Why are Beshear’s Kentucky coronavirus numbers often low, and sometimes wrong?
There are four confirmed cases of the novel coronavirus in Franklin County, according to the Franklin County Health Department. According to Gov. Andy Beshear, there are six.
There are 30 confirmed cases of COVID-19 in Daviess County, Beshear said. According to the Green River Health Department, there are actually 54.
A 75-year-old woman with COVID-19 died in Fayette County last week. The Lexington-Fayette County Health Department says she’s still alive.
Welcome to tracking the coronavirus in Kentucky.
“This is all very preliminary information,” Beshear said in his daily news conference Monday. “It’s all less than 24 hours old. Sometimes it’s the county where someone’s tested, sometimes it’s where they reside. Sometimes, there’s even a mistake in it. But when we give you an update every single day and it’s coming from now I think 15 or 16 different labs, that’s the way the information is ultimately going to flow.”
In the midst of a global pandemic, the Kentucky Department of Public Health has had to quickly establish a system for monitoring the number of COVID-19 cases for a fast spreading disease. To do that, they must coordinate with 61 local health departments and more than 30 private testing labs to compile an accurate list of who’s been diagnosed with the disease and where they’re located.
It is far from perfect.
The Kentucky Cabinet for Health and Family Services, which oversees the state health department, did not respond to questions about how it is tracking cases of the coronavirus, but Beshear said Wednesday that epidemiologists, who “are working shifts and hours that they have never been asked to work before” gather the information from local health departments and private labs.
In his press conference Thursday evening, in response to this article, Beshear explained that the state health department must filter information from a variety of sources — more than 30 private labs, local health departments, hospitals and news reports — in order to compile its list. There are sometimes duplicates or people who get tested twice and the state must re-check all of those numbers, he said.
The system has resulted in an official under-reporting of the number of confirmed COVID-19 cases in the state on any given day. On Wednesday, Beshear’s official total of 687 cases was at least 100 lower than information collected by the Herald-Leader from local health departments and the Beshear administration.
Beshear has expressed concern about the lag in reporting of cases by his administration. After he mistakenly announced a non-existent case in Floyd County Saturday he publicly worried that correcting the information would create a sense of complacency in people who mistakenly think that means the coronavirus isn’t present in their county.
“My concern based on our mistake, and it’s our mistake, is that the clarification, which needs to happen, lulls people into the thought that there isn’t a case in that area, that there’s not a person that has the coronavirus,” Beshear said. “Remember, this is in all of our counties and a virus doesn’t care about a county line. A county line is make believe.”
Mistakes have been common as the Department of Public Health struggles to manage the data.
Sometimes, those mistakes happen because the office gets a last-minute call before Beshear’s five o’clock press conference about a new case and Beshear announces it. Later, it turns out the information was incorrect. For example, he announced on March 26 the first case in a nursing home in Kentucky, a 90-year-old in Perry County. Immediately after his news conference, though, he posted on Twitter that “after reviewing it further, the 90-year-old Perry County nursing home resident has tested negative.”
Sometimes, it takes days for a positive test in a county to make it onto Beshear’s list, even though it’s been reported by the county health department. For example, according to the Allen County Health Department, there have been two cases in Allen County since at least Monday. Beshear’s list still only has one case in Allen County.
It’s unclear why this lag occurs. According to Merritt Bates-Thomas, the spokeswoman for the Green River District Health Department, their epidemiologist emails the information to the state, submits the information in an online tracking system called the National Electronic Disease Surveillance System, and faxes the information to them. Still, the Beshear administration has consistently under-reported cases from the health department.
Sometimes, cases Beshear announces as being from a specific county actually reside in another county. For example, there is a 3-year-old patient from Fayette County on Beshear’s list, but the Lexington-Fayette County Health Department says they have no record of a 3-year-old patient. Beshear has said this happens because the state is receiving information from labs about where the patient is tested, not necessarily where they live.
“There will probably always be a discrepancy — some numbers might get reported to the state later in the day, which could have them off from our 3 p.m. count,” said Kevin Hall, a spokesman for the Lexington-Fayette County Health Department. “Also, because we’re a regional hospital spot, some cases might initially show up as Fayette County but upon more tracking get moved to the appropriate county of residence.”
Kentucky still has not hit its peak of COVID-19 cases. As those numbers increase, the demographic information of patients — the age, gender and location of the patient — will only become more and more difficult to track.
Another number that has been hard to ascertain in Kentucky is just how many people have been tested. The governor’s office is now conducting an audit of all private labs to see how many people have been tested. Beshear has said many labs have failed to report the total number of tests they’ve conducted, which is required.
“We just do the very best that we can and we’ll try to correct it each and every day to give you the best numbers that we can,” Beshear said.
This story was originally published April 2, 2020 at 2:24 PM.
