The implications of the errors with Florida’s positive test rate
Bottom Line: In today’s Q&A I addressed what isn’t affected by the numerous labs which at times have only reported the positive test results for COVID-19. That includes the actual numbers of positive test results and related deaths. What was affected does have meaningful public policy implications, however. Let’s look at why an over-reported positive test rate matters in Florida.
First, it’s important to know what the CDC’s target rate for positive test results represents. The CDC adopted a 10% target rate for positive COVID-19 testing. Anything above 10% is considered problematic, while positivity rates below 10% are manageable. The 10% benchmark was established as a barometer which strikes a balance between performing enough testing, while also being able to determine trends in community spread. We’ll come back to that point in a moment. While Florida initially had positive test rates above 20% in the earliest of testing, when few tests were available, the rate steadily declined as more testing came online. By May, Florida’s target rate dropped below 10% and seemed to support initial reopening efforts taken by much of the state. By the end of May the positive rate dropped to the 3% range and the positive test rate from the onset of the pandemic in Florida dropped to a low of 5.2%. Around this time there was a collective sense of having potentially dodged the worst and along with the weather heating up there was optimism that Florida’s heat and humidity had helped and would only be a greater asset going forward.
That began to change slowly by the second week of June. For the first time since initial testing, positive test rates and total cases began to rise meaningfully. By June 22nd Florida began to test above the 10% target rate and has every day since. During this time, we’ve seen the rise in daily cases from 671 at the time of reopening to over 11,000 most recently. We’ve also seen a near doubling in daily deaths from the previous peak as well. On back of this, and with important decisions about the upcoming school year to make, public officials took notice. This is where it’s time to circle back around to the reason there’s a target rate to begin with. To determine community spread.
Public health officials from the CDC to the Florida Department of Health and local health agencies have been tracking the rise in rates. In so doing, resources and policy decisions have been crafted to attempt to deal with what appears to be rampant community spread. But here’s where it gets sticky. Now knowing that numerous medical labs only reported the positive tests at times, the communities those labs are in would necessarily have exaggerated positivity rates. The community spread would appear to be far greater than it is, and public officials would be inclined to react to this information with policy aimed at curbing the spike. This policy may and in certain communities has included, reclosing dining rooms in restaurants, more restrictive policies towards gyms and like business, curfews, etc. And now as we know - whether to have school reopen in classrooms or online.
The public policy response to the target rate is a potential problem associated with the one-sided reporting of test results from certain providers. This is most recently evidenced by a plan advanced by Florida’s senate Democrats which would only allow for classroom education throughout Florida if a positive test rate were at 5% or below for two consecutive weeks. Again, it doesn’t affect any other reporting and as I illustrated recently, using complete excess death reporting from the CDC starting in April for Florida, our net cases are around 16% under-reported, but the fact remains it’s problematic. The other issue has to do with skeptics. Those looking for flaws in reporting and who feel this pandemic is hyped are using this to attempt to call other data into question. That’s certainly not helpful either because the spike in cases and deaths is real. There needs to be a reconciliation of exactly why certain institutions only reported positive results and if needed accountability for the failures.