With just 15 days remaining before the 2020 presidential election, Ohio Governor Mike DeWine was delivering a stump speech on Monday – “there is a red tide going through Ohio.” However, DeWine wasn’t talking about, and stumping for, Republican President Donald J. Trump. Instead, he was campaigning for COVID.
DeWine was referring to the rising case numbers in rural areas and “just about everywhere,” in Ohio – which has led to counties throughout the state reaching code red on Ohio’s public health advisory system.
However, The Ohio Star reported on both the sensitivity and inaccuracy of the three testing-centric measures of the OPHAS system: cases per capita, sustained increase in new cases and proportion of cases not in a congregate setting.
The latest five-day trend in “recorded” cases alongside the number of tests administered is as follows:
- October 15: 2,178 cases; 49,895 tests
- October 16: 2,148 cases; 42,837 tests
- October 17: 2,234 cases; 39,431 tests
- October 18: 1,562 cases; 31,208 tests
- October 19: 1,837 cases; tests not yet recorded
Because the above cases are “recorded” and not classified by onset date (the date on which a person is counted “positive”), the numbers will deflate. Just how much remains to be seen. “There is an inherent drop off of cases when you look at cases by onset date” said Ohio Department of Health Press Secretary Melanie Amato in an interview with The Star.
A “recorded case” includes numbers from as far back as the onset of the epidemic – officially January, according to the state .csv file found on the Ohio COVID site.
The Ohio COVID dashboard splits case numbers – one section grayed-out and listed as “preliminary.” Preliminary cases take an estimated two-weeks to be assigned by onset dates – although it is unclear why as the Ohio digital reporting system pushes numbers to the Ohio Department of Health every 24 hours.
The Star asked the Ohio Department of Health (ODH) what is driving the recent lift in “reported cases.” Amato wrote:
We do not have one circumstance to pinpoint to in the increase of cases. Majority of the cases are coming from community spread across the state. Gatherings, schools, sports, and so on. Colleges can be playing a part, but we don’t have a breakdown of those cases.”
However, the Ohio COVID site classifies data on the statewide dashboard with space delineated for ‘preliminary’ data – and that’s what the above test numbers are, preliminary.
The ODH spokesperson; however, did share that the shipment from the federal government of BinaxNOW tests the governor has talked about in recent weeks were delivered last week to colleges and “a handful of nursing homes.”
After finding out that the Binax tests were being used, The Star reached back to the ODH to inquire about whether colleges and nursing homes were complying with the U.S. Food and Drug guidelines regarding testing.
Information released by the FDA indicates BinaxNOW tests can pick up non-viable COVID antigen, bacterial infections and some other viruses.
The FDA granted Emergency Use Authorization (EUA) in order for the tests to be used; however, the FDA is clear on several points: the test is to be a point-of-care test, run by certified labs, processed within one hour of collection, given to suspected COVID-positive people within 7 days of onset (otherwise the test loses 25% efficacy).
The Star asked the ODH whether there were accountabilities in place to ensure FDA compliance. Amato wrote “the labs that would be doing the testing all have to be CLIA [clinical laboratory improvement amendments] certified. There were multiple communications from the federal govt. to the facilities that received both the POC [point of care] machines as well as the Binex cards, including instruction on use, requirements, as well as resupply.”
The FDA also mandates clinical correlation to accompany a positive or negative test to validate a positive or negative test.
What that means is that tests should be given additional insight and not taken without considering the test taker’s recent medical history.
Athletes and other Ohioans who have been marshaled into quarantine are potentially “presumed positive,” according to the CDC guidelines that epidemiologically link a COVID-positive person with a person who was within six feet for 15 minutes or more.
Because Ohio counts both confirmed and probable cases in the statewide case total, The Star sought clarification from the ODH on the rising number of athletes and students who have been told to go into lockdown in recent weeks – and whether those numbers are included in the Ohio rise in cases.
According to the ODH, epidemiologically linked people who are demanded to quarantine are not counted as positive cases. “Individuals in quarantine are not counted as cases. They would only become cases if they were to develop symptoms or if they tested positive and meet the case classification.”
So for now, Ohioans who are not counted as positive cases are being forced to quarantine.
The next COVID press briefing is scheduled for Thursday at 2:00 p.m.
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