Changing COVID-19 cases and deaths detection in Florida

Area of Science:

• Epidemiology
• Public Health
• Data Science

Background:

• Interpreting epidemic data is challenging due to inconsistent reporting, especially for COVID-19 with evolving testing protocols.
• An internal audit revealed numerous reporting irregularities in Florida's COVID-19 case and death data.
• Reliable epidemic indicators are crucial for informing policy and projections.

Purpose of the Study:

• To develop and present methods for identifying reporting changes in epidemic data.
• To analyze trends in COVID-19 transmission, case-fatality risk, and hospitalization ratios in Florida during the first year of the pandemic.
• To understand the impact of reporting changes on key epidemic indicators.

Main Methods:

• Utilized COVID-19 case, hospitalization, and death data from Florida over the first year.
• Established baseline detection probabilities from the initial wave to identify reporting shifts.
• Analyzed transmission trends, case-fatality risk (CFR), and hospitalization-to-case and death-to-hospitalization ratios across pandemic waves and age groups.

Main Results:

• COVID-19 transmission trends were similar across age groups, except in the second wave where younger individuals were infected approximately two weeks earlier than seniors.
• A significant decrease in case-fatality risk (CFR) was observed across all age groups over the three waves, most notably in those aged 0-39.
• Hospitalization-to-case ratios varied inversely with cases, while death-to-hospitalization ratios varied proportionally, with stable CFR across age groups during the third wave.

Conclusions:

• The presented approaches offer a generic framework for analyzing reporting changes in epidemic data.
• Understanding reporting trends is vital for accurate interpretation of COVID-19 data and informing public health policy.
• Case-fatality risk trends provide insights into infection detection beyond raw testing numbers.