August 26, 2020 - Cases Up, Tests Down & Positivity Rate Doubled
Cases Up, Tests Down & Positivity Rate Doubled
August 26, 2020
After two days in a row of incomplete data, today was catch-up day for ADPH. Let’s first look at the new cases for each of the last 3 days: (1) 8/24 - 1,650 cases (incl. 975 probables); (2) 8/25 - 532 cases (incl. 347 probables); 8/26 - 2,012 cases (incl. 840 probables). The 3-day average of cases is 1,398 and the 7-day average is now 1,194, which is the highest number in 2 weeks. Fully 52% of the reported cases in the last 3 days were classified “probables.”
The first thing you will notice is the extremely high number of probable cases. A probable case is defined as a person who exhibits multiple symptoms of COVID-19 and is “epidemiologically linked” to a confirmed case (close physical proximity) but there is no confirming test. There are many reasons why a person (esp. poor & disadvantaged) would not have access to a test - lack of transportation, concern about cost, fear of stigma, long wait to get results. Given the high likelihood of COVID-19, Johns Hopkins, as well as most states, include probable cases in their overall data. ADPH does not. BamaTracker tracks ADPH for now (but that might change).
Now, let’s look at tests for each of the last 3 days: (1) 8/24 - 814; (2) 8/25 - 3,469; (3) 15,568. The 3-day test average is 6,617 and the 7-day average is 7,986, which is as low as the test level has been since the first half of July. The resulting 3-day average positivity rate is 21.12% and the 7-day average is 14.95%, which is more than double the rate (7.33%) only 6 days ago.
So, cases are up, tests are down and the positivity rate has doubled in a week. That’s not good. CDC’s announcement today that it is changing its testing guidelines will only make matters worse. If ADPH adopts the change, it presumably will not be possible to obtain a test unless you have symptoms, ignoring the fact that 40% of COVID-19 positives are asymptomatic. Many experts argue that contact tracing is necessary to defeat the virus and that will require testing asymptomatic carriers.
There are only two logical reasons for CDC’s change which make sense ... and both reasons are damning. Perhaps testing capacity remains so limited that tests should be reserved only for the sickest patients. That's why New York was forced to ration tests early in this crisis. If that is still true 6 months later, then that is an indictment of our COVID-19 response. The only other logical explanation for this change is that fewer tests result in fewer known cases and fewer known cases has political benefit. Hopefully, that is not the reason. The CDC did not attempt to explain its rationale and referred all inquiries to higher-ups at the White House.
One final note. I encourage you to read the public statement by UAB in response to a NY Times review of COVID-19 results on college campuses. The Times review was flawed as it pertains to UAB because it combined clinical (i.e. UAB Hospital cases) with non-clinical (i.e. UAB students, faculty and staff) cases. The UAB statement is available here: https://www.uab.edu/news/campus/item/11515-new-york-times-reports-misleading-data-of-high-covid-19-cases-at-uab-in-story-about-colleges-universities
8/13 - 771
8/14 - 700
8/15 - 1,271
8/16 - 853
8/17 - 571
8/18 - 1,358
8/19 - 1,117
8/20 - 971
8/21 - 1,183
8/22 - 900
8/23 - 528
8/24 - 1,650
8/25 - 532
8/26 - 2,012
Jefferson (339) and Mobile (158) counties exceeded 100 cases. The 7-day positivity rates increased in all ten most populous counties, except Montgomery and Calhoun counties.