Slow reporting from labs can hinder coronavirus response, create doubt

·4 min read

May 7—More than a year into the covid-19 pandemic, some virus cases identified during the first outbreak across Western Pennsylvania only recently were reported in Westmoreland County.

The cases were part of a data dump on Wednesday from one lab that included cases from March 2020 to March 2021, causing the county to see its highest five-day case total, according to state health officials. In all, 143 cases were reported in the county that day, compared to the day-to-day average of 91 cases found over the past week.

In reality, there were 43 new cases in the county that day.

Data dumps have occurred throughout the pandemic in places like Missouri, Florida, Texas and recently in Allegheny County, when GS Lab, with locations in McCandless and Upper St. Clair, reported three months' worth of covid test results in one day. The late reports potentially sow doubt in data used to gauge the severity of virus spread.

A late release of data caused state health officials to report 1,321 new covid cases in Allegheny County on April 14, though the county health department showed there were only 382 new cases.

"Given the scale of the pandemic and large increase in tests, some facilities struggle with finding the resources to create files using the appropriate standardized file formats and terminology," said Maggi Barton, spokeswoman for the Pennsylvania Department of Health. "This has happened across labs from all over the country as tens of millions of tests are performed."

Barton declined to identify the facility involved in this week's reported cases in Westmoreland County. She added that, while the data in question was delayed in being reported to the state, the individuals received their test results immediately from the provider "in order to best understand covid's impact on them and next steps."

According to Barton, several hundred labs and care facilities, such as nursing homes, are reporting test results into the state's electronic disease surveillance system. The state system requires results to be entered one-by-one, something that often is unsustainable for entities reporting a large number of tests.

Providers also can create data files containing test results that are submitted through an electronic laboratory reporting system.

The problem, according to Pittsburgh-based infectious disease expert Dr. Amesh Adalja, boils down to labs not recognizing the importance of reporting the numbers, or not having the systems or understanding of how to report covid data.

"I think that many labs that are doing covid testing aren't used to or don't realize the importance of public health reporting of their data and, in the past, they don't really deal with many reportable diseases that have real world implications for public health access and need to be taken now," said Adalja, a senior scholar at the Johns Hopkins Center for Health Security.

Inconsistencies in data reports, as well as instances where media reports do not clarify the timeline of covid data, leads to "a really bad situation," Adalja said. Those numbers are used to determine if there is a cluster of infections in a certain area or workplace, while also determining if case investigations and contact tracing needs to occur.

"All of that gets completely upended if you don't have real-time information about when and where infections are occurring," he said.

Inconsistencies in reported data also make people question the prevalence of the virus within the community, Adalja said.

"I do think it adds to distrust because people have had a lot of questions regarding how the data has been handled. These data dumps just make it much harder for the health department to explain the fluctuations you see in cases," he said.

According to Barton, the state, along with county and municipal health departments, work closely with laboratories to ensure data is reported in a timely fashion and that it is in accordance with orders from the state health secretary. More than 13.2 million PCR test results and 3 million antigen test results have been reported in Pennsylvania during the pandemic.

However, Adalja noted that to bring situational awareness to the pandemic, as well as to other infectious disease emergencies, continuous two-way communication with state officials needs to be established between laboratories, doctors' offices and urgent care clinics.

"It's something that these smaller labs need to realize, that they need to report to the state health department immediately, or the county health department if they have a county health department, in order for the health department to have situational awareness about what's going on. A test that's over a year old is of no use to anybody," he said.

Megan Tomasic is a Tribune-Review staff writer. You can contact Megan at 724-850-1203, or via Twitter .

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