How Texas May Be Over Counting Cases, Creating a False Spike

IS THERE A FALSE NARRATIVE BEHIND THE GREAT TEXAS SPIKE IN COVID CASES?

Many family, friends, social media comments, and news sites have discussed a ‘SPIKE’ in Texas, with COVID-19 cases, during the entire month of June and July.  This may be true with more than 2,000,000 tests given since May 18. Is there another contributing factor to the reporting of cases? You decide.

TXGraphic1-testing.png

What happened on May 18, 2020 is extremely important to understand.  A significant change was made at the Texas Department of Health on definitions for HOW COVID-19 cases are being measured and how deaths are reported, moving forward into 2020. 

Prior to May 18, 2020, Texas measured cases as 1 positive COVID-19 (PCR) test = 1 confirmed case.

On May 18, 2020 the following presentation was given in Collin County, TX at a Judge Commissioners’ Meeting, by the Health Department, explaining a significant change in criteria and definition for reporting COVID-19 cases and also COVID-19 deaths. 

CASES

Slide directly from May 18, 2020 Presentation in Collin County, TX

Slide directly from May 18, 2020 Presentation in Collin County, TX

Texas no longer requires positive tests to qualify as COVID-19 cases reported.  Now, 1 positive case, can potentially be multiplied as 17 cases., due to probable contact with others (regardless if positive cases are confirmed).

DEATH

Texas no longer requires diagnostic testing to be counted as a COVID-19 death.  Previously, a positive PCR lab tested result was required to be counted and defined as a COVID-19 death, on the death certificate.  Now, a positive test result is no longer required.  No diagnostic testing is needed, which may be creating unreliable ‘cause of death’ reports.  

There are four areas these measures will likely significantly impact:

1) Case count 2) Death count 3) Recovery Rate 4) Policies across the state

Cases are now defined by the following criteria; there are 15 different ways/combinations a person can be classified as a ‘probable’ case, which means, consequentially, he/she is counted as a COVID-19 case. 

**Note “lab result” no longer required.  May 18, 2020 Health department presentation Collin County, TX.

**Note “lab result” no longer required. May 18, 2020 Health department presentation Collin County, TX.

QUALIFICATIONS AND CRITERIA 

According to the Collin County health department official, you need to only meet two of the following categories/criteria and you qualify as a case in Texas, with the exception of positive testing, which meets the qualifications with only 1 criteria (see #6 serology and antibodies).

1)     ANY 2 minor symptoms (chills, muscle aches, headache, fever, sore throat, taste disorders)

Of the 2 minor symptoms, if one is a fever, it does not have to be measured. You can subjectively just “feel” like you have a fever for that symptom to count.

2)     Or ANY 1 major symptom (a cough, shortness of breath, difficulty breathing, or undiagnosed pneumonia) plus one other criteria, such as living in TX.

3)    OR Living in TX: You meet 1 of 2 criteria needed above if you simply live in TX.  The State of TX considers the WHOLE state an area of pandemic.

4)    OR Probable case contact with probable case = counted as a case

5)    OR Proximity to confirmed cases

6)     OR Any antibody test, regardless of recent infection or past infection, regardless if your antibodies have been there for a while, if you test and show antibodies, you now qualify as a CURRENT CASE.  ANTIBODIES discovered in a positive serology test reflect ANTIBODIES past or present. According to the health official, these now count as CURRENT CASES. Positive Serology Test is when antibodies are found (a positive test result), it means that a person was infected with SARS-CoV-2 and their body's immune system responded to the virus at some point in the past.

7)     AND Time is no longer is a required criterion for measuring exposure window.  14 Days window of time being in contact with a probable person is NOW waived, and not required.  You can be in contact with a probable case from a month ago and qualify retroactively.

TXGraphic1.png

 To understand the change in reporting, here are some examples:

Example 1: A COVID-19 case can be measured by the following 2 criteria; you ‘subjectively’ feel like you have a fever, with a headache, AND you live in Collin County. 

Example 2: You have a cough AND you live in TX.

Example 3: You have a positive serology test indicating you had the virus at some point in the past.

Example 4: You might have come in close contact with someone, as far away as a month ago, who has a cough AND lives in TX.

Example 5: You are a co-worker of a neighbor, whose neighbor is a ‘probable case’.  You now come in contact with another co-worker of a neighbor, whose neighbor is a ‘probable case’.  Probable = COVID-19 Positive Case.  No testing has been done in any scenario above, except for Example 3.

Direct slide from Collin County, TX, May 18, 2020.  Unable to make it clearer.

Direct slide from Collin County, TX, May 18, 2020. Unable to make it clearer.

In addition, all examples and criteria above would require a person to quarantine, even with the IGG or IGM serology test. At this meeting, the local health department confirmed all cases, tests, and information will be removed from the jurisdiction of the local health departments and handed over to the state.

Texas County Commissioners and Judges have stated extreme concerns about the sudden definition change. 

For those that don’t know about this case definition or who don’t understand it, when they see these dramatic increases in numbers, they are going to be inclined to think either that we have hit some different spike and quite frankly we have this new pandemic raging through the community, which is a false narrative, but that’s not at all what that is sharing with us and communicating to us…
— Collin County Judge Chris Hill warned
There is no guarantee if the State keeps these numbers separately, that the media will.” “Even deaths are going to be no longer accurate either.
— Commissioner Fletcher

Another Commissioner stated at the meeting;  “I know it’s not Collin County, it’s the state, but the question is why.  It seems like it’s going to artificially inflate cases...”

Commissioner Williams: “There could be funding associated coming down the pike later, the federal government may use future funding coming from the federal government, the more cases, the more deaths you have, the more dollars you will get. It’s the only thing that really makes sense.” 

That could be expanded 16-fold.  We have the potential to see a remarkable expansion of those that are considered COVID positive and if you are just doing that for reporting, well it’s not reliable...

“but I am very concerned that we absolutely could see the numbers jump, very rapidly, in a way that is not indicative of what we are seeing here in the community and the public health department.  I fear that this is coming at a time when we are just now starting to reopen and if the numbers jump in a false way, it’s going to start to be very concerning to our citizens that we are actually going backwards.
— County Judge Hill continued

 

See and hear for yourself starting at about the 15:20 mark: Death definition change at 46:55 mark:

Recovery Rates

This is why we do what we do at PERK.  Policies are impacted greatly by changes like this.  Policies are impacted by the interpretation of numbers and statistics. Schools, businesses, and people’s lives are impacted in every way. You decide. Are the numbers increasing because testing has drastically increased? Are antibody tests being combined with testing the virus? We all have to go beyond the ‘media hype’ to the original sources.  Is this definition change impacting policies across Texas, inciting false fear in the people? Or is there truly a spike? Is Judge Hill correct, this “may be creating a false narrative” that impacts the whole echo system. 

Comparing fatalities to estimated recovery rates…https://txdshs.maps.arcgis.com/apps/opsdashboard/index.html#/ed483ecd702b4298ab01e8b9cafc8b83

Comparing fatalities to estimated recovery rates…https://txdshs.maps.arcgis.com/apps/opsdashboard/index.html#/ed483ecd702b4298ab01e8b9cafc8b83

 

The numbers in Texas are impacting other state decisions, to close borders and enforce a 14-day quarantine.  What are the ripple effects of this change in definition and reporting of COVID-19 cases and deaths?  Will businesses be forced to close again?  What about schools? Next time a politician, governor, media, or another declared ‘expert’ talks about Texas, my hope is it will include valid information such as testing increases and changes in definition criteria on cases and deaths. in their educated discussions.