection and reporting efforts? Certainly, more efficient and/or transparent government seems to get scant attention in Richmond.

      1. LarrytheG Avatar

        Yes – but you’re confusing communications WITHIN the corporate body (which are often NOT released to the public) and releasing data to the public and critics are judging based on data they want, more to essentially impugn govt, sorta like the critics of FB wanting internal FB data so they can go after FB.

        In this case – the critics want more data to essentially make the case that Virginia’s COVID policies did harm – no matter those policies were to reduce harm overall.

        That is contested by the critics so now they want the govt to provide the data they can use to make their case!

        THe basic premise of many Conservatives seems to be that there should not have been anylockdown, no masks, no social distancing and schools in-person without social distancing and masks. Even DJ was advocating that those who were “afraid” should “stay home and hide”.

        Over and over, the critics actually use SOL data to SHOW the “harm” of virtual learning… as if Va should have kept all schools open for in-person.

        They do not accept the premise that the schools going to virtual actually saved lives.

  4. DJRippert Avatar

    “At a hearing Monday in Goochland General District Court, a judge found that the agency didn’t need to turn it over because an ongoing data migration was hindering the agency’s ability to provide it.”

    Sounds like, once again, the state’s IT systems are flawed.

    If Youngkin wins perhaps he will reinstate the Secretary of Technology as a cabinet level position … if only to push the various departments to a competent use of technology.

    1. LarrytheG Avatar

      No.. it sounds like the GOvt did what private industry does and make decisions on what they knew -at that time – and not what would be wanted later and especially critics of the govt who want it for ammunition!

      No matter what VDH did – the critics were not satisfied.
      Go back the past year through BR and read the blog posts pillorying VDH for their data reporting!

      It’s as if VDH did not give the critics exactly what they wanted – they were a “failed” agency – no matter what other states did or not – nope – VDH failed to provide the data the critics wanted and that was that!

      1. DJRippert Avatar

        Neither the free markets nor government can wait for a crisis and then decide to upgrade their IT systems and management processes. They have to stay current and address the “tech debt” that builds up over time. All successful businesses know this. Our state government does not.

        If state expenditures were compared to corporate revenues Virginia would be one of the largest companies in the world. Yet it is managed like a Mom and Pop candy store.

        1. LarrytheG Avatar

          It’s way better than it used to be and I’d wager it’s way better than a lot of other states.

          The problem is this state and many others, do not pay competitive wages for IT and too much of it is home-grown.

          I just don’t thing Va is anyone near the bottom on IT compared to other states but you might persuade me otherwise with some real data!

    2. Dick Hall-Sizemore Avatar
      Dick Hall-Sizemore

      In the past, this type of issue would not have fallen under the ambit of the Secretary of Technology. VITA, the only agency under the Secretary, managed the state phone system, enterprise systems, and the shared servers. Management of data within an agency, including the procurement and installation of new systems, were the responsibility of each agency. If Youngkin were to do what you propose, he would have to do a lot more than restore the Secretary of Technology. He would have to create a statewide data management system–a major, major undertaking, especially for someone with no experience in state government.

      1. LarrytheG Avatar

        Virginia has had similar problems with other states as well as the military in trying to develop and maintain a unified state system – after many agencies had already started using IT systems based on their choices – which did not match up.

        Yes, Youngkin would need to try to develop a unifed statewide system – which Virginia SHOULD DO and in process for doing and one way you know this is that virtually every state agency internet address ends like this : “.virginia.gov” which is a major step considering how viruses , malware and ransomware can spread – once “inside” of corporate IT system.

        As any IT professional will confirm – any computer in any state agency that is not properly secured can become infected and spread to all other state agencies. Think in terms of how many different computers and operating systems there are from windows, to Apple to IBM to LINUX and other variants. Think in terms of what is known as zero-day viruses and how many systems across the state are vulnerable and need to be patched – overnight or sooner.

        It’s no small feat tha Virginia’s IT folks have been able to avoid this from happening – and it could still.. but they are far from a failed system.

    3. Dick Hall-Sizemore Avatar
      Dick Hall-Sizemore

      This does not necessarily mean the systems were flawed. It often happens after a new system is installed or a system is upgraded. Data that was in the old system has to be formatted so that it can be read by the new system. Sometimes that is time-consuming; it depends on the compatibility of the old and new systems and how much data is involved. Sometimes, agencies just feel that it is not worth the time and effort to actually bring in all the old data. In such cases, the old data is still available, but folks have to take special steps to get it when it is requested or needed.

      1. LarrytheG Avatar

        So, we went and got our boosters last week and unlike the first two shots at Mary Washington Hospital, this was a VDH site. It was in all respects well set-up and well operated – let me say again – It was a GOVERNMENT RUN site and despite all the naysayers, it was GOOD!

        I DID very much pay attention to the check-in process – they were using laptops connected to Wi-FI and connecting with a database in the cloud with our private data – again – something you HOPE they are doing RIGHT despite DJ’s admonitions that the State’s IT sucks.

        I also note BTW that I have interacted with the states DMV and I PREFER online transactions to in person! I login, they verify my identity – CORRECTLY and I pay by bill via a secure credit card process and they send me my plates which are correct.

        I also have an EZ-Pass transponder and that website works just fine.

        I also login to Medicare – and they work fine – even better now that they’ve fixed their login process!

        My POINT? It’s not near as bad as critics portray and it’s way, way better than it used to be.

        The most lame login sites I have to deal with are my employer-provided health insurance sites…. by far.. no contest.

  5. Is it possible….and I’m only asking for a friend…cuz I would NEVER impute political motives to our political hacks who rule us by decree… that VDH is sitting on the info because it will make them and the people who appointed them look bad?
    I know that’s far-fetched, but I have a very active imagination!

    1. LarrytheG Avatar

      If your motives are anti-govt to start with – sure!

      And once VDH gets a whiff of what your motives are – probably not very accommodating..

      😉

      People DO forget or never knew ALL the various things that VDH actually does and to many thankless types who just want to whack on them cuz that’s what they do!

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