Jumps In COVID-19 Cases Don't Always Lead To Outbreaks: Analysis

CONCORD, NH — The hunt for trends in New Hampshire's daily COVID-19 data can be elusive at times unless someone is paying hard attention to the numbers — and saves them for historical reference.

During the past few weeks, after seeing about two dozen positive daily cases for COVID-19 for days, the state saw some jumps into the high 40s and 50s and then a slow nosedive down to seven cases Monday. On Tuesday, another 59 positive patients were reported — with 17 cases reported Wednesday.

The see-saw motion of the numbers, often based on whether it is 2,200 or 4,300 specimens collected, has a lot of people wondering what is going on in New Hampshire — especially while witnessing spikes around the country. With the state of political discourse in our nation, states, and communities when it comes to the new coronavirus, the worst or best on any given day can be speculative and twisted to fit nearly any narrative. At the same time, the numbers are what they are.

During the past 24 hours, a few Patch readers have posted comments and wondered in emails how New Hampshire's numbers could fluctuate so much. One reader asked about the 26 cases in Rockingham County specifically and surmised people not taking precautions (limited or no social distancing, not wearing face coverings, etc.) might be the culprit.

The state has a lot of data posted on its data dashboard but it does not contain historical data, downloadable, or timeline information for town-by-town searches. While it is great to have the data dashboard, which was not available in the early stages of the pandemic, this limit is a flaw.

But daily, for months, I have screenshotted the data dashboard and added some information into an Excel spreadsheet, in order to track trends and revisit timelines, if needed.

The 26 cases do not appear to be associated with an outbreak or irresponsible behavior — even though that appearance is not completely known.

Hunting For Info On The 26

So what about those 26 Rockingham County cases ... what can an ordinary person find from the state's data dashboard?

Through contact tracing, the state determined only three of the 59 cases in the state Tuesday had no identified risk factors — meaning 56 cases either were in touch with someone with COVID-19 or caught it while traveling. It is unknown if any of those three people lived in Rockingham County because that data is not published.

Comparing both the Monday and Tuesday "risk/epidemic curve" data revealed 11 people had contact with an infected person; five were determined to be "community transmission," meaning from an asymptomatic person or a random person not known to the person but who may have been infected; 11 had traveled recently; and a whopping 23 were determined to be "unclear/unknown."

But wouldn't those 23 people be lumped in with the three people who were undetermined in the identified risk factor? No, it turns out.

Jake Leon, a public information officer for the New Hampshire Department of Health and Human Services, said the difference in the number of cases with unknown risk factors is related to when the data is released.

"When we issue the daily updates, some contact investigations have not been concluded," he said. "Sometimes we have to leave people messages and they don’t respond until after we have published each day’s update. As we learn more about risk factors and other data points during ongoing investigations, we update the dashboard. The increase is caused by completing contact investigations from cases announced the last few days."

In other words, the data entered at the beginning of the day may not be as updated as the daily briefing information sent out to the media during the early evening — and may not be in the morning either.

A look at the summary data dashboard section, which is not separated by county, shows one of the 59 cases lived in a long-term care setting while six were health care workers — so about 12 percent of the new cases. The state has been breaking out these two categories of subset data since the dashboard was created since they are the hardest hit in the state.

In the age category, three were 0-9 years old and four were 10-19 — or about 12 percent were children (the state considers 19 to be in the child category for COVID-19 even though they are technically an adult). Another 24 were 20-29 while the age categories of 30-39, 40-49, and 50-59 had seven each. Only seven cases were 60 years of age or older.

Not a lot of presumptions can be made based on age data and Rockingham County but the limited infections with elderly people shows the new cases were not connected to a long-term care setting outbreak. The 12 percent of children and 41 percent of people in their 20s could be a beach cluster or an outbreak connected to a birthday party or something involving young adults if they were all on the Seacoast at any given time. But that is unknown.

The Current Positive Cases map on the data dashboard does not provide a historical context of infections to compare — but screenshots of maps from Monday and Tuesday show cases in the city of Portsmouth either doubled or tripled during that 24 hour period.

From the color pattern changes between the maps, Portsmouth saw an increase of anywhere from nine to 13 positive cases in 24 hours based on its light orange 1-4 case shade on one day changing to a darker orange shade the next day. In both Exeter and New Castle, which neighbors Portsmouth, cases increased from 1-4 to five. During the last 24 hours, the community of Kingston went from 1-4 cases to zero cases (very light orange to white in the color coding on the map). No other communities changed color in Rockingham County. While Derry and Salem both have dark orange map colorings that represent 20 to 49 cases on Monday and Tuesday, both communities reported 20 cases on both days.

So anywhere from seven to 15 of the new cases were scattered across all the other Rockingham County communities with 1-4 case designations.

In other words, beyond Portsmouth showing increases, no other presumptions can be made about the 26 cases in Rockingham County. It all appears to be vary random infections — something of an unknown, just like COVID-19 itself.

Leon, at post time, was not able to answer if there was a specific event or gathering related to the increase in cases in the county.

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