Alabama seeing cases rises, COVID-19 fatigue, and ‘data dumps’ skewing totals

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HUNTSVILLE, Ala. — The Alabama Department of Public Health COVID-19 Risk Indicator Dashboard shows most of North Alabama in the “high risk” or “very high risk” category for virus spread.

The state overall is seeing an increase in cases, but Madison County’s case rate per day has remained relatively low, averaging 60 cases a day over the past two weeks.

But there are still plenty of serious cases.

Monday, Huntsville Hospital reported it has 151 COVOID-19 patients systemwide; a week ago it was 122 patients.

Health officials are closely watching the numbers, including a new figure posted on Alabama’s COVID-19 Data and Surveillance Dashboard (it’s tab 7a), which looks at cases by date
where the cases could be infectious – either the date of onset of the case or the date the test was performed.

ADPH says that is a better indicator for when a person was diagnosed and when they could have been able to transmit the virus. ADPH said the range is about two days before the onset of symptoms, until about the eighth day in the course of the illness and unlikely to transmit after that date.

The state says the model allows for case visibility during a given timeframe, rather than overall case numbers which can be affected by “data dumps,” as has happened twice in the past week, which include a high volume of cases, but which could date back months in some instances.
Health officials have said timing is a concern as cases rise again, because of flu season. Officials said that the more COVID-19 patients end up in the hospital, the harder it is for hospitals to maintain regular care.

There is also concern about what’s driving the national surge in cases. The U.S. has seen a 32 percent increase in cases in the past two weeks. Alabama figures are a bit skewed due to two labs uploading nearly 3,800 cases last week, but some of the cases date back as far as April.

Dr. Karen Landers of the Alabama Department of Public Health said there are trend lines that are concerning health officials.

“I think another measure that’s concerning to me, is again our numbers are holding somewhere between 800 and a thousand cases a day,” she said. “Our percent positivity has gone up about a percent and a half, and then the third thing is our hospitalizations are up a little over 900, whereas a couple of weeks ago they were about 700.

“So all those things concern me trending back upward. Now what do I attribute that to? I think nationwide you can look at this, and then statewide you can look at this. I attribute a lot of it to persons becoming fatigued with the COVID requirements and the COVID recommendations. I do think people are getting tired of it and they tend to be a bit more relaxed.”

The Alabama Department of Public Health addressed the recent spikes in case numbers, citing backlogged results from labs.

“The Alabama Department of Public Health processed a backlog of 2,565 positive antigen results from a facility in Mobile on October 22,” ADPH said. “These will be classified as ‘probable’ COVID-19 cases reported on 10/22/20 even though the tests were performed during June through October 18, 2020.

“The Alabama Department of Public Health processed a backlog of 1,182 positive results from a variety of facilities all over Alabama. A majority of these will be classified as ‘probable’ COVID-19 cases reported on 10/23/20 even though the tests were performed during April through September.”

Dr. Landers said the more familiar testing system has an electronic notification component through labs and hospitals that sends the results to ADPH, as required by law. But the rapid testing systems, often employed by doctor’s offices and other locations, don’t have an automatic reporting piece and results are getting backlogged. Landers said the state is trying to address the reporting problems, while also acknowledging the additional burdens that puts on medical and office personnel.

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