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Last week, Texas passed the grim milestone of 10,000 deaths from COVID-19.
That is, it was if you went through the local media and the Johns Hopkins Coronavirus Resource Center. Texas State Department Health Services did not report a similar figure until around 5 p.m. EST on Monday.
This seemingly modest little inconsistency could be easily eliminated – especially in the context of divergent COVID-19 statistics across the country – were it not for the fact that the state has endured weeks of data glitches, sowing mistrust in across Texas. State officials blamed coding errors, system upgrades, backlogs, changes in methodology and test center closures for a recent wave of red flags in its coronavirus statistics.
Whatever the cause, the deluge of questions about numbers ranging from infection rates to total deaths has made it difficult to obtain a clear picture of what’s going on in the virus-ravaged state, public health experts told The Daily Beast. That would be concerning in itself, but it’s especially glaring given that the state is using this data to make decisions about reopening schools and other facilities as fall approaches.
“There’s a fog around Texas right now about what’s really going on,” said David Rubin, director of PolicyLab at Children’s Hospital in Philadelphia, whose COVID-19 models have played a role in the White House policy making. “Things are a little messy.”
“It doesn’t make sense,” said Dr. David Lakey, University of Texas vice chancellor for health affairs and chief medical officer of the system and a member of the Texas Medical COVID-19 task force. Association, on state positivity rates. last week.
The positivity rates reflect the proportion of tests that come back positive for COVID-19 out of the total number performed. It’s an indicator, experts generally agree, of whether enough tests are being done to paint a full picture of an area’s workload – as well as, more obviously, the extent of the infection. As of Monday, Texas had 555,394 cumulative cases of the virus, according to data from Johns Hopkins, and a positivity rate over the past week of 12.95%.
But like Lakey explained it, things got weird around July 27, when the state changed its method of reporting deaths, rather than infections. SSpecifically, this responsibility has shifted from a responsibility entrusted to local health services to a count based on death certificates. More than 400 previously unreported deaths were added to the total death toll on that day alone.
“Suddenly it looked like the dead had exploded,” Lakey told The Daily Beast.
Days later, according to the Texas Tribune, an “automation error” resulted in the incorrect addition of approximately 225 deaths to the state’s overall tally. They were then removed after an information quality check found that COVID-19 was not the direct cause of these deaths.
But as soon as these deviations were explained and started to balance out, as a result of the gear change, another – just as worrying – began to appear.
An upgrade in early August increased the capacity of the Texas State Department’s health services from 48,000 to more than 100,000 test results submitted electronically per day, a spokesperson told the Tribune.
Last week, the seven-day positivity rate suddenly jumped dramatically, to about 25% on average in the week ending August 11. For comparison, positivity rates in New York State have hovered below 1% in recent days. Texas Gov. Greg Abbott said in May that if the state’s positivity rate exceeded 10%, it would be considered a red flag.
This red flag has been present every day since the end of June. Despite this, local and state experts on the ground told the Daily Beast last week that actual information from hospitals across the state appeared to conflict with such huge positivity rates. These findings were supported by national experts who said the rates appeared to not match the hospitalization figures.
Meanwhile, the number of COVID-19 tests reported in Texas jumped by 124,693 in a single day on Thursday, August 13, after declining in the previous days, according to the Texas Tribune. A spokesperson for the Texas State Department’s health services told the news site the jump was “the result of coding errors and a system upgrade,” as well as delays in labs that could not be added until the errors were corrected.
Before the pandemic, about 1,200 lab results a day were sent to the State Department of Health Services, but this has increased dramatically. Data now comes in much larger amounts from labs statewide, which are sorted by format – including faxes and electronic records – and then uploaded to the Center for National Electronic Disease Surveillance System. Disease Control and Prevention.
Experts told the Daily Beast on Sunday that Texas’ positive test rate seemed more credible, as it had fallen to 11.25% after a fourth consecutive day of decline, according to a Houston Chronicle state data analysis.
As these issues arose, the data changed in another (probably related) way: The number of reported tests declined, which Abbott said he would investigate. The governor has since noted that a possible explanation for the drop was the closure of temporary test sites, which were opened in July to help manage hot spots. Others have noted a decline in demand for diagnostic tests, a claim apparently reinforced by claims from the state health department to the Tribune that community testing sites have “a lot of capacity” and few lines, if any.
In another twist, a coding error from Walgreens Pharmacy led to an undercoverage of about 59,000 coronavirus test results statewide, KVUE-TV reported.
Diana Fite, president of the Texas Medical Association and Houston-based emergency physician, explained that what keeps a high positivity rate is when “most people who get tested do it because they’re sick.” . A lower positivity rate will only be observed once a sufficient number of people submit to tests that more of them come back negative, but with trial state capabilities, “you hardly can do that now,” Fite said.
And even though in her opinion, “that 11.25 percent makes more sense,” she “still can’t really tell how accurate it is.”
These fluctuations, which Fite recognized were “Confusing” even for professionals, have raised concerns about Texas’ ability to track – let alone manage – the spread of the virus as schools make crucial reopening decisions in cities from Houston to San Antonio this week.
Large changes in numbers, Fite said, “Don’t trust everyone.”
Neither Governor Abbott’s office nor the Texas State Department’s health services responded to The Daily Beast’s requests for comment. But the latter told CNBC last week that he was “reviewing the situation and had contacted clinical laboratories and health care associations in the state.”
“We are investigating why the number of lab tests reported to DSHS has dropped in recent days,” Lyndsey Rosales, a spokesperson, told the news site. “We closely analyze our data to discover any anomalies.”
So what are the experts saying to school boards or counties or the average Texan trying to make decisions about the safety of their children?
“Without really good data, it will be difficult to navigate and know where we are in the response,” Lakey said. “If you don’t know that you can trust that positivity rate and believe that the case matters, then you are stealing blind.”
AgainAccording to Fite, the answer in the meantime is the same as it always has been: pay attention to the big trends rather than the specific numbers. Look at all the metrics together, instead of relying on just one. And be careful.
Regardless of the positivity rate, Fite said, “People at risk, chronically ill or elderly, should stay in quarantine.”
“Anyway, it’s still there,” she added.
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