UPDATE(Oct. 28, 2020 3:32 p.m.)
CHARLESTON, W.V.a – After 12 News brought the issue of disparities between the numbers of active cases being reported on the DHHR’s COVID-19 dashboard and the numbers local county health departments report on their Facebook pages to the attention of West Virginia Gov. Jim Justice and DHHR officials on Wednesday, Oct. 21, the governor and DHHR Sec. Bill Crouch addressed those concerns, at length, during a COVID-19 briefing on Wednesday, Oct. 28.
The 12 News investigation, which can be read below, focused on discrepancies in the north central region of the state. Gov. Justice described the same issue in Kanawha County, where 496 active cases were transitioned to recovered cases, at once, causing the state’s numbers to drop dramatically.
Gov. Justice and Crouch again pledged to help local health departments with their reporting.
You can see their full comments on the issue here.
ORIGINAL STORY(Oct. 25, 2020 9:12 a.m.)
CLARKSBURG, W.Va. – Since the beginning of the COVID-19 pandemic, data has become a much bigger part of many people’s lives, centering around how the number of coronavirus cases is trending. Just as someone might check the stock market or sports box scores on a daily basis, many people are now checking the COVID-19 numbers to see how their community, the region and the state are fairing, or to find out if their children will be going to school in-person or can participate in athletics.
In West Virginia, the state’s Department of Health and Human Resources (DHHR) began releasing twice-daily COVID-19 data in mid-March. Several months later, citing a desire to fall in line with what most others states were doing, the DHHR switched to releasing data once a day. That information shows up in the email inboxes of media around the state at 10 a.m. on most days. There have been several times when this information has shown up later, typically with no explanation. The email usually includes raw numbers for how many COVID-19 tests the state has received results for, how many positives there have been and how many state residents have died as a result of the virus. It also includes a breakdown of how many cumulative positives each of the state’s 55 counties have. All of these numbers are totals since the pandemic began, and they make no reference to the number of active cases in the state or its individual counties. See an example of one of the DHHR emails here.
As soon as that email arrives, 12 News compares that day’s data to the previous day’s numbers. The staff puts together stories, like this one, for both WBOY.com and television newscasts, to show how many new test results were received, how many new cases there are and if there are any additional deaths.
At the same time that the DHHR sends out the morning email, it also updates the COVID-19 dashboard on its website. The dashboard includes much more information than the email, with various rates, trends, interactive maps and specific looks at things like long-term care facilities in the state. The much-discussed color-coded map, which determines whether schools will be virtual or in-person, is also a part of the dashboard.
So how does all of this data make it to the DHHR, and just how reliable and up-to-date is it? Much of the data flows from the 49 local health departments in the state (some county departments have been combined regionally). In an effort to streamline this information flow, this summer the DHHR implemented a new software system for the local health departments to enter their data.
The DHHR has a midnight cutoff for the data it releases the next morning, and that’s where things start to get somewhat muddy. In north central West Virginia’s 14 counties, in addition to the county-specific data put out by the DHHR, health departments from 11 of those counties release their own data, in one form or another. Barbour, Doddridge, Lewis, Randolph and Taylor counties appear to release their numbers daily on their individual Facebook pages. Gilmer, Preston, Ritchie (Mid-Ohio Valley Health Department), Tucker and Upshur counties post their numbers several times a week, while Webster County puts its information out once a week. The region’s three most populous counties: Harrison, Marion and Monongalia, point residents directly to the DHHR’s website and do not post information separately.
12 News compared DHHR and local data for the four most recent days. Out of 31 instances, eight of them match, 15 are within five cases and eight have a disparity of more than five cases. The raw data is below, and it was sourced from the DHHR’s dashboard and the individual Facebook pages of the health departments.
|Oct. 20, 2020|
|County||DHHR #s||County’s Facebook #s|
|Oct. 21, 2020|||||
|County||DHHR #s||County’s Facebook #s|
|Oct. 22, 2020|||||
|County||DHHR #s||County’s Facebook #s|
|Oct. 23, 2020|||||
|County||DHHR #s||County’s Facebook #s|
Over the four day period 12 News looked at, Barbour, Doodridge and Randolph counties showed the biggest differences. On Oct. 20, the DHHR listed 76 more active cases than Barbour County officials posted on Facebook. By the end of the week, the difference dropped to 58 cases in the county. When asked about the difference, Barbour County Health Department officials told 12 News that they were reporting the correct number of active cases each day to the state, but that they have not had a chance to transfer all recovered cases that are documented on paper into the state’s software system, which is the official source for the DHHR’s numbers.
“As with any data system, its only as good as the data that goes into the system,” WV DHHR Sec. Bill Crouch said.
Gov. Jim Justice and DHHR officials have generally attributed the differences to a lag caused by the midnight cut-off of data going into the state system. That explanation may stand to reason in counties where the difference is a case or two, but based on Barbour County’s explanation, this would not seem to apply. Adding to the confusion, some county health departments are posting their numbers in the late afternoon, long before the midnight DHHR cutoff.
