NC ‘reporting error’ fuels 200,000 COVID testing overcount

RALEIGH — North Carolina public health officials have announced a major reporting error in the number of coronavirus tests conducted since the start of the pandemic. North Carolina previously reported having more than 2 million COVID-19 tests performed. Officials now say that is 200,000 more than were actually performed.

The North Carolina Department of Health and Human Services announced Wednesday that it is adjusting its total of completed COVID-19 tests and daily testing increases after an error in reporting from one of the state’s industry partners.

In a news release, NCDHHS said health officials found a discrepancy between the electronic and manual reporting of testing data from Burlington-based company Labcorp, resulting in a higher number of total COVID-19 tests performed.

The error drops the total number of cumulative COVID-19 tests performed by more than 200,000, from 2,044,727 to 1,823,283.

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Labcorp Chief Medical Officer and President Brian Cavey said the company found that since April, at-home test collection kits had been included in the manual data sent to state health officials, regardless of where the kits had originated.

In the release, health officials said the adjusted reporting does not affect the state’s key COVID-19 metrics, which include the number of COVID-like syndromic emergency room visits, trajectory of new cases, percentage of tests that are positive and current hospitalizations.

”Although this reporting error impacts our count of total tests completed, it does not alter our key metrics or change our understanding of COVID-19 transmission in North Carolina, which shows stabilization over the last few weeks,” said NCDHHS Secretary Mandy Cohen, M.D., in a written statement.

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Health officials explained that the discrepancy did not affect the state’s key metrics because while the total number of cases and percentage of positive tests are calculated from patient-level data, the total number of completed tests is an aggregate number sent manually to NCDHHS from labs.

Aggregate test data is not included in the calculation for the percentage of positive tests or total number of cases. Additionally, NCDHHS said the state is working to move all labs to report through the state’s Electronic Disease Surveillance System, which officials said will minimize redundancies and improve data accuracy.

For more information on the error, click here.

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How do labs provide testing data to the state?

Labs submit testing data to the state two ways: at the patient-level and in aggregate.

• Patient-level testing data (positives and negatives) are submitted either electronically through the North Carolina Electronic Disease Surveillance System (NC EDSS) or manually. Approximately 80% of total patient-level tests are now submitted electronically through NC EDSS. The other 20% that are manually submitted must then be hand-entered into NC EDSS.
• Aggregate testing data is provided by labs daily via manual communications. This is what NCDHHS uses to post the daily and cumulative report of total tests performed. NCDHHS has been working to improve data reporting processes to minimize redundancy with all labs to move to reporting exclusively through NC EDSS to improve data accuracy.

How is the rate of positive tests as a percent of total tests calculated on the COVID-19 NC Dashboard?

The percent positive rate is calculated using only patient-level electronic data in NC EDSS in order to accurately match up the total positive and negative tests run each individual day. Aggregate reports of total tests and the manually entered patient-level testing data are not included in the calculation.

So, while the reporting error affected the total tests, it did not impact the critical COVID-19 NC Dashboard metrics of total confirmed cases or the percentage of positive tests.

What is the difference between “tests” and “cases,” and how are they calculated on the COVID-19 NC Dashboard?

• Tests represent a single test performed. Multiple tests may be performed for a single patient and the test could be positive or negative results. Total tests presented on the dashboard are currently calculated using the aggregate data reports submitted via manual communications by labs.
• Cases represent individual patients testing positive for COVID-19, who may have had one or more test. Total cases presented on the dashboard are calculated using data from NC EDSS only.

So, while the reporting error affected the total tests, it did not impact a critical COVID-19 NC Dashboard metric – the total number of cases.

NC ties single-day high for reported new COVID-19 deaths

The North Carolina Department of Health and Human Services reported 45 more COVID-19 deaths, matching the previous daily record for the metric.

However, the state also reported a relatively low increase in new cases with 1,166 -- a slight increase from Tuesday, but a decrease from previous weeks.

In a news conference about the discrepancy in total reported tests, Dr. Mandy Cohen said the low number of new cases reported every day this week was not due to the error, but to the hard work of North Carolinians to slow the spread of the virus.

”We’ve been working hard on our trends,” Cohen said. “Our trends have been going down, and that’s a good thing.”

However, the percentage of positive tests increased slightly, back up to 7%. It had been at 6% for a number of days.

Currently, 1,062 people are hospitalized across the state with COVID-19, with 91% of hospitals reporting.

To date, 560 intensive care unit beds and 5,307 inpatient beds are currently available across the state.

Note: The numbers we show you every day mean everything in how our community recovers from coronavirus -- both in terms of healthcare and the economy -- but they don’t mean much without the proper context and as much transparency as possible.

New cases vary day by day based on a lot of factors. That can include how long it takes to get results back, so a new case reported today can really be several days old.

The other big metric we watch is the percent of positive cases. This is data we can only get from the state because it’s not as simple as factoring a percent of new cases each day from the number of tests. That’s because test results take days and come from a variety of places.

Cox Media Group