On May 19, Gov. Larry Hogan issued an emergency order to expand access to COVID-19 tests with “appointment free” testing. Exciting news, indeed. Unfortunately, the administration failed to back this up with a timely coordinated communications campaign to give consumers accurate and actionable information.
Instead, the only information one could easily find was on the governor’s official website and that lacked specificity, but did link to Maryland’s primary COVID-19 website. Oops — 24 hours later the information, which had been confusing before, was now out of date. Since then, the relevant web page and frequently asked questions have been updated. However, the content and presentation remain confusing. In addition, the chart listing the test sites is arranged alphabetically, not by location, which makes it virtually impossible to use.
This lack of attention to effective communications with consumers is nothing new and it extends to the type and breadth of data they can access. In fact, getting the Hogan administration to release truly comprehensive COVID-19 data is a bit like pulling teeth — never pleasant but almost always necessary.
Why? The answer should be obvious. Information that is complete, accurate and actionable drives good decisions, whether made by individuals, elected officials, policy makers or those in the health care sector. Materials also have to be easy to locate and presented in a manner and language that is readily understood.
Unfortunately, in all of these areas Maryland has not lived up to the high standards it prides itself on. Fortunately, there are opportunities to significantly improve both data collection and how that information is provided to the public.
First, any policy changes, such as expanded testing should not be made public until complete and accurate resources are available to consumers.
Second, the state must address a gaping hole in available data — detailed hospital-specific data. Why isn’t that made public? Yes, we can go to Maryland’s COVID-19 website and discover how many intensive care unit and acute care unit beds there are statewide.
But, how useful is that when we need to know what’s happening in our own community and, specifically, at the hospital just down the road. How many cases are there now, including both patients and staff? How many deaths have there been? Our hospitals are the epicenters of the pandemic and yet we have minimal information on what is happening inside their walls.
This hospital-specific data should be available now. We can hope that it will be soon; however, we know that it took weeks and an aggressive effort to obtain a statistical breakdown of the pandemic’s impact on those most at risk — African Americans and senior citizens. Now that the information on these most vulnerable populations is on the website, is it detailed enough to be actionable? In reality it isn’t at this time, which the following examples illustrate:
- The new reporting for “congregate facility settings” on the home page provides an alphabetized list, but with no county location or street address it is impossible to do a detailed search and analysis. The link “nursing home cases” does take one to a broader dataset with county-level information. However, the facilities again appear without an address or county link. Therefore, individuals still lack a useful picture of what’s happening in their own community.
- Race and ethnicity data, as well as confirmed and probable deaths, are only shown statewide. More granular data, with county/ZIP code breakdowns would, for example, allow the public to assess whether resources are being appropriately allocated;
- The number of total cases are provided by both county and ZIP code but the total number of deaths is only a statewide figure; and
- As regards the ICU and ACU beds discussed above, the other hospital data includes the number of hospitalizations. Again, however, these are only provided as statewide numbers making it impossible to assess what is happening in our own hospital.
More broadly, Marylanders require a single, online, authoritative source of information on the pandemic that is easy to locate. As noted above, one had to go to the governor’s website to find information on new testing protocols. That then linked to the Maryland Department of Health official COVID-19 web pages. However, there is no obvious link from the MDH site to the governor’s. That means that individuals who only visit the latter might not discover important resources. Examples, include all of the executive orders and legal guidance, resources for the deaf and hard of hearing, or Maryland’s Roadmap to Recovery.
One of the most important examples of the difference in the websites is the fact that the governor’s has a link to resources in Spanish. Although hard to locate, that’s an improvement over the MDH website, where the resources are only available in English. That includes the 10 FAQs that range from the stay-at-home order to critical information on testing sites. How is it even possible these are only in English?
To address this and the other issues raised here, the governor should consider adding to his Maryland Strong Recovery Team an individual familiar with specific issues of concerns to consumers and with expertise on how best to communicate public health issues.
There are also many opportunities to learn from other states that have developed more consumer-friendly websites. For example, the Illinois Department of Public Health website provides a clear option for either English or Spanish. And the data they present is detailed and easy to access. That includes a useful Hospital Utilization page where one can hover over an interactive map to find data on both ICU and ventilator capacity, utilization and availability for 11 regions in the state. Another interactive map makes it easy to find information for specific long-term care facilities with numbers for both resident and staff cases and deaths and one can also search by county.
Gov. Hogan is absolutely right when he says that we must “all work together … to get through this crisis.” To achieve that he must take the steps necessary to be sure that all Marylanders can easily find clear and comprehensive information that meets their individual needs.
They expect and deserve nothing less.
— LENI PRESTON
The writer is an independent health policy expert.