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Report: Fed. government considering national health surveillance database

Screening for coronavirus is underway for patients, visitors and staff at Bay Pines VA Healthcare System. A government report says the medical center in St. Petersburg lacks the materials it needs to deal with the disease. (CHRIS URSO/Tampa Bay Times/TNS)
April 10, 2020

Jared Kushner, President Donald Trump’s son-in-law and adviser, is reportedly leading a federal effort to form a centralized hospital reporting system to give the government real-time data on where hospitals are seeing coronavirus cases.

Kushner’s coronavirus task force has reached out to several health technology companies, according to four sources familiar with the efforts who spoke to Politico on Tuesday. The sources described the idea as a surveillance system designed to track where people are seeking treatment, why they are being treated, and which hospitals are approaching their capacity to treat patients.

The medical surveillance system may be envisioned as a tool to help the Trump administration determine which parts of the country can begin to withdraw from restrictive social distancing measures that have been in place through March, to help stop the spread of coronavirus. Tech executives and government officials who spoke with Politico also said the proposed surveillance system would be used to help federal officials determine where hospital resources are needed.

“It allows you to be much more targeted and precise in how you engage,” one source told Politico. “They need data to make the policy decisions, and so that’s what we and others now have been asked to do.”

Critics of the idea, on the other hand, have described the health surveillance system as akin to a Patriot Act for health care.

“This is a genuine crisis — we have to work through it and do our best to protect people’s health,”Jessica Rich, a former director of the Federal Trade Commission’s consumer protection bureau told Politico. “But doing that doesn’t mean we have to destroy privacy.”

It is unclear what health information would be shared with the government under the proposed system. Health privacy laws already come with some exceptions under national security requirements, however there is concern over what individual information is shared. Three officials who spoke to Politico said the surveillance system would only rely on patient data that has been “de-indentified” to protect individual identities.

“We dealt with similar issues in 9/11,” Rich said, warning that any surveillance system would need strict controls over what information is shared to the government. “One reason that the government doesn’t have all of this data is there’s a lot of concern about big brother maintaining large databases on every consumer on sensitive issues like health, and for good reason.”

The White House did not respond to Politico’s initial request for comment before publishing its report, however spokesman Avi Berkowitz later reached out in a Tuesday statement and said Politico’s report “makes no sense and is completely false. The White House gets many unsolicited random proposals on a variety of topics, but Jared has no knowledge of this proposal or the people mentioned in this article who may have submitted it.”

Kushner and other administration officials have, however, raised questions about where hospital resources are being directed throughout the country.

“The goal here is not to have ventilators sitting in a warehouse where you have another state where you have people who need them,” Kushner said at a recent press briefing. “So, what we’re trying to do is make informed, data-driven decisions.”

Tom Frieden, a former director for the U.S. Center for Disease Control and Prevention (CDC) told Politico that the best option for health surveillance would be to expand existing government systems housed with government agencies such as the CDC’s National Syndromic Surveillance Program which draws from around state and local health departments linked to around 4,000 medical facilities.

“In an emergency, what works best is scaling up existing robust systems, not trying to create a new system,” Frieden said. “Use the systems you have.”

In a Wednesday statement, Sen. Ed Markey (D-MA) has also raised questions about the health surveillance system described in Politico’s report.

“The Trump administration has not given me or the American people any confidence that it is capable of creating or maintaining a massive health data network in a manner that doesn’t undermine our fundamental right to privacy,” Markey wrote.