Wednesday, April 15, 2020

Number of COVID-19 Confirmed Cases Increases In Oconee And Clarke Counties And In Northeast Health District Overall

***State Provides Some Measurement Details***

The number of COVID-19 confirmed cases on Wednesday increased by 25 in the 10-county Northeast Health District, and, with a death of an 87-year-old male with known underlying conditions in Walton County, the number of deaths increased by one.

Oconee County added two new confirmed cases with the noon Daily Status Report of the Georgia Department of Public Health on Wednesday, and Clarke County added three.

The number of confirmed cases in the 10-county Northeast Health District, which includes Oconee and Clarke counties, stood at 380 at noon on Wednesday, and the number of deaths attributable to the disease was 22.

Across the state, the number of confirmed cases of COVID-19 increased by 764 to 14,987 and the number of deaths increased by 51 to 552.

For both the Northeast Health District and the state as a whole, the increase in the number of new confirmed cases was less on Wednesday than had been the case on Tuesday, but the number of new deaths across the state was greater on Wednesday than it had been on Tuesday.

The Northeast Health District added one death each of the last two days.

The Georgia Department of Public Health released additional detail on Wednesday of how it gathers data for the Daily Status Report, saying that information is from more than “74 Georgia hospitals and most of the major commercial laboratories” as required by Georgia law.

Late on Tuesday, the Department of Public Health announced it had expanded testing criteria for COVID-19, allowing more people to be tested at the drive-through sites being operated by the Northeast Health District.


Sarah R. Peck, clinic manager at the Clarke County Health Department, sent me an email message today in response to my repeated request, reissued last night, for methodological information on the Daily Status Report.

Peck, who is the communication contact for the Northeast Health District, said she “reached out to our state office and received the following response from the Office of Public Health Informatics.”

The note says that the Department of Public health is the designated entity to receive reports of infectious diseases and others “that are deemed notifiable” from laboratories and health care providers in the state.

The reports are provided electronically, via fax, and via paper, according to the note.

I had asked how cases are assigned to counties in the Daily Status report, and the note said this is based on “address of the patient’s residence.”

As a followup to the information Peck provided me, I asked if the Department of Public Health uses the Zip Code, which has a primary county assigned to it by the Post Office, or a detailed database that relies on Census data for location of addresses by county. Zip Codes usually cross county lines.

I have not heard back with responses to that question.

The detailed note provided to me by Peck is provided in its entirety below the charts that summarize the Daily Status Report for Wednesday.


The first Chart is an update of the data for the Northeast Health District, including Oconee and Clarke counties, based on the noon Wednesday Daily Status Report.

Chart 1 (Click To Enlarge)

The second Chart is an update for the state of Georgia of cumulative data on number of confirmed COVID-19 cases, number of deaths attributable to the disease, number of tests administered, and number of hospitalizations for COVID-19.

Chart 2 (Click To Enlarge)

The third Chart is a combination of two charts I used in the Tuesday summary of the Daily Status Report.

Chart 3 shows the actual number of confirmed cases and actual number of deaths each day going back to the beginning of March. It also shows the data points for those two lines.

In addition, the chart shows a lines for a moving or rolling average for those data, based on a seven-day period. Rather than the data point reflecting the actual data for that day, it shows the seven-day average ending on that day.

The moving or rolling average smooths out the rough line to account for biases in the reports that seems to reflect days of the week. Tuesdays of recent weeks have shown large numbers of new cases and, to a lesser extent, of deaths.

The smoothed lines suggest a leveling off of deaths and a decline in new confirmed cases.

Chart 3 (Click To Enlarge)

Note For Department of Health

What follows is the full report from the Office of Public Health Informatics at the Georgia Department of Public Health, as forwarded to me by Peck.

I have broken the text into smaller paragraphs but otherwise not altered the text:

The Georgia Department of Public Health is the designated state entity to receive reports of infectious diseases and others that are deemed notifiable and that laboratories and health care providers in the state of Georgia are obligated to report under Georgia code,” that note from Office of Public Health Informatics said.

That said, we are almost entirely dependent on our health care providers and laboratories to do so in a complete and timely way,” the note said.

We receive data from numerous sources that include direct reports within our online disease surveillance system, fax and paper reports as well as electronic laboratory reporting from over 74 Georgia hospitals and most of the major commercial laboratories,” the note continues.

Each data source has its strengths and weaknesses,” according to the note.

Case reporting and case investigation is a process that involves a collaborative effort between our state epidemiology teams and in your area, the epidemiology staff of the Northeast Health District.

Our case reporting process depends on obtaining documented scientific evidence of infection for most conditions, although for some diseases in some instances a clinical case definition can be used.

In the case of COVID-19 we require positive laboratory results to be reported in order for us to count a case.

