The Iowa Department of Public Health says its automated system of tracking infectious diseases has not been adequately collecting data on health care workers who have died after contracting the coronavirus.
The agency disclosed the failure, which it is now trying to fix, in response to an Iowa Capital Dispatch request for the data.
“We recognize this is important information to capture and are working to make improvements to our IT systems to support data-collection efforts,” department spokesman Matt Highland said.
The governor and other state officials have repeatedly cited the pandemic’s effect on health care workers as a critical element of their response to the pandemic, which first began to spread in Iowa eight months ago.
Di Findley, who heads Iowa CareGivers, a nonprofit dedicated to building a strong direct-care workforce, has said that “knowing how many nursing home workers have become infected, hospitalized, or even died from COVID-19, would help to inform the state’s mitigation efforts.”
Highland said that while IDPH is now working to improve the collection of data on nursing home staff deaths, it will not be publicly disclosing the information. The release of that sort of statistical information, he said, would raise “privacy concerns.”
Since the beginning of the pandemic, the department has released only combined staff-and-resident numbers for infections and deaths in Iowa’s privately run nursing homes.
Two months ago, the agency refused a request from the Iowa Capital Dispatch to separate the number of staff deaths and infections from the number of resident deaths and infections.
The department’s COVID-19 Communications and Emergency Preparedness Planner Alex Carfrae told the Capital Dispatch that IDPH would not provide the requested information on staff deaths “due to privacy concerns.”
After being asked to cite the specific law that allows the agency to withhold non-identifying statistical information of that sort, an agency official said the department would review its policies and all of the applicable state laws.
The Iowa Capital Dispatch then filed a formal public-records request for two separate pieces of information: the total number of Iowa nursing home staffers, statewide, who have died of COVID-19; and the number of deaths at each care facility where the individuals had worked.
The news organization asked the department to “cite the legal basis” for any denial of the information.
The department has now denied both requests, saying only that the numerical data requested by the Capital dispatch is considered “personal health information.”
Highland also said there “are challenges with the information you’re requesting as it does not automatically feed” into the agency’s Iowa Disease Surveillance System. That system is used by hospital, laboratories, and public health agencies statewide to report information on various diseases. The department has promoted IDSS as “a tool that speeds communication regarding cases of reportable infectious disease to allow public health to respond sooner.”
Highland said that the information on nursing home staff deaths that are tied to COVID-19 has to be “manually entered” into IDSS from death certificates, which, he said, “do not always have complete occupation information, or the physical address of employment.”
Highland’s response suggests that while IDPH has been collecting data directly from nursing homes on both resident and staff infections, it has limited its requests for data about COVID-19 deaths to residents of the facilities.
In making its request for the statistical information on deaths, the Capital Dispatch noted that another state agency, the Iowa Department of Inspections and Appeals routinely discloses staff-specific data, and even ties those infections to the specific care facilities where the individuals worked or lived. The agency also discloses the workers’ job titles and, in some cases, the exact date the workers tested positive for the virus.
However, the DIA data is disclosed only in relation to verified regulatory violations in those same homes, so the information remains unavailable for the vast majority of Iowa care facilities.
The Iowa Department of Human Services also discloses staff-only COVID-19 infections at specific, named care facilities, but only for the six facilities run by the state, rather than the hundreds of facilities run by private corporations.
It’s not clear why DIA and DHS don’t consider that level of disclosure enough to raise privacy concerns, while the Department of Public Health has concluded that a far less detailed form of disclosure would raise such concerns.
In September, IDPH indicated it was relying on Iowa Code section 139A.3(2)(c) in releasing information in a way that “prevents identification of any person or business” and that the goal was to “protect confidentiality of business names.”
The Capital Dispatch responded, noting that the law specifically allows for the disclosure of information that concerns a business in that it states “information disclosing the identity of the business may be released to the public when the state epidemiologist or the director of public health determines such a release of information necessary for the protection of the health of the public.”
Nursing homes house some of Iowa’s most vulnerable citizens, and yet they often make use of temp-agency workers who are deployed to multiple facilities over the course of any given week, allowing for faster spread of the coronavirus.
One indicator of how heavily nursing homes rely on temporary or shared workers: The National Bureau of Economic Research recently reported that 7% of smartphones appearing in a U.S. nursing home also appeared in at least one other senior-care facility, even after visits by residents’ family and friends were restricted.
The typical nursing home has, on average, staff connections with 15 other care facilities, the report concluded.
Randy Evans, executive director of the Iowa Freedom of Information Council, has questioned IDPH’s rationale for keeping secret the number of staff deaths.
“Once again, the Iowa Department of Public Health is showing that its first inclination is secrecy, rather than sharing information that helps the people of this state understand the scope and danger of the coronavirus,” Evans said. “The IDPH does not cite these supposed privacy concerns when it tells Iowans how many babies are born in this state each year, or how many marriage licenses are granted. So there is no legitimate reason for the department to trot out this bogus privacy reason for refusing to tell Iowans how many employees in care centers have died from coronavirus.”