Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.
COVID-19 vaccination variations among top federal officials
Key federal government officials differ regarding what population should be targeted for the first shipment of COVID-19 vaccines, STAT reports, with the current coronavirus task force favoring older people and a key advisory committee favoring healthcare workers. Other factions also disagree on when the vaccines will be ready to ship.
The CDC’s Advisory Committee on Immunization Practices (ACIP) voted Tuesday to recommend that healthcare personnel and long-term care facility residents to be first in line for vaccination. Leaders of Operation Warp Speed had lobbied for the emergency meeting to help prepare states, which ultimately choose how to distribute the vaccines, and to whom. States have until Friday to develop their plans.
Deborah Birx, MD, White House coronavirus task force coordinator, and Health and Human Services Secretary Alex Azar support sending the first batch of vaccines to older people; long-term care residents have comprised 39% of U.S. COVID-19 deaths.
CDC director Robert Redfield, MD, has suggested vaccinations could begin by the end of next week, if the FDA acts immediately following its own advisory committee meeting on the Pfizer/BioNTech vaccine scheduled for Dec. 10.
But last week, the head of the FDA division in charge of authorizing vaccines said it may take several days or even weeks after the meeting before the vaccine may be authorized.
Moderna’s vaccine is expected to be examined about a week after the Pfizer/BioNTech product. Officials have said they believe 20 million people can receive vaccinations in December and 25 million in January.
Cyberattack derails hospital’s operations
A cyberattack shut down the University of Vermont Medical Center’s electronic medical record system for most of November, forcing healthcare workers to rely on paper notes, faxes, and their memories to treat patients, the New York Times reports. Some patients in the hospital’s cancer clinic have had to postpone treatment and are awaiting key information as a result.
It was just one of a spate of cyberattacks on U.S. hospitals beginning in late October. Security experts blame Russian operatives seeking to disrupt services just before November’s election. The recent surge may also have been retribution for an American operation a few weeks earlier that took down 94% of one Russian hacker network’s servers.
The motive for the Vermont attack remains unclear, with the FBI currently investigating.
Healthcare workers there had to turn away three out of every four chemotherapy patients seeking treatment while their servers were shut down. Other patients are awaiting responses related to earlier treatment, such as one man who has been waiting a few weeks for confirmation on possible bone cancer.
The center’s system was finally restored Nov. 22, nearly a month after the attack.
Some of the hospitals (but not Vermont’s) were clearly victims of so-called ransomware attacks. One security firm executive said many had paid up.
Handling the surge in attacks has been hamstrung by President Trump’s firing of Christopher Krebs, director of the Department of Homeland Security’s cybersecurity division, after Krebs said there was no voter fraud in the Nov. 3 election.
Documents show China’s early bungling on COVID
Leaked documents from China reveal some of that nation’s early struggles with COVID-19 before it became a pandemic. The documents, obtained by CNN, show that it took 23 days for symptomatic patients to be diagnosed and diagnostic tests initially were nearly useless. In addition, a previously unreported large influenza outbreak likely complicated the regional response in Hubei province, where COVID-19 was first detected.
The documents present new clues to public health officials investigating the disease’s origin and early spread, leading some experts to question why the Chinese government kept them under wraps. “They were still hoping it was like 2003, and like severe acute respiratory syndrome (SARS) would be eventually contained, and everything can go back to normal,” Dali Yang, PhD, a political science professor at the University of Chicago, said of the national government’s initial response, which was very cognizant of international perceptions.
The documents “do reveal numerous inconsistencies in what authorities believed to be happening and what was revealed to the public,” according to CNN.
China reported 2,478 new COVID-19 cases nationally on Feb. 10, for example, when the documents show Hubei reporting 5,918 cases. The cumulative death toll in Hubei was publicly stated as 2,986 on March 7, when Hubei internally had reported 3,456 deaths.
Influenza hit the Hubei province, home to mega-city Wuhan, as case levels surged to 20 times greater than the year before by early December; the “epidemic” (as labeled in the documents) was still present when the first COVID-19 cases were detected. Dealing with the influenza outbreak sapped resources needed to handle COVID-19 and hindered communication with the national government.
Even after the national government recognized COVID-19’s presence, contact tracing and testing was stalled by bureaucracy, poor information sharing, ignorance of the new disease, and a public health system sapped by chronic underfunding.
Further complicating control efforts was a lack of accurate diagnostic tests. In early January, only 30%-50% of people with clinically confirmed COVID were testing positive with the available assays, the documents indicated.