As the SARS-CoV-2 surge recedes, we need to apply the lessons we’ve learned during this pandemic to improve our response to the next health emergency. One major obstacle has been the lack of health data needed to track the pandemic and assess its impact across the complex U.S. healthcare and public health ecosystem. This lack of timely, standardized data hampered our ability to respond rapidly and effectively to the pandemic.
For too long, we have neglected our nation’s public health data infrastructure, much of which is aging, obsolete and insufficient to meet our needs. We need to modernize our entire approach to data, from its collection and reporting to stewardship and management, to how we share it among public health agencies and health systems so that we have the information we need to protect health and save lives.
During our tenure as Centers of Disease Control and Prevention directors over a quarter of a century, each of us recognized the need for more accurate, timely and comprehensive data and each of us made progress toward that goal. But progress was limited because of both lack of funds and lack of legal authority.
As Congress considers the Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act) we urge lawmakers to include specific authorities needed to standardize and coordinate public health data across jurisdictions. This is critical to managing health threats in local communities as well as to provide local, state and federal policymakers with timely, accurate information to inform guidance and policy decisions to protect Americans.
Early in the pandemic, key local data such as hospital capacity was inaccessible to CDC, complicating the agency’s ability to assess the health impacts and lead our nation’s response. The declaration of a public health emergency temporarily improved the situation by giving the Department of Health and Human Services authority to require reporting of essential data to guide pandemic response.
However, once the public health emergency declaration is lifted, these federal authorities will go away, along with critical data to track deadly emerging infectious diseases and new COVID flare-ups. Without specific congressional authority, the CDC has no legal ability to standardize data.
The National Weather Service relies on a decentralized network of satellites, radar sites and local data to model and predict severe weather events. Their authority to do this does not flip on once a storm begins. Storm trackers are always on the lookout with coordinated streams of real-time data that are consolidated, analyzed and publicly shared, enabling them to alert communities and save lives. In contrast, the CDC has had to rely on uncoordinated data agreements because the agency lacks the legal authority to systematically ensure public health reporting before a health threat strikes. We wouldn’t attempt to predict severe weather like this, so why do we try to forecast the spread of deadly diseases this way?
We urge the Senate HELP committee drafting the bipartisan PREVENT Pandemics Act to include language to provide the necessary authorities so we will not risk flying blind as health threats emerge.
This is a problem that goes beyond COVID. If there is one thing we have learned from the public health emergencies of the past two decades, it is the importance of having robust everyday systems that can be scaled up in an emergency, and this includes a trustworthy stream of reliable public health data. Starting new data systems in a crisis is a recipe for failure.
Of course, any new authorities must maintain the strong privacy protections already in place for public health data — and guardrails to give Congress the appropriate oversight. Likewise, this data should be simultaneously accessible to public health partners at local and state levels.
We must be clear-eyed about fixing a system that has been underfunded for decades. It’s going to take years, resources and improved authorities — with accountability and transparency — for the U.S. to have the modern and secure public health information network needed to protect Americans. Giving the CDC the authority now to direct data coordination efforts will jumpstart longer-term rebuilding and modernization of our public health data infrastructure. As the pandemic has proven, American lives depend on how quickly and comprehensively we can accomplish this objective.
Tom Frieden is president and CEO of Resolve to Save Lives and senior fellow for Global Health at the Council on Foreign Relations. He was director of the CDC from 2009-2017.
Julie Gerberding is the chief patent officer and executive vice president at Merck and incoming CEO of the Foundation for the National Institutes of Health (FNIH). She was director of the CDC from 2002-2009.
Jeffrey Koplan is a professor of medicine and global health at Emory University. He was director of the CDC from 1998-2002.
William L. Roper is a professor of medicine and public health at the University of North Carolina. He was director of the CDC from 1990-1993.
David Satcher is founding director and senior advisor, Satcher Health Leadership Institute at the Morehouse School of Medicine. He was director of the CDC from 1993-1998.