So, it looks like this is what is happening. States are not receiving reports from all their hospitals due to the changes in reporting July 10th. A thread. https://twitter.com/audreydutton/status/1286506957881266178

Hospitals now need to ensure their data complies with the new reporting system. They can report to the state, who reports to HHS for them, if the state is set up to do that, or they can report directly. If they are not reported to HHS, no remdesivir for you! 2/

The new requirements are here. 3/ https://www.hhs.gov/sites/default/files/covid-19-faqs-hospitals-hospital-laboratory-acute-care-facility-data-reporting.pdf

Included in the reporting requirements are "Previous day COVID-19 deaths" as item 16. So what does a hospital do? It reports to HHS and does not submit the report to the state. If you search twitter for incomplete data covid-19 you find this, and NPR has a story on it. 4/

The story is here. 5/ https://www.npr.org/sections/health-shots/2020/07/17/892357733/with-cdc-pulled-off-data-collection-some-states-lose-access-to-covid-hospital-da

Cases do not go through the same reporting stream as hospital data. Different stream, and only relevant for hospitals in-house testing, which is not state public health mediated (not most of it, like the deaths). 6/

So we clearly have under-reporting of hospital data starting from July 10th. These data problems SHOULD be worked out as time unfolds. 7/7