Florida's mistake on child COVID-19 rate raises trust issue
Fort Lauderdale, Fla. – An error by the Florida Department of Health produced a COVID-19 positivity rate for children of nearly one-third, a stunning figure that played into the debate over whether schools should reopen.
A week after issuing that statistic, the department took it back without explanation. The next weekly report on children and COVID-19 showed the rate had plunged to 13.4%.
The department blamed a “computer programming error” for the mistake, in response to questions from the South Florida Sun-Sentinel. Experts said the change and the failure to explain it to the public calls into question the state’s data at a time when accurate and trustworthy information is crucial to a society grappling with an unprecedented health crisis.
“It’s unacceptable to publish information that changes so dramatically that it warrants explanation, and then to not provide any explanation,” said Jason Salemi, associate professor of epidemiology at the University of South Florida College of Public Health in Tampa. “I’m trying to get an understanding of why the number changed so much, what underlies it – and can we trust this new number.”
The unexplained revision of the child positivity rate follows months of complaints and legal fights over what many see as a lack of transparency in the COVID-19 information provided by the administration of Florida Gov. Ron DeSantis.
In the early days of the pandemic, before most people had any idea that coronavirus was spreading in Florida, the state declined to disclose the presence of suspected cases, citing privacy concerns. The state then refused to make public the number of deaths at individual nursing homes, agreeing to do so only under legal pressure from news organizations. And after producing a nationally-praised website on COVID-19, the state Department of Health fired the site’s manager, who has since filed a whistleblower complaint saying she had been punished for refusing to falsify data.
“Each time journalists want more, it’s a struggle to get it,” said Pamela Marsh, president of the First Amendment Foundation, a Florida nonprofit group that advocates open government. “In the very early days, the state wouldn’t give the names of nursing homes. Then they gave the names, then the press asked for numbers within the nursing homes. More recently, it took two or three weeks for the state to provide numbers on hospitalizations.”
This information is vital, she said, as Floridians trying to make real-world choices on protecting themselves and their families at a time of unprecedented uncertainty.
“All these decisions that we have to make – sending our kids to school, whether we shop for one week or two weeks – all these decisions that can’t be made in a vacuum or based on neighborhood rumor,” she said. “We have to have good data. When you have family members in nursing homes and you’re trying to make decisions about their care, there’s so many decisions that require good data because if you make a mistake it’s life-altering.”
The 31.1% positivity rate for children was provided in the health department’s July 10 pediatric report, a weekly summary posted on the state health department’s COVID-19 website. The new report, dated July 17, showed the sudden decline in the rate. The new report also showed what appeared to be a massive increase in testing. The number of children tested rose from 54,022 in the earlier report to 173,520 in the later one.
The state blamed the erroneous children’s statistic on a failure to include thousands of negative test results, which artificially inflated the positivity rate.
“Initially, there was an error in the pediatric reports in which a certain number of negative test results were not included,” the department said in an email. “That error has since been corrected and the current pediatric report available on FloridaHealthCOVID19.gov reflects the most up-to-date data available regarding pediatric COVID-19 cases.”
“It was a computer programming error specifically linked to the production of the pediatric data report. As a result, a subset of negative pediatric test results were unintentionally excluded from the pediatric report.”
Even health officials seemed in the dark about the children’s positivity rate. Dr. Alina Alonso, director of the state health department’s Palm Beach County office, on July 14 told county commissioners that the county’s infection rate for children had risen to an alarming level.
“It has gone up to 33.6%,” she said. “That literally means that a third of the age under 18 that we test are positive. And while many of these, especially younger children, are asymptomatic, when you take x-rays of their lungs they are seeing that there is damage to the lungs in these asymptomatic children.”
But a few days later, a report issued by the department Alonso works for revoked that shocking figure. The new report showed the Palm Beach County rate had dropped to 14.1% – still high, but dramatically less than half the previous week’s rate. Accompanying the decrease was an apparent increase in Palm Beach County child test results of more than 200%, from 4,063 to 12,399, over a single week.
Experts say there’s a “black box” quality to many basic state statistics, which are presented without the underlying data that could allow experts and the public to verify and understand them.
Florida had been an early leader among states in presenting easy-to-read daily COVID-19 updates, but has fallen behind, said Olivier Lacan, a volunteer for the COVID Tracking Project, which tracks data across the country. He said the state fails to report vital statistics, such as detailed racial breakdowns of cases and the number of COVID-19 patients in intensive care units or on ventilators, and fails to make public the raw data that goes into producing the final numbers.
“Florida was surprisingly good at the outset,” he said. “I think they’re completely overrun. I think they’re underfunded, understaffed, inexperienced for this kind of stuff. This is the sense that I get from them. I don’t think DOH was ready for a pandemic. It seems very haphazard, and now they’re clammed up.”
The state positivity rate presented by the department, for example, is impossible to double check because the status of repeat testing of the same person is unclear. The positivity rate also mashes together the results of two types of tests, one of which produces a large number of false negatives, which would have the effect of skewing the positivity rate downward.
Salemi, the University of South Florida professor, said he found the state’s explanation of a programming error for the high child rate to be insufficient.
“What programming error? Why did it only happen for the pediatric report? Why not other age groups?” he asked. “I don’t want to speculate it’s anything more than an honest error, but I just wish they would provide full details to re-instill trust in us all. People are accepting of honest errors if explained and rectified. They are not when details about data issues lack transparency.”