Friday, July 24, 2020

Selective coronavirus reporting creates confusion

As time passes we become aware of more and more “oddities” related to the coronavirus pandemic. Cutting appropriate slack for the doctors and other healthcare authorities who advised President Donald Trump and the nation on how to respond to the crisis, it was a new virus and little was known about it. We can hardly get huffy about the mistakes made early on, and to some extent, even those that persist.

Even so, dramatic mistakes were made, and playing Monday morning quarterback shows that the reactions were — and are — over-the-top, and quite harmful, in many instances.

The shutdowns closed thousands of businesses, many permanently, put tens of millions of people out of work, and contributed to deaths and other health problems not directly related to COVID-19, as elective surgeries were cancelled, and needed appointments were cancelled by people afraid to go to see a doctor, or who were afraid to go to the hospital when they were ill.

A Kaiser Family Foundation poll found that 48 percent of Americans said they or a family member canceled or delayed medical care because of the pandemic, and 11 percent said the person’s condition worsened as a result of the delayed care. Some died.

We have problems with the reporting of COVID-19 data. Media reports focus on “cases” and “deaths,” to the near exclusion of negative tests and recoveries. The Centers for Disease Control and Prevention (CDC) rules allow people who die “with” the virus to be counted along with those who die “because of” the virus, expanding the number of deaths attributed to the virus by some unknown amount.

Furthermore, according to the CDC, a positive test allows for the chance that antibodies from a virus in the same family of viruses as COVID-19, like the common cold, were found. And, if a person tests positive for the virus, and is tested periodically to determine when he/she is no longer positive, each of those positive tests goes into the positive test count until the person tests negative. How many of the positive tests result from this repeat testing practice?

A virus test that is positive is called a “case.” That implies to many people that each “case” is an illness, that people who test positive are sick. But many who test positive experience only mild symptoms, or no symptoms whatsoever.

And then, there is this: The Florida Department of Health released its daily coronavirus testing report on July 14 showing a statewide positivity rate of 11 percent. But WOFL-TV (FOX 35) in Orlando reported, “Countless labs have reported a 100 percent positivity rate, meaning every single person tested was positive.

“Other labs had very high positivity rates. FOX 35 News found that testing sites like one local Centra Care reported that 83 people were tested and all tested positive. Then, NCF Diagnostics in Alachua reported 88 percent of tests were positive. How could that be?”

An investigation into these hard-to-believe results showed that Orlando Health’s 98 percent positivity rate was wrong. When the station contacted the hospital, it corrected the positivity rate to only 9.4 percent.

Orlando Veteran’s Medical Center reported a positivity rate of 76 percent. But, again, a spokesperson for the Medical Center told FOX 35 News that the positivity rate for the Center is actually 6 percent.

How often do such “errors” occur?

Florida, of course, has seen dramatic increases in actual positive tests, but on the positive side, the state’s nation-leading increase in positive tests is not matched by a nation-leading increase in deaths, so far.

One Florida death was a man in his 20s who died in a motorcycle accident, but was classified as a COVID death. FOX 35 News received a statement from the Florida Department of Health attempting to clarify how a "COVID death" is determined. If, "COVID19 is listed as the immediate or underlying cause of death, or listed as one of the significant conditions contributing to death. Or, if there is a confirmed COVID-19 infection from a lab test – and the cause of death doesn’t meet exclusion criteria – like trauma, suicide, homicide, overdose, motor-vehicle accident, etc."

Despite the latter point, this death was classified as a COVID death.

Here are some relevant data from as of July 19, 2020. The overwhelming majority of data comes from local or state/territorial public health authorities:
Total tests = 44,968,536
Positive tests = 3,962,061
Negative tests = 41,273,443
Test results pending = 3,032
Total hospitalized = 276,439
Total deaths = 132,395

These data show that only 8.3 percent of total tests are positive; that only 7.5 percent of those testing positive become hospitalized; that 3.6 percent of those testing positive succumb to the virus.

Also, fewer than half of those hospitalized — 7.5 percent of those testing positive — succumb to the disease, and 96.4 percent of those testing positive survive.

The selective choosing of which data to report can — and does — create a particular response: fear.

It would be far better — and far more responsible — to report the whole range of data so that the public will have a broad set of data on which to base its reaction.

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