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Biden officials trying to recalculate U.S. Covid-19 hospitalizations

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The Biden administration is working on recalculating the number of Covid-19 hospitalizations in the U.S., according to two senior officials familiar with the matter.

A task force comprised of scientists and data specialists at the Department of Health and Human Services and the Centers for Disease Control and Prevention are working with hospitals nationwide to improve Covid-19 reporting. The group is asking hospitals to report numbers of patients who go to the facility because they have Covid-19 and separate those from individuals who go in for other reasons and test positive after being admitted, the two officials said.

The administration’s goal is to get a more accurate sense of Covid-19’s impact across the country and whether the virus is causing severe disease. Senior Biden health officials have increasingly relied on hospitalization numbers, rather than case counts, to determine how to respond to the virus as well as the efficacy of the vaccines. Lower hospitalization rates could inform the administration’s thinking on public health measures such as masking. More accurate Covid-19 numbers also could provide a better picture of the strain on hospitals and which resources they might need during surges.

Recalculating the hospitalization rate will not be easy, said Eric Topol, a professor of molecular medicine at Scripps Research and former advisory board member of the Covid Tracking Project, a team that worked to collect and synthesize local Covid-19 data during the peak of the pandemic.

“You need a panel of experts to review the cases to adjudicate if a hospitalization is for a person who came in for Covid or with Covid,” Topol said. “It’s not something that is coded in the chart. A lot of people will say an individual came in with Covid, but it was actually the Covid that exacerbated the lung or heart disease.”

The Trump administration launched a similar effort at the height of the pandemic in 2020. While some hospital networks have changed how they input Covid-19 admissions since then, many have not been able to consistently separate individuals who arrive at the facility for non-Covid reasons — for example, for a heart problem or a broken leg — and those who test positive for the virus upon arrival. The two senior Biden officials said the process of getting every hospital in the country to report accurately will likely take several months.

“While the guidance and intent of the hospital data collection is to capture people who are admitted for Covid (vs with Covid), in practice the data reported varies by entity,” a senior official at HHS told POLITICO in a statement. “Some entities may be able to delineate … but we do not do this in the national dataset.”

Biden officials are conducting a national review of hospitalization data to determine how many individuals sought care for Covid-19 and unrelated reasons during the peak of the Omicron spread. In one CDC report published last week, a California hospital found that 80 percent of its patients came into the facility for Covid-19 and 20 percent were admitted “primarily for non–COVID-19 conditions.”

Conversations about recalculating hospitalizations ramped up during the spread of Omicron, one of the two senior officials said. As the highly transmissible variant began to move throughout the country, hospitals began to see an increase in the number of individuals arriving for care for non-Covid reasons and testing positive during screenings, skewing the national hospitalization rates.

Administration officials moved to recalculate hospitalization numbers to better understand the dangers of the variant.

In a press briefing Feb. 2, CDC Director Rochelle Walensky said both hospitalization and death rates — as well as vaccination rates — are key to determining whether to lift public health measures such as masking.

As Omicron cases have come down, state and local officials across the country have advocated that the country begin to return back to normal and ease public health measures. New Jersey Gov. Phil Murphy and Delaware Gov. John Carney, both Democrats, announced Monday they planned to lift mask mandates for schools in March.

But, Walensky has said that case rates are more helpful in forecasting Covid-19 trends. “Our hospitalization rates are still quite high,” Walensky said Feb. 3. The current national hospitalization rate is still slightly higher than the rate during the peak of the Delta variant surge, according to data compiled by the CDC.

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