Coronavirus: 13,800+ Tennessee infections left as ‘active’ long after they weren’t – The Tennessean
Tennessee health officials mislabeled about 13,800 coronavirus infections as “active” even after patients recovered from the virus, inadvertently inflating the size of the outbreak for at least three months, state officials confirmed.
Active infections, one of the widely used measurements of the outbreak, were inflated by approximately 40% as of the start of September. The count has since been corrected. The error did not impact positivity rates or the total count of infections or deaths.
The Tennessee Department of Health quietly fixed about 3,800 of the mislabeled infections, which occurred prior to June 30th, during a “data refresh” of public-facing coronavirus statistics on Sept. 3.
The rest of the mislabeled infections — about 10,000 from the months of July and August — were not discovered until officials re-examined data to answer questions for this story, said Shelley Walker, a spokeswoman for the department.
These 10,000 infections were also corrected when the state performed the data refresh even though officials had not yet discovered they were wrong.
Each of these infections should’ve been reclassified from active to recovered within 21 days from the onset of symptoms. Instead, Walker explained that contact tracers mistakenly “hard coded” the infections as active in a state database, so they were not automatically reclassified by a “recovery algorithm” after 21 days.
The Department of Health has not provided a county-by-county breakdown for the 10,000 mislabeled infections in July and August. A breakdown of the 3,800 mislabeled infections from before June 30th shows the the error predominantly impacted Nashville and the surrounding counties of Rutherford, Sumner, Williamson, Robertson and Wilson.
Statistics maintained by the Nashville Metro Public Health Department were unaffected.
This inflation of active infections occurred at a time when Tennessee was deciding how to restart the school year amid the looming threat of coronavirus and may have impacted how city, county and school leaders decided to act.
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For example, in Williamson County, officials hinged the decision of how to restart classes on the number of active infections reported by the state. County officials decided Williamson schools could open with in-person classes if the number of active infections amounted to less that 0.5% of the county population as of late July.
When the time came to make a decision, the state reported Williamson had 1,488 active infections – or about 0.6% of the county population – so schools began with most students learning virtually from home.
But the Tennessee Department of Health now says at least 283 Williamson infections — and possibly considerably more — were mislabeled at that time. With the mislabeled infections excluded, the accurate count of active infections amounted to 0.5% or less of the county population.
Jay Galbreath, a Williamson County school board member, said he was “100%” confident schools would have started in person if officials had the proper statistics.
“We would have started in school if we could do it over again with better numbers,” Galbreath said. “I guarantee it.”
Galbreath, an accountant who spent time scrutinizing state coronavirus data, was one of the first to suspect infections had been mislabeled. Although the Tennessee Department of Health said Thursday it had only recently discovered 10,000 of mislabeled infections, Galbreath said he alerted the state government to the error months ago.
Galbreath provided email excerpts showing at least some communication with state health officials about the topic.
“If they didn’t know, it’s because they didn’t want to know, not because the question hadn’t been asked,” he said.
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The Tennessee Department of Health first confirmed some amount of infections were mislabeled last month.
Walker said in August a “small number of older cases” were “unintentionally” overlooked by an algorithm that reclassified infections as recovered. At the time, Walker did not say how many infections were involved.
Two weeks later, on Sept. 3, the department announced a “data refresh” that brought two significant changes to public-facing data. First, the agency lowered a threshold for when infections are reclassified as recovered from 21 days to 14, leading to thousands of active infections vanishing in one day. The department also shifted about 1,700 cases attributed to an incorrect county, mostly due to zip codes that straddled county lines.
Health officials explained these data changes in an “on background” conference call with journalists, which meant comments from the call could only be attributed to an unnamed “administration official.” During this call, no mention was made that the state also corrected 3,800 mislabeled infections. Officials said the number of active infections would plummet, but attributed the change wholly to the new 14-day standard.
“Every county, and the statewide aggregate, will have a pretty noticeable drop in the active case count,” an official said on the call. “And that is because we are just changing the definition from 21 to 14.”
When the changes took effect later that day, the number of active infections in Tennessee plummeted from about 35,000 to 16,000. During a news conference that afternoon, Health Commissioner Lisa Piercey attributed the decline to the revision of the recovery standard, but did not disclose the correction of the mislabeled cases.
Walker, the department spokeswoman, said this week the correction was not initially disclosed because it was not considered significant.
“This was considered to be the minor and more routine change, and therefore was not prioritized for discussion,” Walker said in an email statement. “We prioritized discussion and understanding of the new active case definition which accounted for the majority of the shift in cases from active to inactive/recovered.”
Two days after providing this statement, the health department discovered 10,000 more mislabeled infections, then confirmed it was in fact the data error — not the new definition —that accounted for the majority of the drop in active infections.
Brett Kelman is the health care reporter for The Tennessean. He can be reached at 615-259-8287 or at brett.kelman@tennessean.com. Follow him on Twitter at @brettkelman.
Kerri Bartlett covers issues affecting children, families, education and government in Williamson County. She can be contacted at kbartlett@gannett.com, 615-308-8324 or @keb1414 on Twitter.
Published 3:31 PM EDT Sep 18, 2020
