Florida’s health department undercounted COVID-19 cases, deaths, due to technical issues: state audit

The variety of COVID-19 circumstances and deaths reported in Florida from March 1, 2020, to Oct. 9, 2020, by the Department of Health had been underreported due to knowledge assortment issues, in accordance to the state’s auditor general report revealed on June 1.  

The report comes after this previous March when a Florida Department of Health Office (FDOH) of Inspector General investigation discovered “insufficient evidence” or no proof to help self-proclaimed whistleblower Rebekah Jones’ claims that she was requested to falsify COVID-19 knowledge on the state’s dashboard, in accordance to Office of Inspector General Investigative Report. Her declare she was directed to limit entry to underlying knowledge was additionally discovered to be false, in accordance to that report.

People lined up to obtain a COVID-19 take a look at, Wednesday, Nov. 18, 2020, in Opa-Locka, Fla.
(AP Photo/Marta Lavandier)

“To evaluate the State’s readiness to provide essential information needed to respond to the global pandemic, this operational audit focused on COVID-19 data collection and reporting processes at the Agency for Health Care Administration (Agency), Department of Health (Department), and Division of Emergency Management (Division) during the period March 1, 2020, through October 9, 2020,” the state’s auditor basic report stated. 

“As subsequently described, the number of entities reporting data, apparent inaccurate or incomplete data reported to the State by those entities, and the lack of effective access controls in the systems used to gather data, impacted the State’s ability to accurately report COVID-19 data at the beginning of the pandemic.” 

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Florida’s Health of Department used a knowledge software program known as the Merlin system, nevertheless it “did not appear complete or contained anomalies” when put next to knowledge within the Bureau of Vital Statistics. 

“We compared Merlin death records to Bureau of Vital Statistics death records where COVID-19 was included as a cause or contributing factor of death and identified differences between the records,” the report stated. 

The health department data additionally didn’t all the time present proof that COVID-19 sufferers had been contacted in a well timed method, which was towards the state’s health department necessities for contact tracing.  

Signage stands on the prepared (foreground) in case COVID-19 testing at Barnett Park reaches capability, as vehicles wait in line in Orlando, Fla., Thursday, July 29, 2021.
(Joe Burbank/Orlando Sentinel by way of AP)

The audit famous “for 168,880 of the 729,552 cases, Merlin did not evidence that the COVID-19 positive individuals were either contacted or contact was attempted by the Department.” 

Using the person’s full identify and date of beginning, the auditor basic concluded that 2,495 loss of life data that had been reported within the Merlin software program system weren’t included within the Vital Statistics reviews, whereas 3,082 loss of life data reported in Vital Statistics knowledge weren’t included within the Merlin knowledge, per the audit. 

“Absent complete and accurate information related to the extent and severity of the COVID-19 pandemic, government officials and the general public may not have had all the information necessary to assess the efficacy of COVID-19 control measures and take appropriate actions,” the report stated. 

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The auditor basic stated if the health department’s administration didn’t obtain a constructive lab outcome or if the demographic information on the laboratory report differed from the loss of life certificates, it might haven’t been ready to definitively observe that the person who died was the identical particular person listed on the take a look at outcome. 

There was additionally “data quality issues” relating to knowledge for the variety of COVID-19 circumstances, impartial of the loss of life data, however FDOH administration stated “data quality issues were due to having to rely on data being sent from the laboratories, along with the large number of cases and limited resources to address data accuracy and completeness issues.” 

The auditor basic discovered that regardless that FHOH did strive to be sure some knowledge was correct and full, the audit additionally discovered “7,718 instances where the dates of follow-up contact attempts were missing from Merlin.”  

But FHOD advised the auditor basic that “inaccurate contact information and the refusal of some individuals to speak with the department hindered” their capacity to contact all COVID-19 people.  

A Florida resident will get vaccinated on the drive-thru web site on the Orange County Convention Center in Orlando, Monday, Feb. 22, 2021.
(Joe Burbank/Orlando Sentinel by way of AP)

State Surgeon General Dr. Joseph Ladapo agreed with the report’s findings with a plan of motion in progress to appropriate it, however added knowledge discrepancies are anticipated, in accordance to WFLA News Channel 8. 

“If COVID-19 testing was not performed, occurred more than 30 days before the death, was not reported to the Department, or could not be matched to a Vital Statistics record because of data quality deficiencies, the death would not be counted as a [COVID-19] associated surveillance death included in the Department’s COVID-19 surveillance reports,” Ladapo wrote. 

He famous “most data quality issues the Department experienced during the COVID-19 pandemic originated from laboratories that submitted inaccurate or incomplete data,” including FDOH now not recommends county health departments do contact tracing for each COVID-19 case. 

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The Agency for Health Care Administration and the Department of Emergency Management famous monitoring and reporting challenges in response to the report, however strengthening IT controls was talked about as a approach to enhance knowledge administration, per the news outlet.  

The report stated knowledge recorded after the audit interval is likely to be subjected to future audit.