A computer code offered to counties by the California Department of Public Health in November as coronavirus cases were beginning to surge statewide caused discrepancies in case and death numbers released by Riverside County, which is why epidemiologists and data researchers spent some time last month correcting those numbers, the county’s lead epidemiologist said Thursday, July 22.
Last month, the county had hit pause on releasing daily numbers to reconcile inaccurate data. On Thursday, county officials confirmed that they have started posting daily COVID-19 data again now that the inaccuracies have been resolved.
State public health officials offered the new code in November to simplify things, but it ended up causing complications and the county had to correct the data, leading to delays in getting information out to the public, said Wendy Hetherington, Riverside County’s chief of epidemiology.
“During the (winter) surge, the number of new cases was causing a backlog in terms of the staff being able to handle the numbers,” she said. “So, CDPH gave counties an option to enable an auto-confirm function in the disease reporting system to speed up the process so we could get cases to the contact-tracing stage.”
Before the winter surge began, Hetherington said, county epidemiologists and data researchers received lab reports and confirmed each report “manually.” This meant that staff members would review each case and match them with a positive lab test to confirm each case. That is what differentiated a confirmed COVID-19 case from a suspected case, she said. That process became untenable during the winter surge.
But the auto-confirm feature, which health officials hoped would clear backlogs and speed up the process, caused problems when the system confirmed a number of cases without lab reports showing positive test results, Hetherington said.
“We discovered that some probable cases were also marked by the system as confirmed,” she said.
Riverside County used this code between November and February, when cases peaked, and went back to manually confirming the cases after that, Hetherington said. After reconciling the numbers, they found the county had 2,000 fewer COVID-19 cases over that four-month period and had overreported fewer than 10 deaths during that time.
“A couple of thousand cases may sound like a lot,” she said of the overreported cases. “But when we look at a total of 304,000 cases, that is less than 1%.”
These types of errors remind everyone of the complexities of real-time data reporting county health departments have been forced to do during the coronavirus pandemic, Hetherington said.
“Typically, when it comes to other communicable diseases like the flu we do monthly or annual reports, which means we have time to spot discrepancies and correct them before we release information to the public,” she said. “Here, we’re looking at data in real time. So there is potential for error.”
But that doesn’t take away anything from the seriousness of the pandemic or the credibility of the information health officials are presenting, Hetherington said, adding that Riverside is not the only county with this number-discrepancy issue.
“What’s important to remember is the exact number of cases or deaths is not as important as what the trends are,” she said. “Right now, we’re trending upwards and that is definitely cause for concern.”
Since February, Riverside County switched back to the manual process of confirming COVID-19 cases, but it is possible that they might go back to using CDPH’s code to auto-confirm cases if here is another massive surge, Hetherington said.
“We’ve tried to build capacity and now have more data staff and epidemiologists than we did before the pandemic,” she said.
Before the pandemic, the county had a staff of nine including five epidemiologists and four data researchers. Now, Hetherington said, she has a staff of 15, including six epidemiologists and nine data researchers.
“The pandemic has definitely exposed lack of resources in our health departments,” she said.
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