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U.S. must collect this data in order to contain pandemic, former CDC director says

More than 1,000 U.S. deaths from COVID-19 were reported Tuesday. As many states struggle with outbreaks, Dr. Tom Frieden, former head of the Centers for Disease Control and Prevention, says the country desperately needs improved data collection to understand how the virus is spreading -- and to contain it. He joins Judy Woodruff to discuss critical metrics and how to obtain and learn from them.

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  • Judy Woodruff:

    With more than 1,000 deaths reported yesterday, many states are struggling to contain COVID outbreaks.

    As we just heard in Stephanie's report, former CDC head Dr. Tom Frieden says, to do that, the country urgently needs much better collection of data.

    Dr. Frieden joins me now. He ran the CDC from 2009 to 2017. He's now president of Resolve to Save Lives. It's a global health initiative.

    Dr. Frieden, thank you so much for talking with us.

    And before we talk about your plan, let me quickly ask you about the testing delays, which we are learning are an even bigger problem than we had realized a few months ago. What can be done about this?

  • Thomas Frieden:

    It's really important to focus on what matters. There's been too much focus on the number of tests, and not enough focus on whether they're being done in the right way, on the right people, with the right actions taken when they come back.

    There are different types of tests out there. The biggest problem are in the large commercial labs. Tests that come back five, six, seven days, let alone 10 or 14 days, are of very little use.

    So, if we hear there are 500,000 or 700,000 tests done, that's much less relevant than knowing what proportion of tests come back within 24 to 48 hours. We need to focus on what's important, so we can improve our response.

  • Judy Woodruff:

    Dr. Frieden, you are calling in your proposal for the states to do a much better job of reporting data, essential data, on this coronavirus outbreak.

    What is it that is not available now that is needed that we need to know?

  • Thomas Frieden:

    Judy, what was really surprising in this analysis is that it's not the states' fault. There isn't a national standard.

    And the two crucial things that we don't have access to are, what is our personal risk of getting infected with COVID if we go out, and how well is our government and society doing in our community to reduce that risk?

    If we know those two things, we can focus and improve and get back or get to the new normal.

  • Judy Woodruff:

    And what's it going to take to get that information? Is this easily gettable, or not?

  • Thomas Frieden:

    Some of it is.

    We identified 15 essential indicators. Of those 15, nine are pretty easily achievable, not very easily, but most places can get that, at least most of that, in some way. Some of it needs to be done much better in terms of race, ethnicity, age, other information on cases, hospitalizations, cases and deaths over time.

    So I think we can get some of that information fairly soon, but, really, the more important information is about how well our response is going, whether tests are quick, whether patients are getting isolated promptly, whether contacts are being identified and quarantined before they develop the disease.

    These are the essential measures that we need to track and improve to be able to get our society and economy back. If we get this right, our kids will be able to go to school in the fall, we will be able to go back to work, our economy will recover, and we will save tens of thousands of lives.

    But if we're flying blind, and we don't know how badly we're doing, we're not going to improve it.

  • Judy Woodruff:

    I want to quote a doctor at Vanderbilt University who was quoted in a New York Times story today about your proposal.

    William Schaffner said he welcomes your proposal, but he says few states have the expertise and money that is needed to generate this data, to analyze this data. He says it's a great ideal, but it's not something that many states can realistically or realistically afford to do.

  • Thomas Frieden:

    Well, Bill Schaffner is one of my favorite infectious disease experts. And he just about always gets it right.

    I think he's correct that states are looking at an enormous challenge. The data feeds coming in are complex. They're not necessarily accurate. There's a problem with duplicating patients. But the CDC has sent out more than $10 billion to state and local health departments.

    And Congress this week is debating the next supplemental appropriation. There's definitely a need for improved data systems all over, county, state and federal. If we don't have those, it will be hard to get this information. But many states have some of this information, and most states can get most of it.

  • Judy Woodruff:

    I think some people may be listening to this, Dr. Frieden, and saying, wait a minute, if it's just a matter of asking questions, putting some information into a computer, it doesn't sound like it's that difficult.

    What do you say to that?

  • Thomas Frieden:

    Well, one of the challenges is how heterogeneous our health care and laboratory system is in this country.

    So, one health department might be getting data in from hundreds or thousands of different providers, in dozens or hundreds of different formats, at different time frames. We and my organization Resolve to Save Lives have worked with one state to streamline that information, de-duplicate it.

    It's a big job. It's hard. It doesn't mean it can't or shouldn't be done.

    The other big part of this information is program information. And, there, it's not just about information. It's about the job we're doing, contact tracing, reaching patients, telling them they're infected, offering them services, getting them isolated.

    That requires a large number of highly trained people, disease investigators, interviewers, who have a combination of social work skills, medical knowledge, detective skills to find people, and counseling skills to support people with COVID and their contacts.

  • Judy Woodruff:

    A spokesperson for the CDC is saying that: We're already doing this. We are already in touch with the states to do, what, 14 of the 15 measurements that you're calling for. So they're saying they're almost there.

  • Thomas Frieden:

    Well, what we see in the data from publicly available Web sites is that not a single state in the country had most of these indicators up.

    And most states in the country only had about a fifth of them available on their Web site. So, we're a long way from where we need to go. But I do think that, with pressure on states to put this information up and support to states from the federal government, from health care providers, from the community, and demands that we should know what's our risk and what's our response, we can see a lot of progress.

    And that can get us all on the same page. If we're on all the same — if we're all on the same page, we can improve our performance and begin to get the upper hand against COVID.

  • Judy Woodruff:

    Dr. Tom Frieden, former director of the CDC, now with Resolve to Save Lives, thank you so much.

  • Thomas Frieden:

    Thank you, Judy.

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