Holman Column: COVID data ‘constant work-in-progress’

Lately, there have been a lot of questions about the data that is posted by the state and in the daily updates and weekly summaries by the Portage County Division of Public Health. It makes sense that people would look to the data to get an idea of how the virus is moving through our community and across the state. The data is helpful, and it is also a constant work-in-progress.

What local health departments post each day is a snapshot in time that is pulled from the Department of Health Services (DHS) servers, usually at or around 2 p.m. each day. That data reflects the tremendous amount of work being done by local health departments, the National Guard, hospitals, clinics, labs, and many others. It’s not surprising that, with such a large undertaking, there are inevitably going to be wrinkles to iron out.

Data is entered into the Wisconsin Electronic Disease Surveillance System or WEDSS. As DHS says on its website, “WEDSS is a secure, web-based system designed to facilitate reporting, investigation, and surveillance of communicable diseases in Wisconsin. It is designed for public health staff, infection control practitioners, clinical laboratories, clinics, and other disease reporters.” You can find a good overview of the system, here. The data that is available to health departments—such as patients’ lab results—is also part of what is called PHAVR (“favor”) reports. PHAVR stands for Public Health Analysis Visualization and Reporting.

One question people have had locally is about the number of people currently hospitalized. Early in the pandemic, Portage County didn’t have many hospitalizations, and we reported on “current hospitalizations” based on our interactions with local health systems. Once we had more hospitalizations occurring here and in Wisconsin in general, it became clear through DHS’ reported data that county residents were not all being hospitalized in local health systems and were, in fact, being hospitalized across systems, outside of our county, and sometimes in other states.

We are in contact with the healthcare systems in our county, and we are made aware of important updates, but there is currently no way to effectively track “current” hospitalizations in real-time. So, the decision was made to stop reporting an inaccurate data point and, instead, report “newly hospitalized” (within the last 24 hours) and “ever hospitalized” as these are accurate in real-time and tracked by DHS through WEDSS and PHAVR reports.

To be clear, it’s not surprising that this discrepancy emerged as positive cases increased and hospitalizations increased as well. It can be hard to track in real-time for anyone, and that is especially true when resources within health departments and elsewhere are being consumed by their efforts to box in the virus through contact tracing, etc. Hospitals are also currently in an exceptionally challenging position with the increases in cases and COVID-19 patients needing their care.

Another example of a statewide situation needing clarification occurred on September 4, when DHS noted on one of its daily Facebook posts that people, “…may notice that the negative and positive case numbers look higher today. Problems with the laboratory test reporting over the last few days delayed the processing of numbers until today, but that has now been fixed. Remember to look at 7-day trends to get the full picture of how the state is doing in its response to COVID-19.”

This sort of thing has generated confusion locally before, too. People have wondered why one day there are only 25 tests reported whereas on another day there are a couple hundred or more. This, too, has to do with laboratory processing because tests aren’t all processed on the same day and those results can come back sporadically under normal conditions. Some tests are processed within 24-48 hours whereas some will take several days or longer. It depends on the type of test and where it is sent to be processed.
In a surge like the one we’re in now, the priority is on positive test results as well. So, there is often a lag between when people are notified of their negative test result, and when that negative test result paperwork is processed into WEDSS. Thankfully, DHS will be providing a new tool and upgrade to its systems early next month, which will help everyone enter and track all testing data more quickly and efficiently.

While I appreciate that data issues can generate some frustration, what’s most worrisome are the accusations that some have leveled at public health departments and personnel because of them. Too often, people jump to what I would consider being the worst possible conclusion as to why any particular changes are made. Accusing the personnel in this county or any other who are working tirelessly—seven days a week—on our local and statewide responses of making decisions to obfuscate or hide data from the
public, of being lazy, immoral, or much worse is not only off-the-mark, it’s just plain wrong. Frustration and anxiety are understandable and expected in a prolonged pandemic like this one—and especially during a statewide surge in cases—but attacking the people who will help to get us through this serves no constructive purpose.

Furthermore, incorrect statements and assumptions based on pure speculation can spread through communities and serve to undermine the public’s trust in public health personnel and their peers at our hospitals, schools, businesses, universities, and elsewhere.

This is why the governor has made repeated appeals to the public to appreciate the difficulties of the situation and to note that health care workers and public health staff—who have dedicated their professional careers to this work—are not only providing a calm, reality-based voice of leadership in all of this, they are on the front lines of an issue that they were never meant to fight on their own. They need us on their side more than ever right now, too.

That means we should be doing everything we can as members of this community to slow the spread of this virus. Wearing a mask, socially distancing, limiting your travel, avoiding non-essential activities, washing your hands regularly, and keeping your circles small will all help to flatten the curve. In turn, that puts our frontline workers in a much stronger position in this fight, and I think that’s something we can all get behind.

Portage County Executive Chris Holman can be reached at 715.346.1997.