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Editorial: SC needs to know more about COVID-19 in hospitals, restaurants, nursing homes, everywhere

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Covid-19 Nurses (copy)

DHEC doesn't require hospitals to report how many of their COVID-19 patients die, so the public has no idea how well hospitals treat patient unless they voluntarily report their numbers, as MUSC does. Here, nurse Rebecca Hale works in MUSC's COVID unit. Sarah Pack/MUSC/Provided

Every day, DHEC tells us how many South Carolinians were tested for COVID-19, how many tested positive, how many are hospitalized, how many of those are in the ICU or on ventilators, and how many have died.

It’s all very useful, particularly since DHEC does the math and provides charts that make it easy to see the trends and visualize the pandemic’s assault on our state.

But if you’re ready to try dining in at one of Charleston’s finest restaurants and want to see which ones had done the best job of stopping outbreaks among their staff, you're out of luck: Unlike health agencies in some states, DHEC doesn’t provide a list of restaurants where employees have tested positive for COVID-19.

DHEC does tell us, twice a week, the total number of infections and deaths at nursing homes and other residential care facilities. But don’t expect to be able to tell if it’s getting safer or more dangerous at the nursing home where your father with dementia has lived a restricted life since March. The agency doesn’t say how many nursing home residents and employees are tested, or when the positive tests come in.

And as The Post and Courier’s Mary Katherine Wildeman tells us, the agency doesn’t require hospitals to report when their patients die from COVID-19. That's important because hospital choice is important. So we don’t have any idea how many patients have died in a particular hospital, let alone whether its numbers are getting better or worse.

Hospitals long have argued that patient outcome data are misleading because they don’t account for how sick patients were on arrival, or for the possibility that the best hospitals could have the worst numbers because the sickest patients deliberately choose them. Those are reasonable points, but hospitals lost that argument years ago when the federal government started regularly reporting measures such as infection rates, bedsores and surgical problems such as collapsed lungs.

It’s particularly disturbing that DHEC doesn’t require hospitals to report that same sort of information about COVID-19 patients, given that the reason for lockdowns, school closings, mask mandates and more wasn’t primarily to protect us from infection. That’s a secondary benefit that we’ve come to believe was the driving force. It was mainly to prevent hospitals from becoming overwhelmed by all the coronavirus patients.

DHEC has a tradition of defaulting to “no” when it comes to providing important information to the public. That’s not just the agency’s fault; the Legislature never has been particularly interested in providing sufficient information to the public about … anything.

But as we’ve seen time and again during the pandemic, DHEC has sweeping authority to protect public health, and the governor has tremendous power during a state of emergency. The agency has demonstrated that it can change its mind: It refused to give paramedics COVID-19 test results by ZIP code, until the governor told it to change course. It refused to name nursing homes where patients or employees had tested positive until a lawsuit was filed.

Now, it needs to change its position on hospitals and on restaurants and on more details about nursing homes.

In fact, it needs to change its attitude entirely. The default for releasing information about COVID-19 ought to be yes, unless there’s a good, specific reason not to — and not simply because the industry doesn’t want the information disclosed. And if there is a good reason for not disclosing data, the agency needs to try to figure out a way around it.

If we want to get kids back in classrooms, South Carolinians back to work and our economy humming again, we're going to have to wear masks, keep at least 6 feet apart and take other precautions public health officials tell us are important. And we need to trust our public health officials. DHEC makes that easier when it's as helpful as it can be about giving us the information we need to make smart decisions.

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