Trump administration set to aggressively enforce data reporting requirements; COVID-19 transmission debate divides health systems — 5 updates

COVID-19 cases in the West and Midwest are driving an uptick of infections, with the nation reporting an average of 43,000 new daily cases, a 16 percent increase from last week.

Over the past week, seven states — Arizona, Colorado, Minnesota, Montana, Texas, Utah and Wyoming — all reported a case increase of more than 60 percent, according to an analysis of COVID Tracking Project data in Axios' "Vitals" newsletter Sept. 24. Nationwide, testing increased by nearly 22 percent over the same period.

Five updates:

1. The Trump administration is planning to aggressively enforce new COVID-19 data reporting requirements for hospitals, internal documents obtained by NPR show. The draft guidance that hospitals will receive this week will ask for additional data reporting, including daily influenza case data in addition to COVID-19 data, such as number of patients and information on their inventory of remdesivir. Hospitals must report the data into a federal system managed by HHS. 

Failure to comply with the reporting requirements after several warnings will result in loss of Medicare funding for the hospitals, NPR reports. 

2. A study of more than 5,000 genetic sequences of the new coronavirus show that it is accumulating new mutations as it spreads through the U.S., the Washington Post reports. The study, which has not been peer-reviewed, did not find that these mutations made the virus deadlier or had a significant effect on clinical outcomes. But one of the mutations may have made it more contagious, the Post reports. A mutation that changes a protein on the surface of the virus — a “spike protein” — may be driving the virus’ spread and increasing its transmissibility. The virus could be responding to interventions such as wearing masks and social distancing, David Morens, MD, a virologist at the National Institute of Allergy and Infectious Diseases, told the Post. 

3. More than 90 percent of Americans are still susceptible to contracting COVID-19, CDC Director Robert Redfield, MD, said Sept. 23, according to Newsweek. While testifying in front of the Senate Committee on Health, Education, Labor and Pensions, Dr. Redfield discussed results from a national CDC serology study, which is expected to be published within the coming weeks. He said susceptibility depended on location, but that the preliminary data suggests that "the majority of Americans are susceptible to this virus." Research regarding COVID-19 antibodies has provided mixed findings, with scientists unsure how long, if any, immunity one has after surviving infection.  

4. The debate over how COVID-19 is transmitted has become deeply divisive among front-line workers and administration at some hospitals, according to Kaiser Health NewsHow the virus is spread, whether via droplets or aerosols, drives two different sets of protective practices. Some hospital administrators and epidemiologists believe the virus is mostly droplet-spread, like the flu, and strict patient isolation practices aren't necessary for routine care of COVID-19 patients. On the other hand, many occupational safety experts, aerosol scientists, front-line healthcare workers and unions note that the virus is far deadlier than the flu and argue that N95 respirators should be required.

5. President Donald Trump said the White House "may or may not approve" the FDA's proposed guidelines that would make it more challenging to issue emergency vaccine approval, reports The New York Times. The new rules would include receiving outside expert approval before a vaccine could be declared safe and effective by the FDA. However, President Trump said Sept. 23 that the change must be approved by the White House, and "We may or may not approve it." When asked why vaccine makers would want to delay the process, he said, "We are looking at that, but I think that was a political move more than anything else."

Snapshot of COVID-19 in the U.S.

Cases: 6,935,799
Deaths: 201,920
Recovered: 2,670,256

Counts reflect data available as of 9:25 a.m. CDT Sept. 24.

More articles on public health:
20 states where COVID-19 is spreading fastest, slowest: Sept. 24
200,000 COVID-19 deaths in context: Local & global virus stats
COVID-19 hospitalizations by state: Sept. 24


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