Sudden increase in COVID-19 cases attributed to data error, not spike in positive cases
STEAMBOAT SPRINGS — On Friday, the Routt County Public Health Department reported a total of 111 positive COVID-19 cases at the same time the Colorado Department of Public Health and Environment was reporting 122 cases in the the county. On Sunday, the state increased that total to 125 positive COVID-19 cases while the county’s tabulation remained at 111.
The sudden jump and significant discrepancy is legitimate cause for concern, as schools prepare to reopen and the county continues to hover in the medium to medium-high range in terms of viral spread.
However, only six of those positive results are new cases, according to local public health officials. Three teenagers, one female in her 20s and a male and a female in their 30s were among the new cases reported from Aug. 3 to Sunday. There is no new outbreak or spike of significance, they said.
While public health officials were unable to grant a request for an interview Sunday when Steamboat Pilot & Today discovered the discrepancy between the state and local numbers, the county did issue a news release mid-morning Monday announcing that in addition to those six new cases, it was discovered that one local clinic had not properly reported about eight positive cases from late July into the state’s database.
The reporting of positive cases is mandatory. The clinic had switched labs in July to an out-of-state lab, which caused the lapse in reporting, said Robin Schepper, acting Routt County Public Health Department public information officer. The lab the clinic had previously used had directly reported positive cases to the state database.
The clinic did report the cases to the Routt County Health Department, Schepper said, but those numbers were not reported to the state. Schepper said the contact tracing process did began immediately as with all positive cases.
New Interim Director of Public Health Roberta Smith discovered the missing cases as she scoured the data. She was unavailable for an interview Monday.
With those old and new numbers taken into account, the county still has not reached the high viral spread benchmark. There have been 17 cases over the past two weeks, according to Smith.
Low spread, which would allow Routt County to apply for the “Protect your Neighbor” phase of reopening, is defined as 25 cases per 100,000 people over two weeks.
For the county’s populations of approximately 25,000 people, a low viral spread would mean seven cases over two weeks, a medium viral spread would be 13 cases in a two-week period, and a high spread would be 26 cases.
According to Schepper, the county would have to have 26 cases in just one week to lose the local restaurant variance. High spread would require the county to present additional mitigation plans to the state to reduce the spread.
Staffing shortages at the local health department continue to contribute to delays and issues with data reporting, according to Schepper. The county is in the process of hiring a public health nurse and an epidemiologist.
Data collection had been under the purview of a nurse who resigned several weeks ago. It will now fall under the responsibilities of the new epidemiologist, Schepper said. The county is in the final interviewing stages for the epidemiologist position and has just closed the job posting for a new public health nurse. The hope is to have someone in both positions before the end of the month, Schepper said.
One missing piece of data that is attributed to this staffing shortage is the number of pending tests. That number is important — especially with the recent backlog in turning around test results by both the state lab and private labs. Without timely results from the labs, contact tracing loses its effectiveness, the potential for positive cases to spread increases, and it isn’t possible to get a real-time sense of disease prevalence in the community.
Another piece of data on the county’s website that has not been updated since July 17 is the number of negative cases. Without that, there is no way to calculate the county’s test positivity rate — a metric being used by the Steamboat Springs School District for moving between the various phases of in-person and remote learning.
That number represents the percentage of positive cases out of the total tests administered. Of course, that number could be impacted if numerous people decided to get tested on a regular basis just to increase the denominator.
Previously, the public health nurse had been calling every clinic or other testing agency in the county to find out how many tests they had administered, how many came back negative or positive and how many were still pending. The nurse was calculating those totals by hand, then presenting that data publicly twice a week. Right now, those calls and calculations simply aren’t happening.
However, test turnaround times have improved significantly, Schepper said. Where they were taking up to a week, or even longer in some cases, now results are coming back in two to four days, she said.
In general, the county will now align itself and rely more heavily upon the state’s database and results, Schepper said.
The county had been waiting to report the results publically until officials received confirmation from the CDHPE that a positive case came from a Routt County resident. The state’s policy of attributing results to a person’s place of residence — not where the test administered and thus where the infected person physically was — has added another challenge to data collection and reporting, Schepper said.
That especially goes for a place like Routt County, where at any given time, there are a significant number of people living here, but whose driver’s licenses are still from a different state. Some of those people may even have lived here for years, but because of their driver’s license, their test results would be attributed to the location on their license.
The county at one time had been reporting the number of cases of people who were tested in Routt County but whose residence was not officially listed as Routt County, but that number is not currently being reported. Schepper said that number would start being reported again at some point.
On Wednesday, the county plans to release a list of all 125 cases with their gender, age range and the date when their COVID-19 test was administered. Previously, the tests were reported in terms of the date when the results came back, Schepper said, which is not nearly as valuable in terms of evaluating the disease prevalence.
To reach Kari Dequine Harden, call 970-871-4205, email kharden@SteamboatPilot.com or follow her on Twitter @kariharden.
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