Iowa Nurse Reveals Flaw in Coronavirus Data, Calls for Transparency

The pandemic has become a numbers game. Every state has its own coronavirus data center where providers and epidemiologists track the rate of new infections, deaths, the number of tests administered, as well as the number of available ventilators and ICU beds. This data is instrumental in the fight against the spread of COVID-19. It’s used to redirect patients to facilities with more resources and in the implementation of state-wide mandates, including the reopening of schools and businesses.

That’s why this data needs to be as accurate as possible.

Some states have run into hiccups over the last few months. Public health officials have even criticized some areas for publishing misleading or outright false information, such as Georgia, which has been accused of manipulating data to support the governor’s plans to reopen.

Dana Jones, a nurse practitioner in Iowa, recently found a major glitch in her state’s coronavirus reporting system and she says her state still isn’t doing enough to fix the issue. She’s quickly become known as a whistle-blower in the fight for more transparency.

Surveying the Virus

Calculating the number of local coronavirus patients is more complicated than you might realize. According to the CDC, “COVID-19 surveillance draws from a combination of data sources from existing influenza and viral respiratory disease surveillance, syndromic surveillance, case reporting, commercial lab reporting, ongoing research platforms, and other new systems designed to answer specific questions.” Together, this results in an accurate picture of how many people have the virus in each state, district, or community.

However, every state has its own method of reporting this information. There is currently no federal oversight of these statistics, so it’s up to each state’s health department to ensure accuracy and transparency.

It’s important to note that every system may have its flaws. Many people may have the deadly virus without their knowledge. Some are even dying at home before they test positive, which means they won’t be added to the official count. However, this data is considered one of our best weapons against the pandemic.

The Glitch That Went Unnoticed

Dana Jones has been closely tracking her state’s coronavirus data for months. She first noticed inaccuracies back in May when the system started reporting additional cases of the virus for March and April. She was initially confused, as she told a local news outlet in Des Moines.  “I noticed that positives were being added in March and April, and it was here now May 28th.”

She took her concerns to several epidemiologists for answers and feedback before going all the way up to the Iowa Department of Public Health.

Rob Ramaekers, MPH, CPH, Surveillance Unit Lead Epidemiologist at the Center for Acute Disease Epidemiology, finally got back to her in an email that recognized the problem. The message says:

“The x-axis of the positive chart is the date first reported to the IDPH. This is a system generated date that never changes once a case is made in our system. So, if I test negative in March and was reported to the IDPH, I would have a ‘Reported to IDPH’ date of March. If I was tested again today and came back positive, my ‘Reported to IDHP’ date does not change and now suddenly I appear on the graph in March.”

Basically, this means the first report to IDPH should never change, but Jones was seeing new cases pop up in the system several months after they should’ve first been reported. 

Adding cases to the system retroactively undermines the accuracy of these numbers. How can we trust the data if the numbers continue to change? 

Iowa Gov. Kim Reynolds finally addressed the issue in a press conference this week, blaming the inaccuracies on the state’s 15-year-old data collection system. Gov. Reynolds said the state does not have the IT infrastructure necessary to accurately track the number of new cases.

State officials say they have since corrected the glitch, with only small changes to the positivity rates in some counties, but Jones isn’t satisfied. 

After the glitch was addressed, Gov. Reynolds says around 80 counties have seen their positivity rates decrease, which could help the state reopen schools over the next few weeks. However, Jones remains unconvinced and skeptical of these figures.

We commend Jones for raising the alarm on this issue. Real-time coronavirus data is crucial to the fight against this virus. Make sure your facility is sending accurate information to your state’s health department.