COVID-19 stats show Blair’s surge
Rough calculation provides insight into disease progression
Some local residents have expressed uncertainty and skepticism about how the state Department of Health arrives at the COVID-19 statistics on its website, while others may have wondered about the less obvious statistics on the website or in the department’s daily COVID-19 news release.
At the request of the Mirror, department spokespeople have provided explanations and clarifications.
This statistic is one of the headlines on the main coronavirus webpage, and it applies to the total number of cases in the state. On Monday, it was 76 percent of the state’s 114,155 cases. It is explained in a footnote, as department press secretary Nate Wardle pointed out in an email: *** “Individuals who have recovered are determined using a calculation, similar to what is being done by several other states.
If a case has not been reported as a death, and it is more than 30 days past the date of (the) first positive test (or onset of symptoms) then an individual is considered recovered.”
The state doesn’t calculate recovery rates for counties, Wardle said.
However, “you could do a rough calculation,” he wrote.
Thus, On July 3, 30 days ago as of Monday, Blair County had 79 cases and one death. Therefore, 78 people were infected up to that time and were alive then, and so are presumed to be recovered now. Because Blair County currently has 233 cases (and three deaths), that is a 33 percent recovery rate, reflecting the relative surge in Blair County cases over the last month.
The DoH assigns cases to the county of residence as listed on the “lab submission form” for tests, according to Wardle.
“This is then double-checked during the case investigation,” Wardle wrote.
If the patient dies, the death is assigned to the place of residence “as reported by the individual who completes the (death) certificate,” Wardle wrote. This latter practice has created controversy with coroners, who are responsible for reporting deaths from contagious diseases that cause a public hazard, and who by law are required to investigate deaths based on the counties that they serve — and thus the counties in which the deaths occur — not based on where the deceased was living at the time, according to Blair County Coroner Patty Ross.
Coroners need to be involved so they can inform ambulance workers, firefighters, police and others who may not be aware that they have come in contact with someone who tested positive for COVID-19, so they can take precautions, Ross said previously.
No. of tests vs No. of cases
Many people who are found to be positive for COVID-19 get tested multiple times during the course of an illness, and sometimes more than one of those tests are positive, but the DoH case numbers represent individuals, not positive tests, according to Wardle and spokeswoman Maggi Mumma.
“Even if the person tests positive five times, it will only count once toward the state and local numbers,” Mumma wrote in an email.
Based on a response from Mumma, it’s less certain, however, whether someone who contracts COVID-19, then recovers, then contracts the disease another, separate time, (say months later) would be counted twice.
As listed on the DoH’s “Early Warning Monitoring Dashboard,” this statistic represents the number of people testing positive for the prior 14 days as a percentage of the number of people tested altogether, according to Wardle.
“It is not the total number of tests,” he wrote. If a person tests positive three times and negative once, that person’s case is reflected in the fraction used to obtain the percentage as one positive for the numerator and one test for the denominator.
The discrepancy between initial case numbers reported for the state day-by-day and case numbers reflected on the line graph “Daily COVID-19 cases” on the DoH website is a common lack of compatibility between two facts.
For example, on April 9, the DoH reported 1,989 new cases, but the hover-activated superscript on the graph point for that date shows 1,793 cases. The difference reflects adjustments that have been made to allow for numbers that were sent in past the daily cutoff time, but still assignable to each day, Wardle wrote.
Regarding a death reported for an area county, a local coroner wrote recently in an email: “There was a death, but the individual did not die directly from COVID-19; it was only a contributing factor because of a positive test. There were other significant medical conditions.”
Coroners and medical professionals often cite COVID-19 as a contributing factor, even though the more direct cause may be the pneumonia or acute respiratory distress syndrome to which the COVID-19 led, Mumma wrote.
The Centers for Disease Control and Prevention provides direction: “COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death,” it states in “Guidance for Certifying COVID-19 deaths” published March 4. “In cases when COVID-19 causes pneumonia and fatal respiratory distress, both pneumonia and respiratory distress should be included.”
But a positive test doesn’t mean that the death is necessarily attributed to COVID-19, according to Mumma. “If someone had COVID-19, and died from a car accident for example, we would not automatically count it as a COVID-19 death,” she wrote.
Tucked into the daily COVID-19 email from the DoH is a note on people who have had a positive serology test. The department has been reporting that number since at least May 23, when it was 513. The tally has risen glacially, and is now at 643. This number is a subset of the total number of cases in the state and of its probable cases, Mumma indicated. It represents less than 1 percent of total cases, she wrote. Probable cases represent about 2.9 percent of the total cases. A serology test shows the presence of antibodies for COVID-19, indicating that the test subject had the disease at some point. The probable category also includes cases based on symptoms or exposure, according to Mumma.
The CDC defines probable cases as those with the clinical criteria for COVID-19 and epidemiological evidence, but without a confirmatory lab test; those with presumptive lab evidence and either clinical criteria or epidemiological evidence; and those with vital records criteria but no confirmatory lab test.
Clinical criteria include symptoms like cough, shortness of breath or difficulty breathing; coupled with “no alternative more likely diagnosis,” the CDC stated.
Lab criteria includes the presence of COVID-19 antibodies.
Epidemiologic linkage includes close contact with a COVID-confirmed person.
Mirror Staff Writer William Kibler is at 949-7038.