COVID cases higher than reported

Staff Written Front Page, News

Morgan County’s coronavirus case count is estimated to be four times higher than previously thought, according to a new report from the AJC

By Tia Lynn Ivey

Managing Editor 

A new report released by the Atlanta Journal Constitution (AJC) estimates that Morgan County’s official current coronavirus case count is most likely four times higher than reported by the Georgia Department of Public Health (DPH). Statewide, the report estimates coronavirus cases are a third higher than the current official tally. 

“In Morgan County, 60 miles east of downtown Atlanta, the most recent two-week case rate would nearly quadruple, according to the latest data analyzed by the AJC,” wrote J. Scott Trubey, a journalist for the AJC, who noted most Georgia counties’ case counts would more than double. “In 60 of Georgia’s 159 counties, the two-week case rate would climb by 50 percent or more, including in 16 counties where the rate would be double or more than what is published daily on DPH’s website, according to the most recent county-level antigen data examined by the AJC.”

According to the new analysis by the AJC, the absence of antigen tests in the state’s calculations “distorts the picture” when calculating coronavirus case counts. 

At the beginning of November, the Georgia DPH added daily counts of “probable”coronavirus cases on the Daily COVID-19 Dashboard. The probable cases are detected by rapid antigen tests. The AJC analysis found that as more Georgians utilize the antigen tests, the state’s calculations become skewed. 

“As more and more Georgians rely on antigen tests, DPH’s dashboard still doesn’t include daily results for these tests in its statewide- or county- level charts and maps of positive cases. Nor do antigen positives figure into the calculations for state and county new case rates on the dashboard, which school systems, businesses and families rely on to assess risk,” wrote Trubey in an AJC article published on Nov. 29. “The lack of consistent reporting on a website that state leaders have pitched to residents as their go-to place for the latest data, critics say, provides an incomplete rendering of the virus’ march through Georgia as cases climb.”

Dr. Harry J. Heiman, a clinical associate professor at the Georgia State University of Public Health, told the AJC people could be making decisions based on incomplete data. 

“By not reporting antigen tests in the daily charts and maps, it distorts the picture and it distorts it at the local level where people make decisions based on this data,” said Heiman.

The AJC poured through the DPH data up through last Wednesday, Nov. 25 and determined that the “state’s two-week per capita case rate would be about one-third higher if antigen positives were included in the calculations with the gold standard PCR tests.”

The reverse-transcription polymerase chain reaction, commonly known as PCR, tests are considered more accurate than antigen tests because PRC tests detect viral RNA. However, while more accurate, PRC tests are also more expensive and take longer to assess. 

According to the AJC, “Public health officials have put their hopes on cheaper antigen tests coming to market to help fill the gap, and tens of thousands of Georgians turned to antigen tests for results. Antigen tests detect proteins on the surface of the virus and can deliver results within minutes. They are most accurate when administered to someone with active symptoms of a coronavirus infection. Fast results can help lead to faster isolation of infected persons and limit spread.”

“On Wednesday, DPH reported a rate of 313 infections per 100,000 people, or three times the level DPH considers as substantial spread. Including antigen tests, the AJC found the two-week case rate that would grow to 412 infections per 100,000, or four times the substantial spread level,” reported Trubey for the AJC. “The seven-day rolling average of reported cases would be 3,362 cases per day through Wednesday if antigen tests were included, or about a third more than PCR tests alone. That rolling average would be about 10 percent below Georgia’s peak reported daily case average level in July (though test positivity now for PCR tests is lower, suggesting Georgia is capturing more cases than in the summer).”

However, the DPH is currently in the process of adding in antigen test data to the COVID-19 dashboard, but has not announced when that will happen. According to Nancy Nydam, a spokeswoman for DPH, DPH follows the White House Coronavirus Task Force recommendation for states to treat positive antigen tests as positive new cases, conducting contact tracing investigations and quarantining patients.   

“There is no question that antigen data provides critical surveillance about COVID-19 in Georgia,” Nydam said. “Like the PCR data, antigen data provides both outbreak information and informs mitigation efforts.”

According to the AJC, the DPH’s website includes antigen data but it can be hard and confusing for untrained users to find. 

“DPH computes the statewide rolling average and county case rate data with antigen cases on a weekly basis and makes it public — but only if you know where to look,” reported Trubey. “Only by digging deep into a separate County Indicator Reports website, linked at the bottom of the state dashboard, can one find weekly data on how new antigen cases are piling up in counties across the state.”

“Right now, data being reported may be incomplete or batched, causing daily antigen data to fluctuate widely,” Nydam said. “As DPH continues to work with providers and facilities, reporting will get better over time.”

Amber Schmidtke, a public health researcher and former Mercer University professor who keeps tabs on Georgia’s coronavirus progress, praised the state for improving data presentation but warns the missing antigen component could mislead Georgians. 

“So many people and organizations rely on (the state’s dashboard) to make decisions that affect millions of people’s lives,” she told the AJC. “It’s painting a very optimistic or rosy assessment of where we are.”

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