COVID-19 recovered numbers confusing

 It isn’t only the actual virus, COVID-19, that has a set of unknowns and is leading to general confusion but also the way statistics are being reported about the number of people infected with the novel coronavirus.

“The numbers weren’t adding up,” Denny Wayne Robinson, White County executive, said. “When I first started out with this, when I started seeing that something’s not adding up, and I started doing the math and tracking them, it wasn’t adding up.”

Robinson was talking about the statistics announced by the state of Tennessee each afternoon that alert the public as to how many positive cases of COVID-19 have been reported in each of the state’s 95 counties, along with the number of cases that are considered to be recovered.

“It’s not just the recovered numbers that seem to be off, it’s everything,” he said.

Robinson, and the 13 other county mayors/executives around the Upper Cumberland Region, got together and sent Gov. Bill Lee a letter demanding clarification and better communication about how the “numbers,” as the daily statistics are commonly referred to, are being derived.

How the state is determining a person to be recovered seems to have been a driving factor in a lot of confusion. Speaking to residents who have tested positive for COVID-19, they were told by the health department they would be considered recovered after 10 days, as long as they had been symptom free for a minimum of 24 hours. However, the state was not reporting a case as “recovered” until 21 days after a positive test had been recorded.

Robinson said the Upper Cumberland county mayors/executives followed up on their letter with a call to the governor’s office and then followed that up with a second call.

“You’ve put it on us to mandate masks or not, but you’re not giving us the information to make that decision,” he said they told the governor and then requested that he make a change.  “Either you give us more information, or you make the decisions.”

After the second phone call, Robinson said the governor responded to the region’s mayors/executives with a letter stating he agreed with them, and a change would be coming Sept. 1.

The change, which did not come until Sept. 3, came in the form of a press release that said:

Starting Sept. 3, TDH case count reports will include figures for “Inactive/Recovered” cases and will no longer include data for “Recovered” cases. “Inactive/Recovered” cases will include people who are 14 days or more beyond their illness onset date (or, for asymptomatic cases, their specimen collection date). This will more closely align with what is now understood about the infectious period of COVID-19, as recent data from the Centers for Disease Control and Prevention show most patients with COVID-19 are no longer infectious after 10 days. Previously, TDH considered a case recovered after a 21-day period.

While the new policy will align better with what the public has been being told, that a person should be recovered in 10 to 14 days, it does not allow for those cases that are still experiencing symptoms of the virus and/or may be hospitalized.

A call to the Tennessee Health Department resulted in the following statement from Shelley Walker, director of communications and media relation for the THD:

Our new calculation of inactive/recovered cases does not account for individuals who may have a longer isolation period due to prolonged symptoms, or that are hospitalized. This calculation is simply meant to provide a more accurate estimation of the number of actively infectious cases in a community than the previous calculation did.

 “Wow,” was the response from Robinson when he was informed of the department’s official statement.  “They’re not using common sense with this. Obviously, if you are still hospitalized, you are not recovered.”

As for those who have tested positive, although the state simply considers them recovered at 14 days, they are still supposed to be receiving regular follow-up calls from the Regional Health Department during the time they are considered infectious and told to stay quarantined. According to the THD, the purpose of the calls is to get a better understanding of how long a person is showing symptoms as well as to be sure the person is not in need of help. However, at least three White County residents have stated they did not receive follow-up calls after initially being informed of their positive test-results.

“[The] TDH aims to complete a case investigation and daily follow-up with all cases during their isolation periods,” Walker said when told of the reports of lack of follow-up calls and said the THD will try to reach out to those residents to find where the line of communication failed. “We recognize that there are occasionally issues connecting with people (for a variety of reasons); however, we like to investigate these situations thoroughly when we hear about them, and we’re working on a more standardized process to receive these ‘complaints’ and respond to them.”

As for the new guidelines for considering a case recovered, while it may line up in a more realistic manner with what patients themselves are being told, Robinson said it still creates a set of issues for reporting the “numbers” to White County residents.

“Now we are starting over,” he said. “In order to measure something, you have to keep using the same tool, and we just changed that tool.”

Robinson’s statement is backed up by what was reported as 99 people being recovered in a single day, on Sept. 3, when the state first used the 14-day gauge for a person to be considered inactive or recovered rather than the 21 days.

Robinson also said the problem includes more than just the recovered “number” as the number reported for hospitalized cases is cumulative, and no report is given regarding the number of people currently hospitalized because of complications directly stemming from COVID-19.

“I’ve called the health department, but they just keep giving me the same stats,” Robinson said and further stated he is frustrated with the lack of explanation and the missing pieces of information he feels are needed to have a better picture of how the virus is affecting the community.

At the moment, what numbers are available show that only 0.61 percent of the White County community have current, active cases of the novel coronavirus.    

“I cannot mandate masks when less than 1 percent of the population is sick,” Robinson stated. “That doesn’t make sense.”