Texas health officials are working through a massive backlog in coronavirus test results that has caused some counties to report higher-than-average new case daily numbers.
Tarrant County Public Health on Saturday reported five deaths and more than 1,400 cases — a sharp increase for a county that had been reporting a seven-day average of 434 new cases as of Friday.
The local health department said the increase was expected to continue for a few days while the county received old data from the Texas Department of State Health Services.
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"It does give me some concern. I will tell you, as I’ve said from the beginning, being able to know how many tests were actually conducted, how they’re coming in with positives, the fact that they report this to the state and then we have to wait for the state to give those numbers back to us... is very frustrating," Tarrant County Judge Glen Whitley said. "It causes jumps like this, you know. We thought were having a good week and things were down a little bit then all of a sudden we get 1,447, so that’s frustrating."
The five deaths include a Fort Worth man in his 80s, a Benbrook woman in her 70s, and three Arlington residents — a man in his 60s, a woman in her 60s and a woman in her 40s. The two Arlington women did not have any underlying health conditions.
The county has reported a total of 451 deaths. Of the new cases reported Saturday, data from the county health department indicates 1,436 are confirmed and seven are probable.
The county began to report both probable and confirmed cases last week at the request of the state health department. To date, the county has reported 35,310 confirmed cases of the coronavirus and 1,762 probable cases for a total of 37,072.
On its online coronavirus dashboard, the county health department said 1,151 of the new cases being reported Saturday were due to the electronic lab report backlog and were from specimens collected more than 30 days ago.
"The county labs, I mean, we know the ones we’re responsible for testing. We know what happens with regards to those," Whitley said. "It’s a lot of the private labs that are doing the testing. They eventually get reported to the state and the state accumulates and eventually reports back to us."
Lara Anton, press officer for the Texas Department of State Health Services, said the latest backlog was the result of a coding error from three labs.
Before the coronavirus upended daily life nationwide, the Texas health department was receiving around 1,200 positive test results a day on reportable conditions, such as the measles.
With COVID-19, the state is tracking every test, an amount of data that the system was never initially set up to handle, Anton said.
When the state got to the point of receiving more than 48,000 electronic reports a day, the system capacity couldn't handle the added workload, which resulted in a backlog of case results, she said.
On Aug. 1, the state's system got an upgrade so it could handle 100,000 results in a day. But the state was still sifting through close to 700,000 results that had to be pushed through the system, Anton said.
This past week, the state discovered three labs had errors in coding that were preventing lab results from being uploaded into the system, Anton said.
As the errors were fixed, about 350,000 test results flooded in from one lab on Sunday and Monday, along with another 95,000 on Tuesday from another lab and about 60,000 on Saturday from the third lab, she said.
One of the labs, Quest Diagnostics, said the issue was not a Quest reporting error. The lab said the state had not informed Quest that data would need to be sent to a new server. In turn, Quest had continued to feed data to the old location. The issue has since been resolved.
CHRISTUS Health, another of the three labs, said in an email that the issue was in "the rigidity of the state's data system, their changing requirements and their specific request for us to resubmit data we have already submitted previously."
Anton said the backlog hasn't affected patients finding out whether they are positive for the coronavirus.
She said the state's data team is working to determine how the backlog will impact its reporting but said it will have an impact on the positivity rate, an average of the previous seven days of positivity COVID-19 cases.
That rate is also being impacted by decreased demand for testing at free sites around Texas. As more testing is done across the state, raw numbers of positive tests will climb.
The state's coronavirus dashboard on Saturday showed a positivity rate of 14.62%. The rate has dipped sharply since Aug. 11 — when it was at an all-time high of 24.5% — because newly reported cases were out of sync with the number of tests, Anton said.
Gov. Greg Abbott has said that having a sustained positivity rate above 10% would be cause for alarm.
For some local health departments, such as Collin County, the backlog means sorting through case reports to align the data — a process that takes time.
Many local health entities also get their data from other sources, such as physicians and hospitals, Anton said, and for those departments that could mean cross-referencing the new cases the state is getting to ensure the results reflect the correct number of positive cases.
“Everybody’s working on how to make this process smoother and make sure that we’re capturing everything," Anton said. "Unprecedented seems like an overused word but this is exactly what this is.”
*Map locations are approximate, central locations for the city and are not meant to indicate where actual infected people live.
**County totals below include all 32 North Texas counties, not just Collin, Dallas, Denton and Tarrant.