Barbour County officials attributed the delay in getting cases entered into the state system to a lack of staffing. The governor’s office has said on several occasions that the state offers help to local health departments that have small staffs. According to West Virginia National Guard Maj. Gen. James Hoyer, 75 National Guard personnel are currently assisting the DHHR in 20 of the state’s 49 health departments and are “prepared to surge where needed in other counties.” Barbour County officials told 12 News that the process to get that help from the state is cumbersome, so instead they have simply told county residents to look at Facebook for up-to-date numbers.
Crouch seemed to acknowledge what county-level workers are dealing with and mentioned that state officials are looking for potential solutions.
“The local health departments are exhausted. They’re doing a terrific job. The issue of recovered cases, we’re also very concerned that those cases are not being cleared. That is a function of the local health department folks to put an end date on that file to show that, that the case is recovered, and until that’s done, it doesn’t come to us as recovered. So, that’s one of the big issues with regard to the differences. We’re actually looking at how we can do that for them, electronically, to take that workload off of the local health departments. It’s a burden, but it’s a necessity in terms of getting an accurate count of recovered cases. So, I want to thank the local health departments. Those folks are working very hard. We will continue to make changes as we move forward to make that data as accurate as possible, and we’ll always be transparent,” Crouch said.
On Oct. 21, Doddridge County showed its widest gap, seven cases fewer than DHHR reports. Randolph County began the week reporting eight more active cases than the state said the county had. The gap decreased each day, truing up by the end of week. Messages left with both Doddridge and Randolph counties’ health departments have so far not been returned.
Diane Gross, a regional epidemiologist at the Monongalia County Health Department offered further reasons for the differences in county and state numbers.
“The other thing to remember is that one reason the county and the state number can be off a little bit is that the county that does the investigation is the one that the patient identifies on their record. So, if a patient comes in, and they are using their old driver’s license to identify themselves, and the provider puts down the address on the driver’s license and it’s not current, then the lab report will go to the old address. That county then has to contact the person, say ‘Oh, wait, you don’t live in our county anymore’ and give it to the new county. That also happens if it’s an out-of-state person. For instance, the students are ones we have a problem with this in Mon County because a student may put their parents’ address down because that’s where the insurance is, and the lab report will go to that state and then has to come back to the county here. So, there can be a delay. Fortunately, we hear from the WVU system that we have a positive case, so that we can start investigating quite quickly. But, that means we may have 10 cases today, but our investigation finds out two of them belong to another county and we give them to that county. So, you look at the results tomorrow and you say, ‘Oh wait, you only have 8? What happened to those two cases?’ It’s because they had to be assigned to the right jurisdiction.”Diane Gross – Monongalia County Health Department regional epidemiologist
Officials with some county health departments are satisfied with the current system. Upshur County, which at most had a difference of one case during the period 12 News examined, falls in this category. The nurse director there said she did not consider the county’s reporting to the DHHR to be an issue.
Monongalia County officials stopped publishing their own numbers several weeks ago, saying that the state system had caught up with the county’s reporting.
“I would say the DHHR dashboard has evolved over time. It’s become much more comprehensive, provides much more data and provides some of the data particularly on race/ethnicity breakdown, breakdown by age. Some of the data that we’d been putting on our webpage, but now, the state is doing that for everybody. I think over time also, the difference between what we might say we have and the state, has become a much smaller difference. We think it is an accurate reflection of what is going on in Monongalia County,” said Cross.
For Gross, it is all in how people look at the data available on the DHHR’s dashboard:
“The number that’s most important to look at would be your total confirmed cases and your cases that are new that day or that week. That’s really the most up-to-date, what’s happening. Active vs. recovered is really how they are being followed within the system, within the surveillance system to whether they’re still ill or whether they’ve recovered. Once we’ve determined that, we have to call back to the case, determine that and then enter it into the system, so sometimes there’s a significant lag, which can be why at the state level, which is looking off of the surveillance system software, may be different then what is at the county level. Really, when you’re looking to see how much active disease is in the county, what kind of trends you’re having, circulation you’re having, really looking at the confirmed and probable cases and seeing how that’s changing over time is a more accurate reflection of the situation than looking at active or recovered cases.”
Justice summed it up as an imperfect situation:
“I could assure you with very fiber of my being that I believe without doubt that there’s not been, nor will there ever be, anyone manipulating numbers or holding something back. Absolutely, the only thing it could be, is it could be there’s a day lag or there’s days to where individuals, we just don’t have the numbers of people, whether they be local, or in the rural counties or they be at our level of DHHR here in Charleston. You should have tremendous faith in the numbers these great people are doing. Now, maybe it’s not perfect, but I’m telling you it’s transparent, and it’s as truthful as I could possibly attest that it is, and you should have complete confidence in these people’s numbers and the work these people are doing. At the point in time that there is an issue or a problem, I’ll bring it right to the people and I’ll tell the people as point blank as I could possibly tell them. This is not going to be perfect West Virginia, but I’m telling you, you’ve got some dad-gum good people who are working this right here, and you should have a lot a lot of confidence in what they’re doing. It won’t be perfect, but I’m telling you they’re doing a good job.”Gov. Jim Justice
Watch the full answers to 12 News’ questions from Justice, Crouch and Hoyer below: