Why some COVID-19 data may differ depending on where you live

Coronavirus

HAYS COUNTY, Texas (KXAN) — There’s a difference in the way local health departments track and report recovered COVID-19 cases, and it affects what you might see on each county’s dashboard.

For example, a look at the latest numbers of active and recovered cases in central Texas shows Hays County stands out, with more than 1,900 active cases.

Travis County, on the other hand, reports just 666 active cases, despite being a much more populated area.

That’s partly because of each county’s method in moving a COVID-19 case from “active” to the “recovered” category.

In Hays County, a patient is not considered recovered until the local health department makes contact with them.

In Travis and other counties, people are automatically cleared based on a timeline.

“I cannot speak to the decisions made by other health departments, but we chose this path, because we want to be sure people are symptom-free, as is everyone else in their house, before we consider them recovered and okay to go back to school/work,” said Hays County epidemiologist Eric Schneider.

Jaylen Cozadd is one of them.

“At first, you think the symptoms are nothing, like it was just headaches, tiredness, you know — stuff you get from being stressed out,” says Cozadd, who ended up being hospitalized in March.

“Literally I felt out of breath just texting sitting there, doing things that wouldn’t even make a person who was sick feel bad,” Cozadd recalls.

They didn’t feel much better until the end of June.

That’s when Hays County followed up again and Cozadd told them the case could be considered recovered.

Jaylen Cozadd said they suffered COVID-19 symptoms from early March through the end of June. (Photo courtesy Jaylen Cozadd)

It’s a process Austin Public Health used to follow until June, when they started automatically marking patients recovered after about 14 days, or about 32 days if they are hospitalized.

APH says the difference translates to more listed recoveries, saying that following up with patients directly takes too much time and causes a lag in data.

Hays County says the payoff is confidence that the residents marked as “recovered” are, in fact, symptom-free.

“This method takes more time and increased staff, but the benefit is that we are more confident about ensuring individuals are symptom free and therefore not likely to continue to spread the virus throughout the community,” a Hays County spokesperson told KXAN.

“We’re still gathering a lot of data, since this is a new infection,” said Dr. Elizabeth Douglass, Dell Medical School Infectious Diseases Specialist.

She says new information indicates more people are showing COVID-19 symptoms past the two week timeline.

“In the outpatient system where you’ve got milder illnesses, there is still a significant percentage of patients that are reporting symptoms beyond 14 days in the range of 30 to 40%,” Dr. Douglass said.

Douglass says while she can’t comment on how counties report cases, she encourages patients to keep communicating symptoms to their doctor.

Cozadd says even when a COVID case is considered cleared, people should know there could still be a lasting impact.

“There are a lot of people out here now with heart issues, breathing issues all kinds of… odd symptoms popping up, and it’s not just about death and recovery rates you know, there’s a lot more to it,” says Cozadd, who has developed asthma since their COVID-19 infection.

The recovery calculation used by Austin Public Health is from the Texas Department of State Health services. It’s also used in Bastrop and Caldwell counties.

A similar system is also used in Williamson County.

“It takes an average of 7.4 days from date of test, when known, to the date the case is reported to WCCHD. Based on the fact that it takes about a week for a case to get reported to WCCHD, and that cases are generally considered infectious for 14 days (if not hospitalized), a crude estimate of 7 days from date of report is used to determine date of recovery,” the county’s dashboard indicates.

A spokesperson says prior to July 4, Williamson County followed up with patients to determine when their quarantine period had ended and they were symptom-free, only using estimates if they weren’t able to make contact with the patient.

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