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Why the data tells an evolving story during COVID-19 pandemic

Epidemiologist Michelle Fredrickson
by Michelle Fredrickson04/15/2020 1:26 p.m.
Updated: 04/20/2020

When you post a picture to social media, you probably pick something that tells a clear story. It’s a great day! The weather is beautiful! You’re doing something interesting! Everyone is having fun!

But that photo is just a snapshot in time. What your friends don’t see is the complicated reality that played out behind the scenes:

  • You stood in the rain for 5 hours. 
  • You spilled juice all over your favorite jeans.
  • The kids were whining about not being able to play with their friends.

Data can be like that. Numbers seem simple, clear and specific. But people’s lives are often complicated, busy and chaotic, even during the best of times. When the numbers are a snapshot of ill people during a pandemic, you can bet there is more to the story.

Every day, we tell you how many Pierce County residents have been diagnosed with COVID-19 and how many have died from it. We do our best to present a picture of who this pandemic has infected—and affected. We share age range, sex, geographic region of the county, and when reporting deaths, if the person had underlying health conditions. 

The picture may change.

Some days, we revise case numbers when our disease investigators learn new information about the person behind the number. That happens for many reasons:

Labs use different test kits and they reports results in different ways.

Test reports often contain limited or incomplete information about patients.

The Washington Disease Reporting System was designed to track a small number of positive cases. The large number of negative and positive cases has overwhelmed the system and caused reporting delays. The state Department of Health is working to fix this. 

People are active. They move. They travel. When they’re sick, they might stay with a family member or seek care in a different county. We make adjustments to reflect this. 

You’ve asked for more perspective.

We are working on ways to report more accurate and meaningful information. This helps all of us get a better understanding of how COVID-19 is affecting our community. 

For instance, many of you have asked us to share illnesses and deaths by race and ethnicity. We’re glad you asked. This information helps us understand if some communities are affected more than others. We want to know this so we can direct resources or modify interventions to meet emerging needs.

People don’t have to report their race or ethnicity when they get sick, but many do. We need to work with a sample size large enough to protect patient confidentiality and to provide accurate data. Now that our case count has grown, we can provide more information about race and ethnicity—and protect personally identifiable health information. Starting today, April 15, we will post this data each Wednesday by 2 p.m.

Among those who tested positive for COVID-19, we are beginning to see evidence that some populations are more affected than others. It’s only the beginning of the full picture of the disease’s effect. We expect the economic effects of COVID-19 to be more severe on some communities than others, but we will not be able to fill in these details of our data picture for some time.

You also asked us to report hospitalizations. We will report this information starting today at 2 p.m. as we have data sets large enough to reflect these stages of COVID-19:

  • Infection.
  • Illness.
  • Hospitalization and intensive care.
  • Death.

People don’t usually move through those stages in a straight line. Some never know they’re infected. Some are ill with mild symptoms and aren’t tested. Many are diagnosed with COVID-19 and recover at home for days or weeks. Others go to the hospital, return home, then go back to the hospital.

With the support of our partners, we can summarize hospitalization data for those who have tested positive for COVID-19. We will update this data every Wednesday by 2 p.m. 

COVID-19 infection has caused some patients to remain ill for longer periods of time. As you might imagine, tracking the individual health status of 1,000 patients (and counting) requires resources that simply aren’t available to us. 

Instead, we make difficult choices and prioritize work that will help us slow the spread of the virus. Case investigations usually involve a brief conversation with each patient when we ask a limited set of questions. If the patient is ill, we talk about what they should do. If they had close contacts, we call those people. If they’ve been to a high-risk facility, we work with the staff there.

We’re working on better ways to provide a picture of how many people are ill and how many have recovered as well as sharing occupations that may have a higher risk of exposure and how the outbreak is affecting long-term care facilities. We hope to release these estimates in the coming weeks.

We are committed to providing you with reliable information about COVID-19. We will do everything we can to improve the quality and clarity of each snapshot.

We appreciate your patience as we do our best to tell one of the most important stories of our lifetime—how COVID-19 affects the picture of health and vitality in Pierce County.

  1. Updated: 04/20/2020
Epidemiologist Michelle Fredrickson

by Michelle Fredrickson

Michelle uses data about our communities to tell stories about your health and how to improve it.

 

We invite your comments but will delete those with profanity, personal attacks, derogatory statements, ads or promotional material. Tacoma-Pierce County Health Department does not provide personal medical advice; please contact your health care provider.