COVID data holes and lack of disclosure hamper policy decisions

Coronavirus

HONOLULU (KHO2N) — As state and county officials weigh what to restrict and where the most risky locations are, we wanted to know what data they’re using to decide. Always Investigating found and what is — and what isn’t — tracked by the numbers.

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Many watching COVID trends — from the public to lawmakers, from scientists to doctors — are clamoring for health officials to release more kinds of COVID data in Hawaii. The Department of Health says more is coming, but I dug into what they may already know that could inform better public policy.

The governor and Honolulu’s mayor say they’re taking a targeted approach with the latest restrictions, a scalpel rather than a hammer, avoiding mass shutdowns or categorical closings.

Governor David Ige said this Tuesday as further Honolulu County restrictions were announced: “We do believe and know that these additional restrictions can further help stop and slow the spread of COVID-19 here on Oahu.”

But how do the officials — or we — really know, beyond the anecdotal disclosures about individual cases or clusters, where is proving to be the areas of most risk?

Always Investigating obtained state COVID case intake forms and database templates to dig into how health officials are gathering information from and about positive COVID cases. From this we can see what is known and whether it’s logged into the databases. This is data that could be made accessible in aggregate to policymakers in order to know the areas that really are proving to be hot spots for the virus.

The intake is set up with specific variables for race and age, also whether there’s been recent travel or a household transmission. But beyond that there are no specific categories on the intake forms to help sort “place of exposure” into the 17 location-specific categories that Hawaii’s reopening plan says it’s watching for risk. The database wouldn’t easily output, for example, exactly how many positives have come from the beach or the bar, the gym or the office.

Dept. of Health COVID Contact Interview Form excerpt

“I do think the general categories of the clusters would be a valuable piece of information” said Dr. Victoria Fan, with the Myron B. Thompson School of Social Work at UH Manoa, and especially since this disease is a superspreading disease, so clusters really, really matter.”

Fan is also part of the Hawaii Pandemic Applied Modeling work group — HiPAM for short. HiPAM’s worst-case model as of the summer came more than true in late July, and their forecast into August warns of a 10,000 to 12,000 case range within weeks if something drastic doesn’t change.

“With HiPAM we’ve been advocating for getting more real-time granular data,” Fan said. “We’ve been communicating with and trying to work with the Department of Health in terms of improving their data systems. We’ve been emphasizing what kinds of key indicators we would like to see including the lab test turnaround time, how long does it take on average from the time a person tested until the time they get a result? Then from the time the test result is delivered to the time the contact is traced. In Hawaii we’ve been more modest in sharing those particular cluster locations, perhaps to our detriment.”

Lawmakers have been asking for more data, too. The state House recently implored health officials to share more details regularly about when and especially where COVID pops up.

Some of HiPAM’s and lawmakers’ wishes are about to come true.

“We have new metrics that we are going to be publishing including response time for case investigations and contact tracing,” said Dr. Bruce Anderson, director of the Department of Health. Neither Anderson nor Ige committed to a timeline but Anderson added: “We are trying to get that information together as best we can so we can report it routinely, as well as lab turnaround times and a lot of other data that we think is going to be useful to give the public a good understanding of exactly where we are and where we’re going.”

Lots of data already exists on the state dashboard, and just Tuesday the state released an aggregated list of previously announced cases and say they’ll keep doing that weekly.

Data experts offer a lesson on a key variable called R0 – pronounced R-naught — the level of infectiousness and number of people each case spreads COVID to on average. Hawaii’s R0 has been really high, making for a steep exponential curve.

“While I think it’s really important that we use data to make informed decisions, so much of this epidemic is really in our own hands and it’s in the hands of everyday people,” Fan said. “Our actions such putting on our face masks, washing our hands, staying apart, staying at home, that will help to drive that rate of transmission down. If enough of us chose, ‘you know what for the next couple weeks I’m going to stay home and just do a little staycation,’ we’ll stop the spread.”

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