Van Hollen, Senators Call for Robust CDC Data Modernization Initiative Funding to Ensure Public Health Preparedness

With the COVID-19 pandemic revealing dire deficiencies in the public health system, U.S. Senator Chris Van Hollen (D-MD) joined Senators Richard Blumenthal (D-CT) and Tim Kaine (D-VA) and a group of eight Senators in calling for increased funding for a Centers for Disease Control and Prevention (CDC) data modernization initiative. In a letter to Senate Majority Leader Mitch McConnell (R-KY) and Minority Leader Chuck Schumer (D-NY), the Senators stressed the need for this additional funding in upcoming coronavirus relief legislation to ensure public health departments have the necessary secure technology and skilled workforce in place to prepare for and respond to public health crises.

“More than ever, it is critical to have a strong national public health surveillance system that detects and facilitates responses to emerging, and existing, health threats. The exchange of public health data from health care providers to public health officials is critical to a coordinated, timely, and effective response—and can save lives,” the Senators wrote. “Funding dedicated to a data modernization initiative would allow CDC, state, local, tribal, and territorial health departments to move from sluggish, manual, paper-based data collection to seamless, automated, and secure IT systems. Similarly, the funding would allow CDC to invest in hiring a workforce that is trained to handle epidemiological data and IT systems.”

As they have grappled with the COVID-19 pandemic, public health departments across the country have been forced to rely on antiquated methods, including pen and paper, faxes, and manual entry, hindering effective response. Health providers have been unable to share electronic health records directly with health departments, which has delayed identification and response. The Senators also raised concerns with the limited data included in the CDC’s National Syndromic Surveillance Program – which will be increasingly relied upon to assess reopening efforts across the country – as nearly 30 percent of all emergency department visits are not submitted to the program, and pointed to it as another example of a public health tool in need of immediate improvement.

The letter was also signed by U.S. Senators Jacky Rosen (D-NV), Tom Carper (D-DE), Gary Peters (D-MI), Michael Bennet (D-CO), Elizabeth Warren (D-MA), and Angus King (I-ME). 

The full text of the letter is available here and below. 

Dear Majority Leader McConnell and Minority Leader Chuck Schumer,

We write to urge you to provide additional funding for public health data and infrastructure modernization in any subsequent COVID-19 response package. While we were pleased that the CARES Act and the subsequent package passed on April 21, 2020 included some funding for a Centers for Disease Control and Prevention (CDC) data modernization initiative, it is increasingly apparent that significantly more funding is needed for adequate COVID-19 data collection and surveillance. More than ever, it is critical to have a strong national public health surveillance system that detects and facilitates responses to emerging, and existing, health threats. The exchange of public health data from health care providers to public health officials is critical to a coordinated, timely, and effective response—and can save lives. 

Rapid community spread of COVID-19 has put a strain on the American economy, American lives, and public health professionals, all the while exposing the very real need for sustained, dedicated investment in public health infrastructure, particularly in a data modernization initiative. Unfortunately, as we have seen, as public health professionals seek to reduce the spread of COVID-19 through social distancing measures and treatment, they have encountered significant barriers as a result of the lack of public health infrastructure.

For instance, public health departments are unable to share data on cases, persons under investigation (PUIs), laboratory tests, and person to person transmission with the CDC seamlessly—instead they are forced to rely on a combination of methods: antiquated pen and paper, faxes, excel spreadsheets, phone calls, and manual entry. Furthermore, health care providers are unable to share electronic health records directly with health departments, impeding initial identification, communication and rapid response. In addition, approximately 30 percent of all emergency department visits are not submitted to CDC’s National Syndromic Surveillance Program, meaning that early detection of and response to COVID-19 through patients presenting at emergency departments may have been missed, and may be missed going forward as we will increasingly rely on this system to assess reopening efforts.

Funding dedicated to a data modernization initiative would allow CDC, state, local, tribal, and territorial health departments to move from sluggish, manual, paper-based data collection to seamless, automated, and secure IT systems. Similarly, the funding would allow CDC to invest in hiring a workforce that is trained to handle epidemiological data and IT systems. Our public health workforce has been hindered from attracting and retaining critical expertise that is desperately needed now to combat COVID-19, and will undoubtedly be essential moving forward. For instance, new data has revealed that in order to effectively respond to community spread of coronavirus, the United States needs to hire 200,000 to 300,000 contact tracers alone, and a minimum of 1,200 epidemiologists. This has left states like Utah, Vermont, and North Dakota reliant on graduate students, retired heath workers, and other furloughed employees who are only receiving one to two hours of training. While, an integrated data system will undoubtedly support contact tracing efforts, the need to hire and train professionals to utilize the system will remain, and without individuals who are trained in public health and IT, our investment will be for naught. More, better, faster data yielded by secure, privacy-defending, interoperable, integrated systems will allow public health professionals and policymakers to make better decisions and get ahead of chronic, emerging, and urgent threats.

In real-time, this would ensure that health professionals can successfully understand and respond to the COVID-19 disease curves, where hot spots are located, the proportion of the population with immunity, and where and how to responsibly ease social distancing measures. These efforts will be just as essential as we move towards appropriate antibody testing, treatment, and vaccine distribution. In addition, such systems would better equip under-resourced departments to address and mitigate the significant cyber security threats commonly posed to public health infrastructure, which are likely to become more frequent in light of rapid transitions to telehealth and COVID-19-related discrimination. 

Unfortunately, chronic underinvestment in public health, combined with a reactionary approach to public health crises, contributed to a scenario in which the United States missed an opportunity to detect and respond to COVID-19 rapidly, prior to community spread. However, if we take steps immediately to invest in a much needed, continuously functioning public health data collection system, we can hopefully take steps to mitigate the impacts of the current pandemic, any subsequent COVID-19 outbreak waves, or any future pandemic. In recent days, the Administration has discussed a National Virus Data System that would allow for seamless transmission of data during the COVID-19 pandemic. While needed, this step would be yet another short-lived, disconnected, fragmented, solution to a chronic, recurring issue within public health. If the United States fails to once again invest in a well-rounded enterprise data collection system, our nation will be set up for yet another deadly epidemic or pandemic.

Public health experts have cited the need for a $1 billion investment over the next ten years in CDC data modernization. While we appreciate the inclusion of funding in COVID-19 responses thus far, we urge you to include the remaining funding in the next response package. Given the threat posed by COVID-19, and the potential threats posed by future viruses, it is critical that CDC receive this funding expeditiously. Public health threats rapidly evolve, and do not wait for public health professionals to catch up. If we fail to seriously invest in public health moving forward, another virus will surely emerge and lead to the next pandemic taking millions of more lives once again. 

Thank you for your consideration of this request.

Sincerely,