HHS Vows to Reduce Racial Disparities in COVID-19 via Testing Data

Troy Brown, RN

June 05, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Laboratories will now be required to report additional demographic data to the US Department of Health and Human Services (HHS) in addition to results of laboratory testing for COVID-19, according to information presented at an HHS media telebriefing on June 4.

"The requirement to include demographic data like race, ethnicity, age, and sex will enable us to ensure that all groups have equitable access to testing, and allow us to accurately determine the burden of infection on vulnerable groups," Admiral Brett P. Giroir, MD, assistant scretary for health, HHS, said in a news release. "With these data we will be able to improve decision-making and better prevent or mitigate further illnesses among Americans."

ZIP codes and information as to the type of test performed will also now be collected. The deadline for compliance is August 1.

The updated reporting requirements will improve monitoring of disease incidence and trends by facilitating epidemiologic case investigations and contact tracing and will help determine the availability and utilization of testing resources. The information will also be useful for addressing potential supply chain problems.

Giroir began his remarks at the media briefing by sharing his "personal sadness and concern" and that of the surgeon general in his office regarding "the recent deaths of George Floyd, Breonna Taylor, and Ahmaud Arbery. These tragic events have devastated our country, and as public health officials, we cannot be silent.

"We must, and will, continue to acknowledge and address the racial disparities faced by minority communities, and as public health professionals, particularly my office, we are dedicated to leading America to healthier lives, regardless of race, ethnicity, gender, faith, geography, or sexual orientation," he said.

A recent survey found that the infection rate was threefold higher and the death rate was sixfold higher in predominantly black US counties than in predominantly white counties, as reported by Medscape Medical News.

"While these data are often being gathered currently, they are rarely being reported to the CDC in a usable format to provide a clear national picture," Giroir explained. He noted that the data will help federal, state, and local public health officials with decision making. Information regarding the real-world performance of tests, the effectiveness of interventions, and patient outcomes will be integrated into electronic health records and will be available to clinicians.

Together with case reports and other data, laboratory testing data help guide mitigation and control activities, according to guidance from HHS. "As the country begins to reopen its doors, access to clear and accurate data is essential to communities and leadership as they use data to make decisions for a phased reopening. For individuals, access to personal test results improves feelings of safety, security, and awareness, and empowers them to take action, if necessary, to protect themselves, their families, and their communities."

Some Labs May Have More Difficulty

Approximately 400,000 to 500,000 tests are currently being performed each day in the United States, and this number "is growing steadily each week," Giroir said. The CDC reports that as of May 31, nearly 19 million tests had been performed, and almost half (48%) of states had "achieved this benchmark of being less than 10% positivity," he added. The overall percentage of positive tests in the past 7 days is less than 6% nationally.

Guidance will be coming out soon about how to use the tests, Giroir said. Point-of-care tests are particularly useful in certain settings, such as nursing homes, where it is important to find out quickly whether an individual has COVID-19, but they are "relatively insensitive," he noted.

Larger institutions that have more resources will likely be able to meet this increased reporting deadline easily, whereas it may be more difficult for others. "We recognize that a number of larger labs that may have more robust technology and space will be able to comply very quickly, but...there are still labs that are faxing and having to create work-arounds" that will likely have more difficulty, Shannon Sartin, chief technology officer, Center for Medicare & Medicaid Innovation, said during the briefing.

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