August 27, 2020 - The Problem With Probables
The Problem With Probables
August 27, 2020
There were 1,769 new cases today (incl. 1,101 probables). The 7-day average of cases rose to 1,225. Of the 8,574 total cases this week, ADPH has classified 3,263 of them as “probable” - all in the last four days.
There were 12,023 tests reported today and the 7-day average of tests stands at 8,110. There were also 31 deaths (incl. 6 probables), which takes our total deaths from COVID-19 up to 2,071. By way of comparison, 741 soldiers from Alabama died during the Vietnam War.
The salient datapoint today, as yesterday, is the exploding number of “probable” cases. It is not clear what is driving probables up but it is worth trying to find out. The term “probable” is a misnomer. Perhaps “almost certain” is a better way to describe these people who have multiple symptoms and are epidemiologically linked (close physical proximity) to a confirmed case. The only difference is they don’t have a confirming test. There are many reasons why one might not have access to a confirming test - lack of transportation, concern about cost, fear of stigma, distrust of testing labs, inability to wait 7 days for a result. Most states include probables in their calculations. ADPH does not.
The important point about today is that 691 of the “probables” were reported out of either Lee County (536) or Tuscaloosa County (155). In those two counties, “probables” completely dwarf the confirmed cases (55 for Tuscaloosa and 25 for Lee). There is no word whether or not these unconfirmed cases are students of Auburn and Alabama. Since, by definition, “probables” have had no confirming test, they might include some students who are still awaiting their test results. Or, they might include persons in the community who came in contact with infected students, subsequently got sick, and have been unable to get tested off-campus. Both possibilities are dreadful to contemplate.
If you follow Bamatracker, he has agreed to begin showing 7-day positivity rates both ways - with and without probables. If probables are excluded, then the rate is 9.36%. If they are included, the rate is 14.28%, according to BamaTracker. Other trackers may show Alabama’s 7-day positivity rate as high as 15.1%. Either way, the exploding number of probable cases will likely stir considerable debate over whether progress is being made in this state...or not.
The growing gap between “confirmed” cases and “probable” cases is a byproduct of insufficient testing, which may or may not be driven by politics. Today, the director of CDC tried to “clarify” the agency’s earlier statement that persons who have been exposed to the virus, but have not yet experienced symptoms, should not be tested. Responding to a storm of criticism, Dr. Redfield stated, “testing may be considered for all close contacts of confirmed or probable Covid-19 patients.” The totals:
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
8/27 - 1,769