Climbing Cases And Data Quandaries: COVID-19 Update For June 22-26

Jun 26, 2020

California was one of many states to set a record this week for the number of new cases reported in a single day. For a closer look at what’s been happening in our seven-county coverage area of the San Joaquin Valley, we bring you this update for the week of June 19-26, 2020. Meanwhile, you can always find up-to-date information for your county here.

The outlook

  • As of June 25: 292 deaths out of 15,371 cases.
  • As of June 18: 250 deaths among 12,489 cases.
  • In the last week, 42 people in our coverage area succumbed to the disease. In the week before, the total was 33.
  • New cases were reported this week in every county in the region, and all reported new fatalities except for Mariposa County. In many of these counties, new daily case reports are accelerating. Hospitalization totals are also climbing in Fresno, Kern, Kings and Tulare Counties.
  • Skilled nursing facilities in Fresno, Tulare and Kern Counties are among the state’s 15 deadliest COVID-19 outbreaks.
  • Avenal State Prison remains the 2nd-largest outbreak among state prisons.

Highlights from throughout the FM89 coverage area:

  • Fresno County: Health officials have been trying to contain an outbreak at the county’s North Annex Jail in downtown Fresno. After initially reporting 13 positive cases, the county sheriff’s office tested 1200 people incarcerated at that facility and found that over 100, or nearly 10% of them, had the disease. Dycora Transitional Health in downtown Fresno now has the dubious honor of being the deadliest nursing home in the state, with 33 COVID-19 related fatalities. County health officials also announced a third free testing center at the West Fresno Regional Center.
  • Kings/Tulare Counties: Still reporting the highest density of cases in the Valley, partly because of outbreaks in nursing homes and state prisons. The health departments in both counties have teamed up with hospitals and clinics to form a local COVID-19 coalition. Officials at Avenal State Prison reported the first two deaths this week out of nearly 1,000 cases among the incarcerated population. The case count at California State Prison - Corcoran is also creeping up.
  • Kern County: Valley Public Radio uncovered the first known COVID-19 case at the Mesa Verde immigration detention center in a member of the medical staff. Kingston Healthcare Center in Bakersfield has reported 21 deaths among its nursing home population, now the 13th highest death count of the state’s 1200 nursing homes.
  • Madera, Mariposa, Merced Counties: New cases continue to be reported.

So often in public health, the problem with understanding a disease is a lack of data. With COVID-19, one problem is too much data, from too many sources:

  • For instance, every county health department updates its case count and other data daily, as do the California Department of Public Health, the Centers for Disease Control and Prevention, and Johns Hopkins University.
  • And yet these data sets don’t all align, even for one of the most basic measures of the disease: The new daily case count. For instance, on July 25, the state reported that Tulare counted 85 new cases and Merced counted 40. But the counties themselves reported 99 and 30 new cases, respectively. When I asked Fresno County Health Officer Rais Vohra about this discrepancy, he said when in doubt, rely on county rather than state data.
  • Another data discrepancy: the “positivity rate,” which measures the percentage of all tests that come back positive. The state puts a lot of weight on this positivity rate, and yet during press conferences in the last week, health officials with both Fresno and Kern County said they’ve been unable to replicate the positivity rates that state health officials have calculated for each county.

And yet many data gaps exist too:

  • Although the state shares ethnic information about those who test positive for the disease, it’s up to county health departments whether they want to share that with the public. In our region, only Fresno and Kern Counties do. Most counties do provide some sort of age distribution of cases and some geographic information about where those who test positive live.
  • Fresno is also the only local county to share at least some information about comorbidities, the other conditions tending to afflict those who test positive for the disease.
  • The California Department of Corrections and Rehabilitation has a thorough dashboard online to track cases within state prisons, but there’s no equivalent for county jails.

Pointers for those who want to navigate the data themselves:

  • We’ve aggregated the links to all seven local county COVID-19 web pages here.
  • To evaluate an outbreak size, total case counts reveal all cases in a population, whereas counts of daily new cases will better show what’s changing day by day.
  • When comparing communities, it may be more useful to evaluate case incidence – that’s usually the number of cases for every 10,000 or 100,000 people – rather than raw case numbers. Bigger cities will almost invariably have larger case counts than smaller ones, but looking at case incidences will reveal where case density is highest, regardless of population.
  • Also: bigger outbreaks aren’t necessarily deadlier. For instance, those nursing homes with the largest outbreaks don’t all have the highest fatality rates.
  • Looking for data in nursing homes? The state public health department updates daily the case data from 1223 nursing homes around the state. Locally, only Kings and Tulare County health departments share their nursing home case counts.
  • Looking for case counts in state prisons? There’s a state website for that too. Kings County also shares these case counts.
  • Most health departments share the number of people hospitalized with COVID-19, but utility of those numbers is limited without knowing the total number of beds available.