Further, we are dependent upon our reporting partners to provide accurate and complete data associated with patient demographic and risk related data elements such as underlying conditions and hospitalization etc.

The reality is that these data are often not communicated in real time, nor are they always complete or entirely accurate when first received. Our epidemiology staff are tasked with follow up and investigation of each case to ensure that each report is complete and accurate.

As you can imagine, this process takes some time, and cases cannot always be reached for various reasons. In the interest of being as transparent as possible, we are posting twice a day the most accurate cases counts that we have at the time of the posting.

As we are in the midst of this response, these data are continually changing and what we post is only a snapshot of a moment in time.

With respect to assigning a case to a county, this is based on the address of the patient’s residence, and while mostly this is known there are instances where this is not known at the time of report and it is also sometimes found to be inaccurate through later review and is changed in the data.

The immediate goal of this case reporting is to drive the epidemiologic response focusing resources toward clusters and outbreaks, and to better understand patterns of risk in terms of geographic distribution and what populations are being affected.

These data should be used to understand trends and identify outbreaks, rather than to have the most accurate case counts.

I hope this gives you some background on what we are doing and where these data come from.

I would encourage you to work with your health care community to promote the importance of their public health reporting activities, but given the current situation, their primary focus, of course, has to be caring for their patients.

While we endeavor to reduce the reporting burden through electronic means, it still does take some time and human involvement to obtain the most complete and accurate information.

Long-Term Care Facility COVID-19 Report

On Tuesday afternoon, the Department of Public Health released a Long-Term Care Facility COVID-19 Report as an update to one it has released on Friday.

The Atlanta Journal-Constitution on Wednesday contained a front-page story under the headline “Faulty data obscures virus’ impact on Georgia.”

The story said the report was “riddled with errors and omissions” based on reporting done by the paper.

The Friday report listed six nursing homes in the 10-county Northeast Health district, including one in Elberton with three confirmed COVID-19 cases.

The Tuesday report listed eight nursing homes in the 10-county area with confirmed cases, but it does not include the Elbert County nursing home.

The Tuesday Long Term Care Facility COVID-19 Report includes nursing homes in Greene, Morgan, Clarke and Oglethorpe counties.

One of the Greene County homes, Savannah Court of Lake Oconee, lists more than 20 (“>20") confirmed cases and nine deaths, but the Daily Status report for Wednesday lists 34 confirmed cases but only one death in Greene County.

Clarke Discrepancies

The Tuesday report lists confirmed COVID-19 cases in four Clarke County nursing homes. The Friday report had listed only one nursing home in Clarke County.

Those four Clarke County nursing homes have a total of 20 confirmed COVID-19 cases, according to the report.

The PruittHealth Grandview home has 16 confirmed cases and nine deaths, according to the Tuesday report, but it had only eight cases and no deaths listed in the Tuesday report.

PruittHealth said on April 8 it had counted 10 deaths at the facility at that point.

The Daily Status Report for Wednesday lists a total of 12 deaths from COVID-19 in the Clarke County.

The Tuesday Long Term Care Facility COVID-19 Report lists a nursing home in Glascock County with 11 confirmed cases of the disease, but the Wednesday Daily Status Report lists Glascock as one of only two counties in the state of Georgia without a single case of COVID-19.

The other county without a case, according to the noon Wednesday Daily Status Report, is Taliafarro. Both counties are between Athens and Augusta.

New Testing

The news release on Tuesday from the Department of Public Health said the drive-through sites being operated by the Northeast Health District will accept people for testing with an expanded set of criteria.

People with symptoms of COVID-19 (fever, cough, shortness of breath) can be tested if they are healthcare workers, first responders, and other critical infrastructure workers.

Persons with those symptoms residing in long-term care facilities or other group residential settings also will be accepted, as will persons 65 years of age and older, persons with underlying medical conditions, household members or caregivers of any of these groups.

People with symptoms who are not a part of any of the listed groups may be approved for testing, as capacity allows, according to the news release.

If capacity allows, people without symptoms may also be tested if they are healthcare workers, first responders, and other critical infrastructure workers that have been exposed to COVID-19 or residents of a long-term care facility or other group residential setting experiencing an outbreak of COVID-19.

The Northeast Health District has a hotline available to screen and refer for testing: 706-340-0996.

Prior to the Tuesday announcement, testing was available for mildly ill people who did not require medical care or hospitalization and were healthcare workers and other first responders, people working with and caring for vulnerable populations, such as long-term care facility staff, or people living and working in congregate settings where the disease could spread rapidly.

1 comment:

Unknown said...

It is good that there are tests now available for more people. It will be interesting to see what effect this has on case numbers. I is amazing that the nursing home cases are not being counted. But this is apparently a nationwide and worldwide problem. I hope they can get figure out a way to record this information.