Most states don’t report probable COVID-19 cases to CDC despite guidelines, data show
The Centers for Disease Control and Prevention are missing data on probable COVID-19 cases from many states.
More than half of states didn’t provide the agency with data on their probable coronavirus cases, based on daily data from Monday. This is despite CDC guidelines that states should report such cases — meaning the CDC could be undercounting the number of cases in the country.
Probable cases are those in which a patient either meets “clinical criteria” and ”epidemiological evidence” for an infection but wasn’t tested for COVID-19, meets one of those criterion along with “presumptive laboratory evidence” or meets “vital records criteria” without being tested, according to the CDC.
The agency has been including such cases in its count since April 14 based on guidelines from the Council of State and Territorial Epidemiologists.
A CDC report from Monday shows an additional 17,919 cases were reported for a total of more than 1.9 million confirmed infections in the U.S.
The report breaks down the number of cases in each state and U.S. territory by the number of confirmed COVID-19 cases and the number of probable cases. The CDC says that not all states report probable cases to them, in which case it says it indicates “N/A.”
And the data show that 28 states and the District of Columbia did not provide data on such cases to the CDC.
Some of the most populous states — including California, Florida, New York and Texas — are among those the CDC does not have data from.
A state not reporting these cases to the CDC doesn’t necessarily mean it doesn’t track them.
A Washington Post review found that while Georgia keeps data on such cases internally, it doesn’t report them publicly or to the CDC. Other states, such as Montana and Rhode Island, told the Post they don’t have any probable cases to report due to widely available testing or low numbers of cases. Additionally, some states lump probable and confirmed cases together, the Post found.
But there is concern about under-reporting cases.
Janet Hamilton, Council of State and Territorial Epidemiologists executive director, told the Washington Post that the “failure” of states to document probable cases is historic.
“There are lots of probable case classifications and probables are regularly and normally reported on,” Hamilton told the Post. “We are definitely concerned about the undercounting of COVID-19 deaths and cases.”
Kristen Nordlund, CDC spokesperson, also told the Post the CDC’s count is likely low.
This isn’t the first time public health experts have expressed concern about underestimating the impact of COVID-19.
Medical statisticians say cases have likely been underreported around the world since the start of the pandemic due to people contracting the virus without being officially diagnosed and the lack of tests in some areas, among other things, NPR reported in May.
The death toll is likely higher as well, many health experts agree, with some citing a lack of testing, misclassification of illnesses and varying standards between states, McClatchy News previously reported.
Additionally, a previous CDC report on excess deaths in New York City suggests that even reported probable deaths could be missing many fatalities that could have been related to COVID-19.
The CDC said in the Monday report it doesn’t know the exact number of COVID-19 cases in the country due to the prevalence of asymptomatic cases, delays in reporting and testing, the fact some patients do not get tested or seek care and differences in how jurisdictions report numbers.
State health departments may also update their data over time as more information becomes available, according to the CDC.
